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A Mixed Methods Approach of End-of-Life Care, Social Rites, and Bereavement Outcomes: A Transnational Perspective

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Abstract

The current article focused on examining the potential benefits of the End-of-Life (EoL) informal caregiving, communication, and ritualistic behaviors in adaptation to the conjugal bereavement across two different cultural-background contexts: France and Togo, West Africa. The investigation adopted a transnational approach including a total of 235 bereaved spouses. Despite the variation in the length of time since death, no significant difference was found between the Togolese and French bereaved with respect to the level of complicated grief symptoms. However, the Togolese bereaved perceived a significant postloss growth, fostered by EoL communication with the dying and the performance of ritualistic behaviors. In the French sample, bereaved individuals who had experienced more intimate communication with their dying spouse reported a high level of postloss growth. Moreover, findings showed that EoL caregiving without ritualistic support or communication is associated with poor postbereavement outcomes. These findings suggest a clinical need to promote informal caregiving to the dying, communication with the dying, and ritualistic support during the process of dying as entangled components of EoL care.

Résumé

Dans cet article, nous avons examiné le potentiel effet positif de l’assistance au conjoint en fin de vie, de la communication avec lui et des actes rituels sur le processus d’adaptation à la perte. Adoptant une approche transculturelle comparative, l’étude a été menée en France et au Togo (Afrique de l’ouest), deux contextes culturels differents dans leur approche du mourir, à la mort et au deuil. Les deux échantillons ont inclu au total 235 conjoints endeuillés. Bien que les deux échantillons ne soient pas homognènes pour la période du deuil, aucune différence significative n’a été constatée quant au niveau des symptômes du deuil compliqué. Cependant, les endeuillés Togolais ont plus rapporté une croissance postdeuil perçue surtout lorsque le défunt meurt âgé. Cette croissance postdeuil est également favorisée par la communication en fin de vie avec le mourant et l’accomplissement des actes rituels en soutien à la phase d’agonie. Dans l’échantillon français, la croissance postdeuil est plus vécue par les endeuillés qui avaient eu des communications plus intimes avec leur conjoint mourant. Nos résultats ont clairement montré que l’assistance au mourant sans un soutien rituel ou sans communication avec lui constituait un facteur de risque associé à un processus de deuil difficile. Ces résultats suggèrent, sur le plan clinique, de promouvoir la communication avec le mourant, les actes rituels symboliques dans l’accompagnement de la fin de vie et en particulier dans l’assistance des proches au mourant.

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Acknowledgements

The authors thank wholeheartedly all the participants of this study.

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The author(s) received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Department of Psychology, University of Picardy Jules Verne, Amiens, France

    Cyrille Kossigan Kokou-Kpolou & Charlemagne S. Moukouta

  2. Laboratoire Subjectivité, Lien Social et Modernité, University of Strasbourg, Strasbourg, France

    Cyrille Kossigan Kokou-Kpolou, Livia Sani & Marie-Frédérique Bacqué

  3. Vulnerability, Trauma, Resilience and Culture Research Laboratory, University of Ottawa, Ottawa, Canada

    Sara-Emilie McIntee & Jude Mary Cénat

  4. Department of Anthropology, University of Lomé, Lomé, Togo

    Atiyihwè Awesso

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  1. Cyrille Kossigan Kokou-Kpolou
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  4. Sara-Emilie McIntee
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Correspondence to Cyrille Kossigan Kokou-Kpolou.

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Cyrille Kossigan Kokou-Kpolou, Charlemagne S. Moukouta, Livia Sani, Sara-Emilie McIntee, Jude Mary Cénat, Atiyihwè Awesso, and Marie-Frédérique Bacqué declare that they have no conflict of interest.

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Kokou-Kpolou, C.K., Moukouta, C.S., Sani, L. et al. A Mixed Methods Approach of End-of-Life Care, Social Rites, and Bereavement Outcomes: A Transnational Perspective. Cult Med Psychiatry 44, 501–523 (2020). https://doi.org/10.1007/s11013-020-09669-3

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