Bereavement and grief in old age – Acceptability of a web-based self-management intervention from the perspective of persons affected and health care experts
Problem
The death of a close person is a highly stressful, yet common life event in later life. Objective of the present study was to assess the acceptability, possible access ways and barriers for implementation of a web-based self-management intervention for older adults with prolonged grief symptoms from the perspectives of older persons affected and health care professionals.
Approach
The qualitative study comprised the implementation of two focus groups: focus group A consisted of older adults (60+years) with previous loss experience (N=12), and focus group B comprised experts of the medical care system (N=8). Both focus groups have been carried out with the help of a focus group guide by qualified moderators. Qualitative content analyses were performed based on Mayering (2015) using MAXQDA.
Findings
Participants of focus group A were on average 64.5 years old and balanced with respect to the distribution of gender (50% female). Health care professionals of focus group B were on average 41.1 years old and predominantly female (87.5% female). Participants of both focus groups supported the idea of a web-based self-management intervention focusing on prolonged grief symptoms in old age. According to older individuals with previous loss experience a web-based intervention should include ideas for improving self-respect and activities in everyday life as well as information for relatives, information on beliefs and spirituality and coping strategies for negative emotions. Participants further preferred a flexible use of the intervention modules rather than a fixed sequence. The majority of older individuals affirmed the usability of the web-based intervention. Possible access ways were seen through general practitioners, medical specialists, bereavement groups, local media and undertakers. Personal preferences were perceived as potential barriers (e.g. preferences for personal contact) by persons affected, while the lack of guidance was perceived as a potential barrier by health care experts.
Consequences
Usability and user acceptance are important aspects and necessary preconditions for the successful implementation and the effectiveness of an e-health intervention targeting individuals with prolonged grief symptoms in old age. The judgements of health care professionals and older persons affected showed a high user acceptance. Pathways for the implementation of such e-health interventions should consider the mentioned access ways and barriers.