Life after death: A comparison of coping and symptoms of complicated grief in survivors of homicide and suicide decedents

This study explored the coping strategies and the development of symptoms of complicated grief in survivors of homicide decedents and suicide decedents. The study identified the coping strategies used by these populations at the time of initial discovery or notification of the death of a loved one by homicide or suicide. Associations between survivorship and survivors' development of symptoms of complicated grief were tested. The Theory of Coping by Lazarus and Folkman (1984) and The Theory of Attachment by Bowlby (1980) were the conceptual frameworks used in the study. Forty-two survivors of homicide or suicide decedents (21 participants in each survivor group) participated in the study. Two-sided chi square or Fisher's exact tests were used to check for significant differences between proportions of demographic categories by decedent manner of death (homicide or suicide) and by event (32 pre-Katrina participants, 10 post-Katrina participants), revealing significant differences in age, occupation, religious affiliations, and relationships to the decedents. Hypothesis 1 stated there is a difference in coping strategies between the two survivor groups (homicide and suicide) and was tested using Mann-Whitney U and descriptive crosstabs. Hypothesis 2 stated that symptoms of complicated grief were more prevalent in survivors of suicide decedents more than in survivors of homicide decedents and tested using Fisher's exact tests to compare frequencies between survivor groups (38 participants not assessed with symptoms of complicated grief, 4 participants assessed with symptoms of complicated grief), and pre- and post-Katrina event groups.;Recommendations were made based on the findings of this study. Nursing education should incorporate coping and attachment concepts and theories as they relate to survivors of trauma throughout generic nursing programs to better prepare nurses to care for these vulnerable individuals and families. Designated portions of didactic and clinical experiences using these concepts and theories should be utilized to promote application of the concepts and interactions with these vulnerable populations.;Recommendations for nursing research include replication of this study on a much larger geographic scale and exploration of initial coping strategies used by survivors of homicide and suicide decedents using qualitative methods. Further, the development and testing of interventions designed to limit or prevent further trauma to the survivors during investigation of the death, and initiation of longitudinal research studies that isolate and identify time frames for the onset of symptoms of complicated grief should be conducted.;Nursing practice should include the exploration of collaborative development of standards of clinical nursing experiences that will support and provide care for survivors of homicide and suicide decedents. The development of clinical affiliations that integrate clinical knowledge with field observations and practice will support the promotion of positive interactions between nurses and survivors of trauma.