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CME/CE

The Role of the Health Professional in Addressing Issues of Loss, Grief, and Bereavement Experienced by Cancer Patients and Their Families

  • Authors: Linda Emanuel, MD, PhD; Frank D. Ferris, MD; Charles F. von Gunten, MD, PhD; Jaime H. Von Roenn, MD
  • CME/CE Released: 5/4/2011
  • THIS ACTIVITY HAS EXPIRED
  • Valid for credit through: 5/4/2012
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Target Audience and Goal Statement

This activity is intended for health professionals caring for persons with cancer, including physicians, nurses, nurse practitioners, physician assistants, social workers, and therapists.

The goal of this activity is to describe the patient and family experience of loss, grief, and bereavement throughout the cancer trajectory and to explore effective clinical interventions to address issues related to grief and bereavement.

Upon completion of this activity, participants will be able to:

  1. Define loss, grief, mourning, and bereavement
  2. Screen for and assess uncomplicated and complicated grief
  3. Develop strategies to manage reactions to loss, including anxiety and depression
  4. Follow through with bereaved family members after a patient's death


Disclosures

As an organization accredited by the ACCME, Medscape, LLC, requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest.

Medscape, LLC, encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.


Authors

  • Linda Emanuel, MD, PhD

    Author, researcher, educator, previously practicing clinician; Principal, The EPEC Project; Director, Buehler Center on Aging, Heath and Society (where the EPEC Project and its derivatives are housed), Northwestern University Feinberg School of Medicine, Chicago, Illinois

    Disclosures

    Disclosure: Linda Emanuel, MD, PhD, has disclosed no relevant financial relationships.

    Dr. Emanuel does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the US Food and Drug Administration (FDA) for use in the United States.

    Dr. Emanuel does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

  • Frank D. Ferris, MD

    Director, International Programs, Institute for Palliative Medicine at San Diego Hospice, San Diego, California; Professor, Department of Family and Preventative Medicine, University of California School of Medicine, San Diego, California; Co-principal, The EPEC Project

    Disclosures

    Disclosure: Disclosure: Frank D. Ferris, MD, FAAPHM, has disclosed no relevant financial relationships.

    Dr. Ferris does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics not approved by the US Food and Drug Administration (FDA) for use in the United States.

    Dr. Ferris does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

  • Charles F. von Gunten, MD, PhD

    Medical Director, Center for Palliative Studies, San Diego Hospice & Palliative Care; Associate Clinical Professor, University of California, San Diego, School of Medicine; Co-principal, The EPEC Project; Past Chairman, The American Board of Hospice and Palliative Medicine

    Disclosures

    Disclosure: Charles F. von Gunten, MD, PhD, has disclosed no relevant financial relationships.

    Dr. von Gunten does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the US Food and Drug Administration (FDA) for use in the United States.

    Dr. von Gunten does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

  • Jaime H. Von Roenn, MD

    Medical Director, Palliative Care and Home Hospice Program, Northwestern Memorial Hospital, Chicago, Illinois; Professor of Medicine, Division of Hematology/Oncology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Co-Principal, The EPEC Project; Editor, EPEC-O Curriculum; Editor-in-Chief, The Journal of Supportive Oncology

    Disclosures

    Disclosure: Disclosure: Jamie H. Von Roenn, MD, has disclosed the following relevant financial relationships:
    Serves as a consultant for: GX International Inc.

    Dr. Von Roenn does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics not approved by the US Food and Drug Administration (FDA) for use in the United States.

    Dr. Von Roenn does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Editor

  • Cheryl Arenella, MD, MPH

    Cancer Education Program Specialist, Contractor, National Cancer Institute, Office of Education and Special Initiatives, Rockville, Maryland

    Disclosures

    Disclosure: Cheryl Arenella, MD, MPH, has disclosed no relevant financial relationships.

CME Reviewer(s)

  • Nafeez Zawahir, MD

    CME Clinical Director, Medscape, LLC

    Disclosures

    Disclosure: Nafeez Zawahir, MD, has disclosed no relevant financial relationships.

  • Laurie Scudder, DNP, NP

    CNE Accreditation Coordinator, Medscape, LLC

    Disclosures

    Disclosure: Laurie Scudder, DNP, NP, has disclosed no relevant financial relationships.

Nurse Planner

  • Susan Yox, RN, EdD

    Director, Editorial Content, Medscape from WebMD

    Disclosures

    Disclosure: Susan Yox, RN, EdD, has disclosed no relevant financial relationships.


Accreditation Statements

    For Physicians

  • Medscape, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

    Medscape, LLC designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Medscape, LLC staff have disclosed that they have no relevant financial relationships.

    Contact This Provider

    For Nurses

  • Medscape, LLC is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

    Awarded 1.25 contact hour(s) of continuing nursing education for RNs and APNs; none of these credits is in the area of pharmacology.

    Accreditation of this program does not imply endorsement by either Medscape, LLC or ANCC.

    Contact This Provider

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]


Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page.

Follow these steps to earn CME/CE credit*:

  1. Read the target audience, learning objectives, and author disclosures.
  2. Study the educational content online or printed out.
  3. Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. Medscape Education encourages you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates by accessing "Edit Your Profile" at the top of your Medscape homepage.

*The credit that you receive is based on your user profile.

CME/CE

The Role of the Health Professional in Addressing Issues of Loss, Grief, and Bereavement Experienced by Cancer Patients and Their Families

Authors: Linda Emanuel, MD, PhD; Frank D. Ferris, MD; Charles F. von Gunten, MD, PhD; Jaime H. Von Roenn, MDFaculty and Disclosures
THIS ACTIVITY HAS EXPIRED

CME/CE Released: 5/4/2011

Valid for credit through: 5/4/2012

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Editor's Note: This text has been excerpted and adapted from Emanuel LL, Ferris FD, von Gunten CF, Von Roenn J, editors. EPEC™-O: Education in Palliative and End-of-life Care for Oncology (Module 4, Loss, Grief, and Bereavement. Copyright The EPEC™ Project, Chicago, Ill, 2005). The EPEC™-O curriculum was produced by The EPEC™ Project, with major funding provided by the National Cancer Institute and with supplemental funding provided by the Lance Armstrong Foundation.

Loss and Cancer

All cancer patients and their families experience loss. Loss, grief, and bereavement are a significant part of the cancer experience. Competence in caring for these aspects of the cancer experience should be a high priority for the cancer care team.

Despite the fact that patients routinely face illness-related losses, and despite the frequency with which physicians and other health professionals encounter bereaved patients and families, medical education has historically provided minimal training in addressing issues of loss and grief with patients and families.

Cancer patients face losses from the onset of their illness, starting with the loss of their expectations for their future. Loss results in grief responses; mourning a loss and learning to live life without what is lost are part of creative adaptation. Patients can respond creatively to multiple major losses, but adverse responses to grief can occur. These include anxiety, depression, and associated pathological manifestations.

Family members, caregivers, and members of the cancer care team also experience and respond to losses. This article describes experiences of loss and grief. Methods for screening and assessment, as well as management of uncomplicated and complicated grief, are presented. Finally, approaches to follow-up with bereaved family members are offered.

Loss Terminology

Loss. Loss is the condition of being deprived of something or someone. Loss may be anticipated, real, or perceived; primary or secondary.

Grief. Grief is the experience of a loss. Grief is a personal and normal response to loss. It has emotional, intellectual, spiritual, physical, behavioral, and/or social components.

Mourning. Mourning is the act of grieving -- the outward expression of a loss. Mourning can involve private expressions of grief as well as socially or culturally defined customs such as rituals and traditions.

Bereavement. Bereavement is the state of living with a loss. Grief and bereavement are part of the process of adjusting to a loss.

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