Drug Death Related Bereavement and Recovery (The END project)

Project owner

Western Norway University of Applied Sciences

Project period

January 2017 - September 2023

Project summary

The END-project main aim is to focus and improve the life situation for drug death bereaved (DDB). The societal impact of the project is related to UNs sustainable developmental goal for health and well-being. The output will contribute to promote good psychosocial health and functioning among a group of potentially vulnerable and marginalized people. Very little research has examined DDB`s psycho-social function and what kind of help and support they receive, related to their needs (Titlestad et al., 2019). By documenting the DDB`s situations before and after death, how health and welfare services can be optimized, generating knowledge about preventive and health-promoting factors and suggesting tailored interventions, the main aim of the ENDproject is to develop effective services to increase recovery for the DDB.

The secondary project objectives are to:
1) Fill in the knowledge gap on bereaved after drug-related deaths by documenting their psycho-social health, functioning, health-promoting factors, and needs for help.
2) Document how the health and welfare services help and relate to the bereaved.
3) Contribute to research-based municipality service innovation and to develop educational programs to meet professional practitioners’ training and competence needs.
4) Develop innovative ways of cross-sector collaboration (users, practitioners, NGO’s, educators, researchers).
5) Produce knowledge applicable to various stigmatized losses; focusing on multidimensional and inter-sectional dimensions of bereavement to create coherent public services and integrated patient pathways for bereaved with complex needs.
6) Develop a leading research community on stigmatized grief at Department of Welfare and Participation (IVD) at HVL and facilitate employees in their "academic boost".

The user perspective represented by four bereaved is very central throughout the entire project working closely with the researchers and in all phases of the research project. The END-project will use Research Circles (RC) as a model for structuring the cooperative innovative process improving welfare services for the bereaved. The RC-group will consist of persons from: Church Aid and Fransiskushjelpen (2), the municipalities with most drug-related deaths (2)(Oslo and Bergen), educators and PhD students from different professional educational programs at HVL (2), and researchers from the Project Group (2). Based on the results from the research, The RC-group will develop and implement innovative models of welfare services, especially adapted to the needs of DBB`s in order to increase the quality of various welfare services. Thus, the END-project will contribute to research-based municipality service innovation. Research-based teaching will be feasible through the project- and RC-groups´ work on developing educational programs and an e-learning program relating to loss, stigma and bereavement. These programs will be relevant for Ba-programs in social work, nursing, social educators, etc., Ma-programs in Mental Health and Substance Abuse Care and in Community work, and for the PhD program in Health, Participation and Functioning. Results from the END-project will benefit society in helping to improve the quality of public health, enhance quality of life and network support for the bereaved, and thereby reduce social inequalities in health. The research results will help motivate and direct politicians, policy makers and public authorities to improve competence and efficiency in the services. END has 5 PhD students working on different topics in the four studies.

The project is funded by Research Council Norway, Western Norway University, Directorate of Health Norway, Dam, and Bergen Municipality.

Research period: 2017-2023.

Method

The project will be initiated gradually for four sub-studies, which together provide a comprehensive picture of an understudied area. The project has an exploratory, inductive and theoretical design, with the goal of developing measures for coping and recovery. The theory development will be seen in the context of research on other vulnerable populations of bereaved; ex. bereaved by suicide, murder, accident and terror (e.g. see K. Dyregrov's research).


The project applies Mixed Methods; i.e. questionnaire, document analysis, focus group interviews and in-depth individual interviews. All sub-studies are based on cross-sectional studies.


The user perspective is central to the entire project, as the informants are represented by bereaved in all the four sub-studies (bereaved and helpers), and four bereaved participate as co-researchers throughout the entire project period. Methodology-, researcher- and perspective- triangulation will secure that the research problems are studied widely, generalizable as well as gaining depth, and processual understanding.

 

Sample selection, measurement methods and methods of analysis for sub studies 1 and 2:
 

- 200-300 bereaved family members and close friends over 18 years are recruited for a survey. Statistical and descriptive analyzes.
- 14 bereaved parents, 12 siblings and 10 close friends are selected from the questionnaire sample (theoretical width committee) for in-depth interviews. Interpretative phenomenological analysis (IPA) and thematic analysis.

 

Sample selection, measurement methods and methods of analysis for part-study 3:
- 12-15 bereaved for single in-depth interviews. Interpretative phenomenological analysis (IPA) and thematic analysis.


Sample selection, measurement methods and methods of analysis for part-study 4:
- 120 representatives from different helper groups of professionals will participate in multiple focus group interviews. These will be recruited from six case municipalities a 20 people (i.e. 4 focus groups each consisting of 5 persons). Narrative / Thematic analysis.
- A questionnaire with background variables, scope of relief measures, and attitude questions (stigma) will be filled out by the helpers (n = 120) before participation in the focus group interviews. Quantitative descriptive analysis.
- Central steering documents relevant to psychosocial follow-up after drug deaths will be analyzed by thematic content analysis.
SurveyMonkey, SPSS, NVivo will be used for data collection and analysis tools.

The ethical approach of the project will be based on project manager and Professor Kari Dyregrov's long experience of researching vulnerable populations and bereaved after unnatural death. All research and dissemination will follow the Helsinki Declaration and be organized so that no informants suffer. Part 1 and 2 are approved by REK, case no. 2017/2486 / REK West. Approval from REK and NSD to substudies 3 and 4 will be obtained before startup.

Dissemination

At least 15 scientific articles will be published. In addition to scientific publications from PhD, Post Doc and the project group, bachelor and master students at HVL will be able to write assignments on anonymous material. These will be supervised by members of the project team.