Paradigm Shift From Severance of Bonds to the Deceased to Continuing Bonds with the Deceased

Friday, 17 July 2009: 8:30 AM

Nancy S. Hogan, PhD, RN, FAAN
School of Nursing, Loyola University Chicago, Maywood, IL

Learning Objective 1: describe the rationally-based Separation of Bonds Grief Theory and implications for research and practice.

Learning Objective 2: describe the evidence-based Continuing Bonds to the Deceased Grief Theory and implications for research and practice.

Purpose: To develop a valid and reliable instrument to measure continuing bonds. This instrument challenges the psychoanalytic theory of emancipation of bonds to the deceased.

Methods: Qualitative research was used to generate empirically derived items, psychometric research was used to assess reliability and validity of the instrument 

Results: The CBI is a self-report questionnaire developed with data from written responses from bereaved adolescents siblings (n=187) and bereaved parent data (n=207) to the question, “If you could tell your dead sibling something what would it be?”  Data were analyzed using constant comparison of responses and items were generated. Cronbach’s Alpha was computed, the 16 items were found to represent two factors with 64.16% of the variance explained by these 2 factors. The first factor labeled Continuing Presence is an 11 item factor that represents the participant’s assertion that their loved one is a continuing presence in their life, that memories of the deceased and feeling the loved one’s presence and feeling close to them is comforting and that the loved one will always be with them. The Cronbach’s alpha for this scale was .92. The second factor, Miss and Love contains 5 items representing participant perception that they continue to love and miss the deceased, that they anticipated always missing and loving them and that their love was as strong as it had been before the death occurred. The Cronbach’s alpha for this scale was .91. 
Conclusion: The items on the Continuing Bonds Inventory inform clinicians and researchers of the ways in which bereaved adults maintain continuing bonds to the deceased. The findings challenge the traditional grief theory that mandates that separation of bonds to the deceased is necessary for healthy bereavement recovery.