Eating approach of bereaved individuals: A protocol proposal

CAMPOS, Maria Teresa Fialho de Sousa; PELUZIO, Maria do Carmo Gouveia; ARAÚJO, Raquel Maria Amaral

doi:10.1590/1678-98652018000300006

Maria Teresa Fialho de Sousa CAMPOS Correspondência para/Correspondence to: MTFS CAMPOS. E-mail: <mtcampos@ufv.br>.

Universidade Federal de Viçosa, Departamento de Nutrição e Saúde, Programa de Pós-Graduação em Ciência da Nutrição.Campus Viçosa, Av. P.H. Rolfs, s/n., 36570-000, Viçosa, MG, Brasil.

http://orcid.org/0000-0002-5429-1312

Maria do Carmo Gouveia PELUZIO

Universidade Federal de Viçosa, Departamento de Nutrição e Saúde, Programa de Pós-Graduação em Ciência da Nutrição.Campus Viçosa, Av. P.H. Rolfs, s/n., 36570-000, Viçosa, MG, Brasil.

http://orcid.org/0000-0003-4665-7043

Raquel Maria Amaral ARAÚJO

Universidade Federal de Viçosa, Departamento de Nutrição e Saúde, Programa de Pós-Graduação em Ciência da Nutrição.Campus Viçosa, Av. P.H. Rolfs, s/n., 36570-000, Viçosa, MG, Brasil.

http://orcid.org/0000-0003-1323-8707

Correspondência para/Correspondence to: MTFS CAMPOS. E-mail: <mtcampos@ufv.br>.

Figures (3)
Tables (1)

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Figure 1
Methodological procedures to guide the investigative approach regarding the eating habits of bereaved individuals*.Note: * shows a diagrammatic indication using arrows for the application of the forms that compose and and other methods (R24h, QFA, Hedonic Sensitivity Scales, Dietary records). The dotted arrows signify a preferred sequence to approach the information and the continuous arrows highlight the focus of the approach. The whole proposal is based on previous care with the emotional preservation of the bereaved. Inferences to the words death and bereavement already trigger affective-emotional reactions in the bereaved person, thus, the principle of logic contributes, above all, to the care instituted to the approach of bereavement, while respecting the boundaries that may be established by the bereaved individuals themselves; **Scales for measuring the dimension of pain. For bereavement, the combination of two scales is indicated - the Visual Numerical Scale (VNS) and Behavioral Scale (BS) are suggested. The VNS consists in quantifying the pain intensity through a numerical classification ranging from zero (no pain) to ten points (maximum pain, of unbearable intensity). The BS has a differential because it is based on the evaluation of occupational activities and care due to the reminder of pain. The VNS quantifies the intensity of pain and the BS shows whether pain compromises the individual’s occupations and eating, hygiene and health habits. The result of the pain intensity associated to the BS provides to collaborate data to the analysis of the influence of pain regarding the loss of a beloved one in food ingestion and eating practices; ***Optional, depending on the willingness of the individual and the stage of bereavement to perform the dietary records.

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Figure 2
Registration form of the hedonic sensations of hunger, appetite, satiation and satiety.Note: *1=extremely; 2=moderately; 3=slightly; 4=feeling of indifference; 5=slightly; 6=moderately; 7=extremely.

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Figure 3
Indication of dietary habits record with bereaved individuals.Note: *The categories in the first column of Figure 3 are represented by four variables to be observed, and for each of these variables, the possibilities of success in applying the dietary habits record are described horizontally as indicated by the arrow. The conditions signaled in lighter gray, and closer to the arrowhead, are more favorable circumstances for the instrumentation of the bereaved individual with their dietary habits record; **The intensity of color, as represented the arrow and the columns, indicates differences in the chances of obtaining the dietary habits record. The further away from the black color, the greater the chances of success with the activity of recording dietary habits; ***Stages of bereavement as proposed by psychiatrist and thanatologist Kübler-Ross [37] – it should be noted that the temporariness of each stage varies from individual to individual, due to personal singularities and the context of loss, which reinforces the need for diagnostic dexterity; ****The individual’s personality interferes in the profile of emotional regulation [22] – in the presence of personalities (proactive and passive) that favor the bereaved to resignify the pain caused by the loss of the beloved one and the meaning of life, the use of the dietary habits record can be applied, depending on the instrumentalization of method and the sensitization of these to this activity.

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Figure 3
Indication of dietary habits record with bereaved individuals.Note: *The categories in the first column of Figure 3 are represented by four variables to be observed, and for each of these variables, the possibilities of success in applying the dietary habits record are described horizontally as indicated by the arrow. The conditions signaled in lighter gray, and closer to the arrowhead, are more favorable circumstances for the instrumentation of the bereaved individual with their dietary habits record; **The intensity of color, as represented the arrow and the columns, indicates differences in the chances of obtaining the dietary habits record. The further away from the black color, the greater the chances of success with the activity of recording dietary habits; ***Stages of bereavement as proposed by psychiatrist and thanatologist Kübler-Ross [37] – it should be noted that the temporariness of each stage varies from individual to individual, due to personal singularities and the context of loss, which reinforces the need for diagnostic dexterity; ****The individual’s personality interferes in the profile of emotional regulation [22] – in the presence of personalities (proactive and passive) that favor the bereaved to resignify the pain caused by the loss of the beloved one and the meaning of life, the use of the dietary habits record can be applied, depending on the instrumentalization of method and the sensitization of these to this activity.

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Chart 1
Approach of eating attitudes in bereavement from the perspective of the non-directive eating habits interview.

Guiding questions for approaching eating attitudes in bereavement

PART I – Knowing the bereaved individual’s attitude towards food before the death of the beloved one Tell me about your eating habits, before bereavement (if not stated during the spontaneous report, ask): Tell me about the sensations, feelings and emotions linked to the act of eating. (thirst, hunger, appetite, satiation and satiety, feelings and emotions that one can feel when eating).Tell me about the sensations, feelings and emotions experienced in a meal environment. Tell me what, in your perception, would be important for me to know.

PART II – Knowledge of the bereaved individual’s attitude towards food after the death of the beloved one Tell me about your relation with food, after the death of your beloved one. Tell me about your attitude toward food after the death of your beloved one. (explain the meaning of “attitude”).

Directives: changes in diet; changes in attitudes linked to the act of eating; description of the sensations, feelings and emotions experienced in a meal environment; absence of the beloved one at mealtime imposing any kind of difficulties; identification of food or cuisine that symbolize the memory of the deceased; identification of changes from the beginning of bereavement until the present moment.

Tell me, today, of your attitudes toward food. What observations could you describe to me? What is your opinion about eating in bereavement?

[1] Correspondência para/Correspondence to: MTFS CAMPOS. E-mail: <mtcampos@ufv.br>.

Brasil

Brasil

Eating approach of bereaved individuals: A protocol proposal

Abordagem alimentar de enlutados: uma proposta de protocolo

ABSTRACT

Objective

Methods

Results

Conclusion