Thirty-one family physicians, from 19 primary care teams in Biscay (Spain), were randomly assigned to intervention or control group. The 75 intervention family physicians, after training in primary bereavement care, saw 43 widows for 7 sessions, from the 4th to 13th month after their loss. The 16 control family physicians, without primary bereavement care training, saw 44 widows for 7 ordinary appointments, with the same schedule. Outcome measures were collected at 4, 10, 16, and 24 months after the loss. A linear mixed model was used. No significant differences were found in favor of the intervention group on grief and indeed control group widows experienced more improvement in somatisation, general health, and general emotional outcomes.

Basing ourselves on the assumption that healthy deaths are associated with healthy grieving processes, we proposed using Advance Directives (ADs) as a tool to promote health in death and grief. The sample from the general population for the study was recruited through four community associations, from which we convened people who wished to make an AD. The sample from health professionals was collected through two palliative care teams and five health centres, with the stated objective of informing them about ADs and to ‘learn by doing’. These samples were put into groups and two sessions were held with each group: one session was to present ADs and the other was to formalize them. In one year, 111 people from 10 groups from the general population participated, and 102 (92%) of those formalized an AD. In six months, 140 professionals from seven groups from the health system collaborated. We conclude that disseminating ADs in a general population is possible through community associations and that the role played by the health system is yet to be clarified.

empoderar a la comunidad en voluntades anticipadas. Lecciones aprendidas: El centro de salud en coordinación con el ayuntamiento pueden ser agentes facilitadores en la elaboración del DVA