Bereavement care in primary care: a systematic literature review and narrative synthesis

Abstract

BackgroundOver half a million people die in Britain each year and, on average, a GP will have 20 patients die annually. Bereavement is associated with significant morbidity and mortality, but the research evidence on which GPs and district nurses can base their practice is limited. AimTo review the existing literature concerning how GPs and district nurses think they should care for patients who are bereaved and how they do care for them. DesignSystematic literature review. MethodSearches of AMED, BNI, CINAHL, EMBASE, Medline and PsychInfo databases were undertaken, with citation searches of key papers and hand searches of two journals. Inclusion criteria were studies containing empirical data relating to adult bereavement care provided by GPs and district nurses. Information from data extraction forms were analysed using NVivo software, with a narrative synthesis of emergent themes. ResultsEleven papers relating to GPs and two relating to district nurses were included. Both groups viewed bereavement care as an important and satisfying part of their work, for which they had received little training. They were anxious not to 'medicalise' normal grief. Home visits, telephone consultations, and condolence letters were all used in their support of bereaved people. ConclusionA small number of studies were identified, most of which were >10 years old, from single GP practices, or small in size and of limited quality. Although GPs and district nurses stated a preference to care for those who were bereaved in a proactive fashion, little is known of the extent to which this takes place in current practice, or the content of such care.

The Economic Cost of Bereavement in Scotland

“…GPs and community nurses view bereavement care as an important and satisfying aspect of their job. However, they feel underprepared and practice varies markedly across services (Nagraj & Barclay, 2011). Accordingly, the true cost of bereavement in terms of consultations at Scottish GP practices may be more substantial.…”

Grief and loss in older people residing in nursing homes: (un)detected by nurses and care‐assistants?

“…Current understandings on grief care derive mostly from primary care (Birtwistle et al . , Nagraj & Barclay ), hospital care (Warren ) or hospices (Foliart et al . , Field et al .…”

Hospice Services for Complicated Grief and Depression: Results from a National Survey

“…Consistent with theories that participation of and interactions among providers of a variety of backgrounds can enhance care, [31][32][33] research has demonstrated that social worker and volunteer involvement, and interdisciplinary collaboration more broadly, are associated with better quality of care for people in hospice. 22,34,35 Training requirements have also been associated with quality of bereavement care provision specifically, 36 but these associations have not been adequately studied for hospice bereavement care. As previous findings and existing theory predicted, it was hypothesized that lengthier training requirements, interdisciplinary team attendance from a large range of providers, and a lower ratio of volunteer hours to number of individuals in hospice would be associated with higher likelihood of conducting CG and depression screening and referral.…”