Bereavement needs assessment in specialist palliative care: a review of the literature

Agnew, Audrey; Manktelow, Roger; Taylor, Brian J.; Jones, Louise

doi:10.1177/0269216309107013

Cited by 70 publications

(63 citation statements)

References 50 publications

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“…While Medicare Conditions of Participation require hospice programs to conduct an initial bereavement risk assessment shortly after patient admission, 10 the utility of these assessments has been criticized, as they are often based on clinical opinion, lack consistent completion, and have poor psychometric properties. 11 Research that identifies readily available, empirically based, pre-loss risk factors could aid in addressing these limitations.…”

Section: Introductionmentioning

confidence: 99%

Bereavement among Hospice Caregivers of Cancer Patients One Year following Loss: Predictors of Grief, Complicated Grief, and Symptoms of Depression

Allen

Haley

Small

et al. 2013

Journal of Palliative Medicine

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Background: Informal caregivers are an integral part of end-of-life care for hospice patients with cancer. Although adjustment following loss is highly individual, many caregivers have significant psychological distress after the death of a loved one. This study investigated risk factors that may predict psychological distress, which could aid hospice bereavement departments in targeting bereavement services. Method: Demographic characteristics, patient impairment, caregiver baseline symptoms of depression, and caregiver resources were assessed among 188 cancer patient-caregiver dyads. Regression analyses identified predictors of symptoms of depression, grief, and complicated grief one year following loss. Results: Over 50% of bereaved caregivers had clinically significant depressive symptoms one year after death of their relative. Caregivers with fewer years of education and more baseline symptoms of depression had significantly worse grief, complicated grief, and depression. Younger patient age was a significant predictor of poorer outcomes for grief and complicated grief; and less patient impairment was a significant predictor of more post-loss symptoms of depression. Lower social support satisfaction was correlated with worse grief and complicated grief but was not a significant multivariate predictor of poorer outcomes. Conclusion: Despite having access to hospice bereavement services, many former caregivers had high psychological distress one year following loss. Bereavement departments could consider utilizing readily available risk factors to target services to former caregivers who may benefit from bereavement services. Bereavement departments might also consider including brief, standardized screenings of caregiver depression in initial risk assessments. Future studies should investigate evidence-based approaches for assessment and interventions among highly distressed former hospice caregivers.

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Section: Introductionmentioning

confidence: 99%

Bereavement among Hospice Caregivers of Cancer Patients One Year following Loss: Predictors of Grief, Complicated Grief, and Symptoms of Depression

Allen

Haley

Small

et al. 2013

Journal of Palliative Medicine

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“…Where specialist rather than generalist palliative care is available, carers may receive more direct support. Many community and hospice based specialist palliative care teams conduct bereavement risk assessments in relatives and friends of the dying [25,26]. Prebereavement formal and informal counselling may be available for families, and many palliative care services get back in touch with families in the first few weeks of bereavement to offer further support.…”

Section: Discussionmentioning

confidence: 99%

Mortality and medical care after bereavement: a general practice cohort study

King¹,

Varagunam²,

Petersen³

et al. 2012

BMJ Support Palliat Care

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Bereaved spouses or partners are thought to be at increased risk of morbidity and mortality. However, there are few large prospective studies and results are inconsistent. We estimated the relative mortality, prescription of psychotropic medication and use of primary medical care services in adults whose cohabitee died of cancer. To do this, we undertook a cohort study using The Health Improvement Network (THIN) UK primary care database. Participants were 1) people aged over 40, who were registered with general practices and had been exposed to the death of a cohabitee from cancer; and 2) a comparison cohort frequency matched on five year age bands and sex who were cohabiting with a living partner. The baseline was chosen as six months before the date of the cancer death for the exposed group and a random date for the unexposed group. Incidence rate ratios (IRR) with 95% confidence intervals (CI) were estimated using random effects Poisson regression to account for clustering within general practices and adjusting for other key variables. 92,129 patients were studied for a median follow up of 4 years. Cohabitees of patients who died of cancer were less likely to die of any cause (IRR 0.71, CI 0.68-0.74) after adjustment for age, gender, number of non-psychotropic prescriptions 6 months before the cancer death/index date, use of psychotropic medication 6 months before the cancer death/index date, smoking, alcohol and area deprivation score. Exposed patients were more likely to receive a prescription for antidepressant or hypnotic medication and to attend their GP both before and after the death of the cohabitee. In conclusion, we did not confirm increased mortality in cohabitees of people dying from cancer.

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“…Major domains of interest include functional status, pain, spirituality, mood and anxiety symptoms, nonpain physical symptoms, social support, and grief (Agnew, Manktelow, Taylor, & Jones, 2010;National Consensus Project for Quality Palliative Care, 2009).…”

Section: Assessment Of Common Physical and Mental Health Conditionsmentioning

confidence: 99%

Opportunities for psychologists in palliative care: Working with patients and families across the disease continuum.

Kasl‐Godley¹,

King²,

Quill³

2014

American Psychologist

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Interdisciplinary palliative care services have been rapidly expanding in health care settings over the past 10 years, particularly through the establishment of interdisciplinary palliative care teams. Relatively few of these teams formally include psychologists, although their skills of enhancing patients' and families' well-being and lessening suffering make an enormous contribution to the care provided. In this article, we define palliative care in broad terms, distinguishing it from hospice and end-of-life care. Using a case-based approach, we then explore the contribution of psychologists to the patient- and family-centered approach espoused by palliative care, including the knowledge, skills, and self-awareness needed to work effectively with these very ill patients and their families. We close with a call to action to better train and integrate psychologists into the rapidly growing field of palliative care.

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Bereavement needs assessment in specialist palliative care: a review of the literature

Cited by 70 publications

References 50 publications

Bereavement among Hospice Caregivers of Cancer Patients One Year following Loss: Predictors of Grief, Complicated Grief, and Symptoms of Depression

Bereavement among Hospice Caregivers of Cancer Patients One Year following Loss: Predictors of Grief, Complicated Grief, and Symptoms of Depression

Mortality and medical care after bereavement: a general practice cohort study

Opportunities for psychologists in palliative care: Working with patients and families across the disease continuum.

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