Hospital-based bereavement care provision: A cross-sectional survey with health professionals

Abstract

Background: An in-hospital death is a profound experience for those left behind and has been associated with family members’ psychological morbidity. Supporting bereaved family members is an essential part of end-of-life care and includes attentive presence, information-giving, and emotional and practical support. The actual adoption of hospital-based bereavement care, however, remains little understood. Aim: To investigate hospital-based bereavement care provision and associated barriers. Design: Cross-sectional survey using an online questionnaire. Setting/participants: Health professionals ( n = 196) from two University-affiliated acute and psychiatric hospitals in Switzerland. Results: The most frequent bereavement services (⩾40%) were viewing the deceased, giving information on available support, and making referrals; the most often named barriers were lack of time and organizational support. Acute care health professionals faced statistically significant more structural barriers (55.1% vs 21.4% lack of time, 47.8% vs 25.9% lack of organizational support) and felt insufficiently trained (38.4% vs 20.7%) compared to mental health professionals ( p ⩽ 0.05). Nurses provided more immediate services compared to physicians, such as viewing the deceased (71.3% vs 49.0%) and sending sympathy cards (37.4% vs 16.3%) ( p ⩽ 0.01). In contrast, physicians screened more often for complex bereavement disorders (10.2% vs 2.6%) and appraised bereavement care as beyond their role (26.5% vs 7.8%) ( p ⩽ 0.05). Conclusion: The study indicates that many barriers to bereavement care exist in hospitals. More research is required to better understand enabling and limiting factors to bereavement care provision. A guideline-driven approach to hospital-based bereavement care that defines best practice and required organizational support seems necessary to ensure needs-based bereavement care.

Perceptions, attitudes, and behaviors of bereavement care in emergency department staff: a descriptive qualitative study

“…Several qualitative studies have explored the experiences of healthcare nurses providing bereavement care to family members focusing on healthcare nurses' experiences of providing bereavement care to deceased patients and family members [13,14], their psychological perceptions of the death event [15], elements of good bereavement care [16], and factors in uencing healthcare nurses' perceived bereavement care [13]. Although a lack of knowledge and skills has been identi ed as one of the main challenges in delivering bereavement care [12,17], few studies have dug deeper into the perceptions and attitudes of bereavement support in ED staff. Therefore, this study uses a descriptive qualitative research method to gain an in-depth understanding of ED staff's cognition and attitude towards bereavement care, as well as the behavior of providing bereavement care for patients with unexpected death and their family members, so as to provide a basis for effectively promoting bereavement care behaviors of ED staff.…”

Practice of Supporting Family Caregivers of Patients with Life-Threatening Diseases: A Two-phase Study Among Healthcare Professionals

“…These results correspond with previous literature in more specific target populations. 11,13,14 Interventions aiming to improve family caregivers' outcomes have proven effective. [5][6][7]19,20 However, the barriers experienced by healthcare professionals may have to be overcome first, or parallel to implementing such an intervention, which requires a certain extent of organizational change.…”

“…Facilitators and barriers have been identified in cancer settings, 13 end-of-life home care, 11 and hospital-based bereavement care. 14 An overarching mapping of facilitators and barriers across settings and illness trajectories is needed to improve support for family caregivers across a wider range of circumstances.…”

Facilitating family needs and support at the end of life in hospital: A descriptive study

“…Social workers are integral to supporting optimal family-centred care 18 and addressing emotional, social and existential concerns at the end of life. 19 Given these factors can act as barriers to timely support for families in hospital, 20 time spent assessing and supporting family needs, including spiritual and cultural needs is a priority area. 21 These suggest a missed opportunity to use anticipation of death as a trigger to prioritise family needs beyond formal family meetings.…”