Rahel Naef1, Simon Peng-Keller2, Horst Rettke1, Michael Rufer3, Heidi Petry1. 1. Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland. 2. Faculty of Theology, University of Zurich, Zurich, Switzerland. 3. Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland.
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.
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.
Entities:
Keywords:
Bereavement care; delivery of health care; hospitals; professional–family relations; surveys and questionnaires
Authors: Caroline Pearce; Jonathan R Honey; Roberta Lovick; Nicola Zapiain Creamer; Claire Henry; Andy Langford; Mark Stobert; Stephen Barclay Journal: BMJ Open Date: 2021-03-03 Impact factor: 2.692