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McGill K, Bhullar N, Pearce T, Batterham PJ, Wayland S, Maple M. Effectiveness of Brief Contact Interventions for Bereavement: A Systematic Review. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221108289. [PMID: 35758167 DOI: 10.1177/00302228221108289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Brief contact interventions are an efficient and cost-effective way of providing support to individuals. Whether they are an effective bereavement intervention is not clear. This systematic review included articles from 2014 to 2021.711 studies were identified, with 15 meeting inclusion criteria. The brief contact interventions included informational and emotional supports. Narrative synthesis identified that participants valued brief contact interventions, however some did not find them helpful. Exposure to a brief contact intervention was typically associated with improvements in wellbeing. Studies with comparison groups typically found significant but modest improvements in grief, depression symptoms and wellbeing associated with the intervention. However, one intervention was associated with significant deterioration of depression symptoms. Existing brief contact interventions for bereavement appear feasible, generally acceptable to the target population and are associated with improvements in wellbeing. Further development and evaluation to account for why improvements occur, and to identify any unintended impacts, is required.
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Affiliation(s)
- Katie McGill
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Navjot Bhullar
- School of Psychology, University of New England, Armidale, NSW, Australia
| | - Tania Pearce
- School of Health, University of New England, Armidale, NSW, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Sarah Wayland
- School of Health, University of New England, Armidale, NSW, Australia
| | - Myfanwy Maple
- School of Health, University of New England, Armidale, NSW, Australia
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Porter AS, Weaver MS, Snaman JM, Li C, Lu Z, Baker JN, Kaye EC. "Still Caring for the Family": Condolence Expression Training for Pediatric Residents. J Pain Symptom Manage 2021; 62:1188-1197. [PMID: 34062219 DOI: 10.1016/j.jpainsymman.2021.05.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 05/24/2021] [Indexed: 11/25/2022]
Abstract
CONTEXT Insufficient communication from the medical team following a child's death may compound parental grief. Pediatric residents care for children who die, yet the landscape of condolence expression education within residency programs has not been studied. OBJECTIVES The objective of this study was to evaluate pediatric residents' levels of experience and comfort with condolence expression and to assess their needs and desires for training in condolence expression. METHODS A cross-sectional, mixed-methods survey was developed by palliative care clinicians in collaboration with bereaved parents. In 2020, following pilot testing, an electronic survey measuring resident experience with, comfort with, and training on condolence expression was distributed to 202 third-year pediatric residents across 17 Accreditation Council for Graduate Medical Education-accredited programs representing varying sizes and geographic regions. RESULTS Ten percent of pediatric residents surveyed reported having training on condolence expression. Almost all residents considered condolence expression to be beneficial for bereaved families and most for clinicians, too, yet very very few had formally expressed condolences in their roles as physicians: 83.1% had never written a condolence letter; 85% had never made a condolence phone call; and 90.5% had never attended a memorial event. Commonly reported barriers to condolence expression included lack of experience and training, as well as concern about upsetting families. CONCLUSIONS Pediatric residents lack comfort with and training in condolence expression and desire education to address these gaps. These findings should inform development and investigation of educational resources and training opportunities for residents to learn and practice compassionate provision of condolences to grieving families.
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Affiliation(s)
- Amy S Porter
- St. Jude Children's Research Hospital (A.S.P., C.L., Z.L., J.N.B., E.C.K.), Memphis, Tennessee, USA.
| | - Meaghann S Weaver
- Department of Pediatrics, Children's Hospital and Medical Center (M.S.W.), Omaha, Nebraska, USA; National Center for Ethics in Healthcare (M.S.W.), Washington, District of Columbia, USA
| | - Jennifer M Snaman
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute (J.M.S.), Boston, Massachusetts, USA; Department of Pediatrics, Boston Children's Hospital (J.M.S.), Boston, Massachusetts, USA
| | - Chen Li
- St. Jude Children's Research Hospital (A.S.P., C.L., Z.L., J.N.B., E.C.K.), Memphis, Tennessee, USA
| | - Zhaohua Lu
- St. Jude Children's Research Hospital (A.S.P., C.L., Z.L., J.N.B., E.C.K.), Memphis, Tennessee, USA
| | - Justin N Baker
- St. Jude Children's Research Hospital (A.S.P., C.L., Z.L., J.N.B., E.C.K.), Memphis, Tennessee, USA
| | - Erica C Kaye
- St. Jude Children's Research Hospital (A.S.P., C.L., Z.L., J.N.B., E.C.K.), Memphis, Tennessee, USA
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Ó Coimín D, Prizeman G, Korn B, Donnelly S, Hynes G. Dying in acute hospitals: voices of bereaved relatives. BMC Palliat Care 2019; 18:91. [PMID: 31672137 PMCID: PMC6824032 DOI: 10.1186/s12904-019-0464-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 09/12/2019] [Indexed: 11/24/2022] Open
Abstract
Background Internationally there is an increasing concern about the quality of end-of-life care (EoLC) provided in acute hospitals. More people are cared for at end of life and die in acute hospitals than in any other healthcare setting. This paper reports the views of bereaved relatives on the experience of care they and the person that died received during their last admission in two university adult acute tertiary hospitals. Methods Relatives of patients who died were invited to participate in a post-bereavement postal survey. An adapted version of VOICES (Views of Informal Carers - Evaluation of Services) questionnaire was used. VOICES MaJam has 36 closed questions and four open-ended questions. Data were gathered in three waves and analysed using SPSS and NVivo. 356 respondents completed the survey (46% response rate). Results The majority of respondents (87%: n = 303) rated the quality of care as outstanding, excellent or good during the last admission to hospital. The quality of care by nurses, doctors and other staff was highly rated. Overall, care needs were well met; however, findings identified areas of care which could be improved, including communication and the provision of emotional and spiritual support. In addition, relatives strongly endorsed the provision of EoLC in single occupancy rooms, the availability of family rooms on acute hospital wards and the provision of bereavement support. Conclusions This research provides a powerful snapshot in time into what works well and what could be improved in EoLC in acute hospitals. Findings are reported under several themes, including the overall quality of care, meeting care needs, communication, the hospital environment and support for relatives. Results indicate that improvements can be made that build on existing good practice that will enhance the experience of care for dying persons and their relatives. The study adds insights in relation to relative’s priorities for EoLC in acute hospitals and can advance care providers’, policy makers’ and educationalists’ priorities for service improvement.
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Affiliation(s)
- Diarmuid Ó Coimín
- End-of-Life Care, Mater Misericordiae University Hospital, Quality and Patient Safety Directorate, Eccles Street, Dublin 7, Ireland.
| | - Geraldine Prizeman
- Trinity Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Bettina Korn
- End-of-Life Care, Hospice Friendly Hospital Programme, 1st Floor CEO Building, St. James's Hospital, James Street, Dublin 8, Ireland
| | - Sarah Donnelly
- Social Work, School of Social Policy, Social Work and Social Justice, University College, Dublin, Ireland
| | - Geralyn Hynes
- Palliative Care, School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland
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Azoulay E, Forel JM, Vinatier I, Truillet R, Renault A, Valade S, Jaber S, Durand-Gasselin J, Schwebel C, Georges H, Merceron S, Cariou A, Moussa M, Hraiech S, Argaud L, Leone M, Curtis JR, Kentish-Barnes N, Jouve E, Papazian L. Questions to improve family-staff communication in the ICU: a randomized controlled trial. Intensive Care Med 2018; 44:1879-1887. [PMID: 30374690 DOI: 10.1007/s00134-018-5423-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 10/17/2018] [Indexed: 01/15/2023]
Abstract
PURPOSE Relatives of intensive care unit (ICU) patients suffer emotional distress that impairs their ability to acquire the information they need from the staff. We sought to evaluate whether providing relatives with a list of important questions was associated with better comprehension on day 5. METHODS Randomized, parallel-group trial. Relatives of mechanically ventilated patients were included from 14 hospitals belonging to the FAMIREA study group in France. A validated list of 21 questions was handed to the relatives immediately after randomization. The primary endpoint was comprehension on day 5. Secondary endpoints were satisfaction (Critical Care Family Needs Inventory, CCFNI) and symptoms of anxiety and depression (Hospital Anxiety and Depression Scale, HADS). RESULTS Of 394 randomized relatives, 302 underwent the day-5 assessment of all outcomes. Day-5 family comprehension was adequate in 68 (44.2%) and 75 (50.7%) intervention and control group relatives (P = 0.30), respectively. Over the first five ICU days, median number of family-staff meetings/patient was 6 [3-9], median total meeting time was 72.5 [35-110] min, and relatives asked a median of 20 [8-33] questions including 11 [6-13] from the list, with no between-group difference. Satisfaction and anxiety/depression symptoms were not significantly different between groups. The only variable significantly associated with better day-5 comprehension by multivariable analysis was a higher total number of questions asked before day 5. CONCLUSIONS Providing relatives with a list of questions did not improve day-5 comprehension, secondary endpoints, or information time. Further research is needed to help families obtain the information they need. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02410538.
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Affiliation(s)
- Elie Azoulay
- Medical Intensive Care Unit, APHP, Hôpital Saint-Louis, ECSTRA Team, and Clinical Epidemiology, UMR 1153 (Center of Epidemiology and Biostatistics Sorbonne Paris Cité, CRESS), INSERM, Paris Diderot Sorbonne University, Paris, France.
| | | | - Isabelle Vinatier
- Surgical ICUs From Montpellier or Marseille Hospitals, Medical-Surgical ICUs From La Roche sur Yon, La Roche sur Yon, France
| | - Romain Truillet
- Statistical Department of Marseille, AP-HM, Marseille, France
| | | | - Sandrine Valade
- Medical Intensive Care Unit, APHP, Hôpital Saint-Louis, ECSTRA Team, and Clinical Epidemiology, UMR 1153 (Center of Epidemiology and Biostatistics Sorbonne Paris Cité, CRESS), INSERM, Paris Diderot Sorbonne University, Paris, France
| | - Samir Jaber
- Medical Intensive Care Unit, APHP, Hôpital Saint-Louis, ECSTRA Team, and Clinical Epidemiology, UMR 1153 (Center of Epidemiology and Biostatistics Sorbonne Paris Cité, CRESS), INSERM, Paris Diderot Sorbonne University, Paris, France
| | | | | | | | | | - Alain Cariou
- Medical Intensive Care Unit, AP-HP, Cochin Hospital, Paris, France
| | | | | | | | - Marc Leone
- Medical Intensive Care Unit, APHP, Hôpital Saint-Louis, ECSTRA Team, and Clinical Epidemiology, UMR 1153 (Center of Epidemiology and Biostatistics Sorbonne Paris Cité, CRESS), INSERM, Paris Diderot Sorbonne University, Paris, France
| | - J Randall Curtis
- Cambia Palliative Care Center of Excellence, University of Washington, Seattle, USA
| | - Nancy Kentish-Barnes
- Medical Intensive Care Unit, APHP, Hôpital Saint-Louis, ECSTRA Team, and Clinical Epidemiology, UMR 1153 (Center of Epidemiology and Biostatistics Sorbonne Paris Cité, CRESS), INSERM, Paris Diderot Sorbonne University, Paris, France
| | - Elisabeth Jouve
- Statistical Department of Marseille, AP-HM, Marseille, France
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Burmen B, Mogunde JO, Kwaro DP. Ethically providing Routine HIV testing services to bereaved populations. Nurs Ethics 2017; 26:195-200. [PMID: 29281932 DOI: 10.1177/0969733017693442] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND: The delivery of public health policies may be in conflict with individualism. OBJECTIVES: To propose measures to ethically provide routine HIV testing services to persons visiting a funeral home. RESEARCH DESIGN: A document analysis of study documents and presentations made to an institutional review board. PARTICIPANTS AND RESEARCH CONTEXT: Institutional review board members (both lay and professionals) and Study investigators attending an `open session' where study investigators were invited to elaborate on some study procedures. ETHICAL CONSIDERATIONS: Identities of all parties were anonymized. FINDINGS: Opt-out approaches to HIV testing, grief counseling, relational ethics, and a modular consenting process were proposed to safeguard clients' autonomy. The golden-rule approach and protective empowering were suggested to protect clientele beneficence. DISCUSSION AND CONCLUSION: It is possible to ethically provide universal HIV testing and counseling services among grieving populations in this setting; elsewhere, this should be contextualized.
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Coombs M, Mitchell M, James S, Wetzig K. Intensive care bereavement practices across New Zealand and Australian intensive care units: a qualitative content analysis. J Clin Nurs 2017; 26:2944-2952. [DOI: 10.1111/jocn.13624] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Maureen Coombs
- Graduate School of Nursing, Midwifery and Health; Victoria University Wellington; Wellington New Zealand
- Capital and Coast District Health Board; Wellington New Zealand
| | - Marion Mitchell
- NHMRC Centre of Research Excellence in Nursing; Menzies Health Institute Queensland; Southport Qld Australia
- Princess Alexandra Hospital; Woolloongabba Qld Australia
| | - Stephen James
- Capital and Coast District Health Board; Wellington New Zealand
- Wellington Intensive Care Unit; Capital and Coast District Health Board; Wellington New Zealand
| | - Krista Wetzig
- Princess Alexandra Hospital; Woolloongabba Qld Australia
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Kentish-Barnes N, Chevret S, Champigneulle B, Thirion M, Souppart V, Gilbert M, Lesieur O, Renault A, Garrouste-Orgeas M, Argaud L, Venot M, Demoule A, Guisset O, Vinatier I, Troché G, Massot J, Jaber S, Bornstain C, Gaday V, Robert R, Rigaud JP, Cinotti R, Adda M, Thomas F, Calvet L, Galon M, Cohen-Solal Z, Cariou A, Azoulay E. Effect of a condolence letter on grief symptoms among relatives of patients who died in the ICU: a randomized clinical trial. Intensive Care Med 2017; 43:473-484. [DOI: 10.1007/s00134-016-4669-9] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 12/27/2016] [Indexed: 10/20/2022]
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Family Members’ and Intensive Care Unit Nurses’ Response to the ECG Memento© During the Bereavement Period. Dimens Crit Care Nurs 2017; 36:317-326. [DOI: 10.1097/dcc.0000000000000269] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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