• Emilie Stendahl Ramstad, Laura Sabroe Thegen, Mai-Britt Guldin, Mette Asbjoern Neergaard, and Mette Kjaergaard Nielsen.
• Research Unit for General Practice (E.S.R, L.S.T, M.G, M.K.N), Aarhus, Denmark; Aarhus University (E.S.R, L.S.T). Electronic address: emstendahl@gmail.com.
• J Pain Symptom Manage. 2023 Jan 1; 65 (1): 384638-46.

ContextThe Danish health care system provides palliative care for terminally ill patients and their family caregivers. However, initiatives to support family caregivers are not systematically organized.ObjectivesWe aimed to examine the association between self-reported experience of missing contact to health care professionals involved in palliative care, and symptoms of grief and depression three years post-loss.MethodsWe conducted a prospective population-based survey of 3635 family caregivers to terminally ill patients. At six months follow-up, the caregivers reported whether they missed contact to the general practitioner, home care nurse, hospital staff, and/or palliative care team. Associations between missing contact and symptoms of prolonged grief (Prolonged-Grief-13) and depression (Beck Depression Inventory-II) three years after bereavement were analyzed with multivariable logistic regression analysis.ResultsWe found that an experience of missing contact with health care professionals six months after bereavement was significantly associated with symptoms indicative of prolonged grief disorder and depression after three years. The strongest association was found for missing contact with the general practitioner with an adjusted OR = 4.0 (95%CI: 1.9;8.3) for prolonged grief and an adjusted OR = 5.2 (95% CI: 3.4;7.9) for depression.ConclusionExperiencing missing contact with health care professionals shortly after bereavement was associated with adverse psychological reactions. Family caregivers may benefit from bereavement support to prevent further complications. A proactive approach with assessment of support needs and risk of complications early during the patient's illness trajectory may target support at those who needs it.Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

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