• Journal of critical care · Apr 2019

    Review

    The state of bereavement support in adult intensive care: A systematic review and narrative synthesis.

    • Nikolaos Efstathiou, Wendy Walker, Alison Metcalfe, and Brandi Vanderspank-Wright.
    • University of Birmingham, College of Medical and Dental Sciences, Institute of Clinical Sciences, School of Nursing, Medical School, Vincent Drive, Edgbaston, Birmingham B15 2TT, United Kingdom. Electronic address: n.efstathiou@bham.ac.uk.
    • J Crit Care. 2019 Apr 1; 50: 177-187.

    PurposeDespite advances in medical science, patient death and family bereavement are commonly encountered in adult intensive care units (ICUs). This is the first review to investigate the state of ICU bereavement support globally, and the availability and effectiveness of bereavement support interventions.MethodsA systematic review and narrative synthesis. Medline, CINAHL Plus, PsycINFO, Web of Science, EMBASE were searched and inclusion/exclusion criteria were applied. Included studies were appraised using relevant appraisal tools.ResultsFourteen papers formed the review; five of which were international surveys reporting variable bereavement practices and levels of support. A lack of training and resources were identified barriers. Nine papers reported the effectiveness of primarily discrete bereavement support interventions including: a personal memento, a handwritten condolence letter, a post-death meeting; storytelling, research participation, use of an ICU diary. One study evaluated a bereavement follow-up program. Generally, all identified interventions were well accepted by bereaved families.ConclusionsThe reviewed evidence was weak, and findings were contextually bound. As such, it is difficult to make recommendations for the most acceptable and effective bereavement support intervention(s). Bereavement support in ICU needs further exploration and clinicians must be adequately trained and supported for the delivery of evidence-informed, culturally competent care.Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

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