• Rahel Naef, Simon Peng-Keller, Horst Rettke, Michael Rufer, and Heidi Petry.
• Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland.
• Palliat Med. 2020 Apr 1; 34 (4): 547-552.

BackgroundAn 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.AimTo investigate hospital-based bereavement care provision and associated barriers.DesignCross-sectional survey using an online questionnaire.Setting/ParticipantsHealth professionals (n = 196) from two University-affiliated acute and psychiatric hospitals in Switzerland.ResultsThe 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).ConclusionThe 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.

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