1. Definition of topic
“Most bereavement services are based on the assumption that loss through death challenges coping abilities and that supportive interventions may facilitate post-death adaptation, reduce complicated grief reactions and promote wellbeing” (Field et al. 2004).
2. Guidance/Evidence available
Guidance
Improving supportive and palliative care for adults with cancer - the manual
Chapter 12 covers guidance on services for families and services and carers, including bereavement services. However, it refers to the type of support needed for bereaved people but does not consider the shape of the service.
When a patient dies: advice on developing bereavement services in the NHS
This outlines services that should be implemented in the immediate aftermath of a death but does not delineate a service which provides a bereavement service providing ongoing support over a number of months or years.
Evidence
A synthesis of psychological interventions for the bereaved
This study, retrieved from the DARE database, comments on a literature review which looks at bereavement interventions. Authors concluded that, overall the interventions were largely methodologically flawed, rarely specified what theory of bereavement they were testing, and showed surprisingly weak effect sizes.
Bereavement care interventions: a systematic review
This literature review published by Biomed Central, comes to a similar conclusion to that above. Due to a paucity of reports on controlled clinical trails, no rigorous evidence-based recommendation regarding the treatment of bereaved persons is currently possible except for the pharmacologic treatment of depression. The authors postulated the following five factors as impeding scientific progress regarding bereavement care interventions: 1) excessive theoretical heterogeneity, 2) stultifying between-study variation, 3) inadequate reporting of intervention procedures, 4) few published replication studies, and 5) methodological flaws of study design.
Support for women/families after perinatal death
This Cochrane review also concludes that no information is available from randomised trials to indicate whether there is or is not a benefit from providing specific psychological support or counselling after perinatal death.
Discussion
It is perhaps not surprising that evidence for a benefit from bereavement services is difficult to assess since: (a) the population is very diverse. Bereaved inviduals range from young children to the elderly; (b) bereaved inviduals have a myriad of relationships with the person who has died and with those with whom they grieve; (c) the length of time since bereavement varies considerably, should someone be referred to a service; (d) bereaved people come from every possible cultural, ethnic and religious group. Studies on both child and adult bereavement services in the UK indicate that the type of service provision varies considerably. Evaluation of services is especially problematic as the extent of bereavement support can be provided/integrated into standard care. For example, in the case of perinatal death, hospital ward staff often offer support which is specific to bereavement, but is not regarded per se as a bereavement service. However, surveys of services provide evidence of what is happening in various areas in the UK - examples include the following references.
References
- Rolls L, Payne S. 2003, Childhood bereavement services: a survey of UK provision, Palliative Medicine 17(5):423-432. (Available via NHS Core Content with an Athens password).
- Rolls L, Payne S. 2004, Childhood bereavement services: issues in UK service provision Mortality 9(4):300-328.
- Field D, Reid D, Payne S, Relf, M. 2004, Survey of UK hospice and specialist palliative care adult bereavement services. International Journal of Palliative Nursing 10(12):569-576.
- Reid D, Field D, Payne S, Relf M. 2006, Adult bereavement in five English hospices: types of support. International Journal of Palliative Nursing 12(9):430-437.
Standards
There have been other attempts to develop standards for the provision of bereavement services. However, at this stage for the NHS in England users are referred to the Guidance section above. The resources below should be read as an introduction to the subject.
(The library at St Christopher’s Hospice has some standards that were created a few years ago. They have not been updated but may be useful as a guide to examining relevant issues in the creation of new ones. Email: d.brady@stchristophers.org.uk )
Conferences
Abstracts can be downloaded from these recent conferences:
7th International conference on grief and bereavement in contemporary society 12-15 July 2005, Kings College, London
[
To see abstracts arranged by author, see this web page]
Abstracts from the 9th EAPC conference in Aachen, Germany 2005, 3rd EAPC Research Forum in Stresa, Italy 2004, 8th EAPC conference in The Hague, Netherlands, 2003 and 4th EAPC Research Forum in Venice, Italy, 2006.
[Select the category 'grief, bereavement & support' on this page to see all results for this topic from all these conferences]
Literature search
A search was also conducted on the databases provided by the NLH to its users. It should be noted that here the quality of the research has not yet been critically appraised in detail. However, the results presented provide helpful background to those researching the provision of bereavement services.
The search was conducted using the terms bereavement and service evaluation, using all the databases available on NHS core content. The term bereavement was searched as a subject heading (in PsycInfo the subject heading used was grief). In cases where the term service evaluation was unavailable as a thesaurus term, an appropriate alternative term was used. However, if there did not appear to be any appropriate other term, the term bereavement service$ was used.
Excluding services for children and adolescents, 86 items were identified as being of potential use to anyone seeking material on this subject. Most items are post 1996, though a search on one database yielded earlier items. Some of the items below are available in full text to NHS users.
The titles are listed first:
1. When a patient dies; advice on developing bereavement services in the NHS. Department of Health, (London), 2005, iii,42p.
2. Spotlight on bereavement services and support. Foss T. British Journal of Nursing 2005 14(20):1053.
3. Patients who die in hospital. Series: HSG, (97)43, Department of Health, London, 1997, 2p.
4. Between the idea and the reality: a study of the counselling experiences of bereaved people who sense the presence of the deceased. Taylor S. Counselling and Psychotherapy Research 2005 5(1):53-61.
5. Bereavement services report. Department of Health, (London) 2001, 5p., URL: <http://www.dh.gov.uk/assetRoot/04/06/93/90/04069390.pdf>.
6. Establishing a bereavement service. Duke S. Nursing Standard 1990 5(10):34-37.
7. Traumatic bereavement and the Asian tsunami perspectives from Tamil Nadu, India. Tharyan P. Bereavement Care 2005 24(2):23-6.
8. Crisis intervention, grief therapy, and the loss of life. McBride J, Johnson ED. Editor(s): Roberts AR. Crisis intervention handbook: Assessment, treatment, and research, 3rd ed, 2005, p. 279-290, pp. xxvi + 845, ISBN: 0-19-517991-9 (hardcover). Publisher: Oxford University Press, New York, NY, US.
9. Tasks perceived as necessary for hospice and palliative care unit bereavement services in Japan. Saraguchi Y, Tsuneto S, Takayama K. Journal of Palliative Care 2004 20(4):320-323.
10. The Ohio hospice bereavement study: meeting NHPCO standards. Rathbun A, Denham SA, McCarthy CC. American Journal of Hospice and Palliative Care 2003 20(6):448-458.
11. Setting up and running a bereavement service. Earnshaw-Smith E. p53-64.
12. Survey of bereavement care and other support services. Department of Health, (London), 2005, 5p., URL: <http://www.dh.gov.uk/assetRoot/04/06/93/90/04069390.pdf>.
13. Developing a multi-agency bereavement service. (For children and their families in York). Wright B, Elvans H, King P. European Journal of Palliative Care 2002 9(4):160-163.
14. Use of a bereavement service among suddenly bereaved families in Hong Kong. (Research in Brief series. Research with people present in A&E when their relative died). Ping S, Chan W, Lee T. Journal of Clinical Nursing 2002 11(2):289-90.
15. The midwife's role in perinatal bereavement. Plagnard N. INFO Kara: Revue Internationale Francophone de Soins Palliatifs 2004 19(3):105-110. [IN FRENCH]
16. A bereavement service in a critical care unit. Wilkins K, Dalby L. Nursing Times 2000 96(45):38-39.
17. A bereavement care service to address multicultural user needs. Chaplin D. Nursing Times 2003 99(39):26-29.
18. A Group approach to overcome loss. A model for a bereavement service in general practice. Fenner P, Manchershaw A. Professional Nurse 1993 8(10):680,682-684.
19. Description and evaluation of a bereavement group for people with learning disabilities. Mappin R, Hanlon D. British Journal of Learning Disabilities 2005 33(3):106-12.
20. Mediating and moderating effects of parental distress on family bereavement program effectiveness. Twohey-Jacobs JL. Dissertation Abstracts International: Section B: The Sciences and Engineering, 2004, vol. 64, no. 10-B, p. 5239, ISSN: 0419-4217. Publisher: Univ Microfilms International, US, http://www.il.proquest.com/umi/.
21. Art therapy with incarcerated women who have experienced the death of a loved one. Ferszt GG, Hayes PM, DeFedele S, Horn L. Art Therapy 2004 21(4):191-199.
22. Psychological intervention in Madrid March 11 after terrorist attacks. De La Cruz AL, Muñoz PFA, Torres EP, Torres AP, Martín MR, Dávila MP, Val-Espinosa MSD, Olivares AG. Cliníca y Salud, 2004 15, no. Monograph, p. 7-88, ISSN: 1130-5274. Publisher: Colegio Oficial de Psicólogos de Madrid, Spain, http://www.cop.es. [IN SPANISH]
23. Effects of an educational bereavement program on health care professionals' perceptions of perinatal loss. Di Marco M, Renker P, Medas J, Bertosa H, Goranitis JL. Journal of Continuing Education Nursing 2002 33(4):180-6.
24. Bereavement care interventions : a systematic review. Forte AL, et-al. BMC Palliative Care 2004 3(3) URL: <http://www.biomedcentral.com/content/pdf/1472-684X-3-3.pdf>.
25. An active postvention program. Campbell FR, Cataldie L, McIntosh J, Millet K. Crisis: The Journal of Crisis Intervention and Suicide Prevention 2004 25(1):30-32.
26. Insights on death & dying. Memorial service: forget me not. Ufema J. Nursing 2005 35(7):26.
27. The Family Bereavement Program: Efficacy evaluation of a theory-based prevention program for parentally bereaved children and adolescents. Sandler IN, Ayers TS, Wolchik SA, Tein JY, Kwok Oi M, Haine RA, Twohey-Jacobs J, Suter J, Lin K, Padgett-Jones S, Weyer JL, Cole E, Kriege G, Griffin WA. Journal of Consulting and Clinical Psychology Jun 2003 71(3):587-600.
28. What works for therapists conducting family meetings: treatment integrity in family-focused grief therapy during palliative care and bereavement. Chan EKH, O'Neill I, McKenzie M, Love A, Kissane DW. Journal of Pain and Symptom Management 2004 27(6):502-512.
29. Survey of UK hospice and specialist palliative care adult bereavement. Field D, Reid D, Payne S, Relf M. International Journal of Palliative Nursing 2004 10(12):569-576.
30. The use of research findings in bereavement programs: a case study. Murphy SA. Death Studies 2000 24(7):585-602.
31. Exploring bereavement care in inpatient settings. Street AF, Love AW, Blackford J. Contemporary Nurse: A Journal for the Australian Nursing Profession 2004 17(3):240-250.
32. Outcome evaluation of bereavement groups for adults with intellectual disabilities. Stoddart KP, Burke L, Temple V. Journal of Applied Research in Intellectual Disabilities 2002 15(1):28-35.
33. Acute bereavement care in the emergency department: does the professional-supported volunteers model work? Ting SM, Li P, Lau FL, Chan YC, Chan YK, Lai PW, Choi K, Au A, Cheung B, Tse CY. European Journal of Emergency Medicine 1999 6(3):237-43.
34. An evaluation of a hospice memorial service. Duncan F, Findlayson R, Wilson P. Bereavement Care 2004 23(1):8-10.
35. A bereavement after-care service for intensive care relatives and staff: the story so far. Williams R, Harris S, Randall L, Nichols R, Brown S. Nursing in Critical Care 2003 8(3):109-15.
36. Support groups helping women through pregnancies after loss. Côté AD, Freije MM. Western Journal of Nursing Research 2004 26(6):650-70.
37. A year in the life of a bereavement counselling and support service for people with learning disabilities. Read S. Journal of Learning Disabilities 2001 5(1):19-33.
38. The ABCs of bereavement volunteers: Acquire, build, cherish. Osborne C. American Journal of Hospice and Palliative Care 1999 16(1):380-5.
39. Establishing a bereavement program: caring for bereaved families and staff in the emergency department. LeBrocq P, Charles A, Chan T, Buchanan M. Accident and Emergency Nursing 2003 11(2):85-90.
40. Evaluating a support group for perinatal loss. DiMarco MA, Menke EM, NcNamara T. MCN: The American Journal of Maternal/Child Nursing 2001, 26(3):135-140.
41. Bereavement support for couples following death of a baby: program development and 14-year exit analysis... reprinted from Death Studies 26:21-37. Reilly-Smorawski B, Armstrong AV, Catlin EA. Neonatal Intensive Care 2002 15(7):40-47.
42. Does grief counseling work? Jordan JR, Neimeyer RA. Death Studies 2003 27(9):765-786.
43. Broad-spectrum group treatment for parents bereaved by the violent deaths of their 12-28 yr old children: a randomized controlled trial. Murphy SA, Johnson C, Cain KC, Gupta AD, Dimond M, Lohan J, Baugher R. Death Studies 1998 22(3):209-35.
44. Developing a multi-agency bereavement service. Wright B, Elvans H, King P, Schneider J, Thompson R, Gillance H. European Journal of Palliative Care 2002 9(4):160-163.
45. Collaboration between hospital social work and pastoral care to help families cope with serious illness and grief. Hart CW, Matorin S. Psychiatric Services 1997 48(12):1549-1552.
46. Palliative care nursing: part 2. Addressing bereavement issues through education. Douglas M, Pemberton S, Hewitt B. Nursing Times 2002 98(42):36-37.
47. Death-related crisis intervention, grief counseling, grief consultation, and death education: A national survey of the role of school psychologists. Seadler KM. Dissertation Abstracts International Section A: Humanities and Social Sciences, Mar 2000, vol. 60, no. 8-A, p. 2816, ISSN: 0419-4209. Publisher: Univ Microfilms International, US, http://www.il.proquest.com/umi/.
48. Should paediatric units have bereavement support posts? Jennings P. Archives of Disease in Childhood 2002 87(1):40-42.
49. Development of a bereavement program in a tertiary medical center. Snyder D, Ellison NM, Neidig N. Journal of Palliative Medicine 2002 5(6):877-882.
50. Facilitating older spouses' adjustment to widowhood: A preventive intervention program. Raveis VH. Social Work in Health Care 2000 29(4):13-32.
51. Professional issues. A bereavement counselling service for parents: part 2. Herkes B. British Journal of Midwifery 2002 10(3):135-139.
52. Development of a grief workshop at a community college. Trammell M. TCA Journal 1999 27(2):87-9.
53. Beneficial effects of a hospital bereavement intervention program after traumatic childhood death... including commentary by Jurkovich GJ, Cooper A, Mullins RJ, Rivera FA and Hammond JS with author response. Oliver RC, Sturtevant JP, Scheetz JP, Fallat ME. Journal of Trauma 2001 50(3):440-448.
54. Teaching grief and bereavement. Involving support groups in educating student midwives. Mitchell M, Catron G. Practising Midwife 2002 5(8):26-27.
55. A bereavement service in a critical care unit. Wilkins K, Dalby L. Nursing Times, 2000 96(45):38-39.
56. Telephone support groups for HIV-positive mothers whose children have died of AIDS. Wiener LS. Social Work 1998 43(3):279-285.
57. Through grief to healthy parenthood: facilitating the journey through a family pregnancy support programme. Caelli K, Downie J, Knox M. Birth Issues, 1999 8(3):85-90.
58. Evaluation of a pet loss support hotline. Turner WG. Anthrozoos, 1997 10(4):225-230.
59. Bereavement services in acute care settings. Fauri DP, Ettner B, Kovacs PJ. Death Studies, 2000 24(1):51-64.
60. Bereavement support for couples following death of a baby: program development and 14-year exit analysis. Reilly-Smorawski B, Armstrong AV, Catlin EA. Death Studies 2002 26(1):21-37.
61. Life, loss and living program. Gillmore VL. Creative Nursing 2001 7(4):13.
62. Beneficial effects of a hospital bereavement intervention program after traumatic childhood death. Oliver RC, Sturtevant JP, Scheetz JP, Fallat ME. Journal of Trauma 2001 50(3):440-446; discussion 447-448.
63. A bereavement intervention for parents following the sudden, violent deaths of their 12-28-year-old children: description and applications to clinical practice. Murphy SA. Canadian Journal of Nursing Research, 1997 29(4):51-72.
64. Parenting classes as a part of a hospice bereavement program. Glazer HR, Clark MD. Hospice Journal 1997 12(3):33-40.
65. Young widows' experience with an Internet self-help group. Bacon ES, Condon EH, Fernsler JI. Journal of Psychosocial Nursing and Mental Health Services 2000 38(7):24-33.
66. Introducing a bereavement support programme in ICU. Tunnicliffe R, Briggs D. Nursing Standard 1997 11(47):38-40.
67. Effects of a program of intervention on parental distress following infant death. Murray JA, Terry DJ, Vance JC, Battistutta D, Connolly Y. Death Studies 2000 24(4):275-305.
68. Student interns help expand hospice bereavement services. Oman K. Continuum: An Interdisciplinary Journal on Continuity of Care 1997 17(2):16-19.
69. Weekend courses for families who have lost a child with cancer. Sirkiä K, Ahlgren B, Hovi L, Saarinen-Pihkala UM. Medical and Pediatric Oncology 2000 34(5):352-355.
70. The Forget-Me-Not Program: incorporating bereavement care into the continuum. Skiba LA, Clark EJ, Kalmer KA. Continuum: An Interdisciplinary Journal on Continuity of Care, 1997 17(2):11-15.
71. Bereavement follow-up: an opportunity to extend nursing care. Ruden BM. Journal of Pediatric Oncology Nursing 1996 13(4):219-225.
72. A memorial service for renal patients. Ormandy P. EDTNA/ERCA Journal (English ed.) 1998 24(3):22-24.
73. Acute bereavement services and routine referral as a mechanism to increase donation. Duckworth RM, Sproat GW, Morien M, Jeffrey TB. Journal of Transplant Coordination : Official Publication of the North American Transplant Coordinators Organization (NATCO) 1998 8(1):16-18.
74. Efficacy of an educational bereavement program for families of veterans with cancer. Abrahm JL, Cooley M, Ricacho L. Journal of Cancer Education 1995 10(4):207-212.
75. International hospice - Australia. A qualitative evaluation of a bereavement service: an analysis of the experiences of consumers and providers of services in Australia. Marquis R. American Journal of Hospice and Palliative Care 1996 13(4):38-43.
76. Workshops to support the bereavement process. Beem EE, Eurelings-Bontekoe EH, Cleiren MP, Garssen B. Patient Education and Counseling 1998 34(1):53-62.
77. A memorial service for families of children who died from cancer and blood disorders... with commentary by Cleaveland MJ. Heiney SP, Wells L, Ruffin J. Journal of Pediatric Oncology Nursing 1996 13(2):72-80.
78. Trauma bereavement program: review of development and implementation. Buchanan HLK, Geubtner MD, Snyder CK. Critical Care Nursing Quarterly 1996 19(1):35-45.
79. Perceptions of social work intervention with bereaved clients: some implications for hospital social work practice. Lord B, Pockett R. Social Work in Health Care 1998 27(1):51-66.
80. Developing strategies to assist sudden-death families: a 10-year perspective. Williams M, Frangesch B. Death Studies 1995 19(5):475-487.
81. The Blue Pages. Current Canadian neonatal research: memories of a gentle presence... the Neonatology Bereavement Program... the family's perspective. Jack A. Neonatal Network: The Journal of Neonatal Nursing 1995 14(8):49.
82. Camp Carousel: a weekend grief retreat. LoCicero JP, Burkhart J, Gray S. American Journal of Hospice & Palliative Care 1998 15(1): 25-27.
83. Bereavement services development in a rural setting. Wilker HI, Lowell B. Hospice Journal 1996 11(4):25-39.
84. Parents' evaluation of a preventive intervention following the sudden, violent deaths of their children. Murphy SA, Baugher R, Lohan J, Scheideman J, Heerwagen J, Johnson LC, Tillery L, Grover MC. Death Studies 1996 20(5):453-468.
85. Parent bereavement stress and preventive intervention following the violent deaths of adolescent or young adult children. Murphy SA. Death Studies 1996 20(5):441-452.
86. A psychoeducational bereavement-support group for families provided in an outpatient cancer center. Goldstein J, Alter CL, Axelrod R. Journal of Cancer Education: Official Journal of the American Association for Cancer Education 1996 11(4):233-237.
