Bereavement follow-up after critical illness

Area of Science:

• Critical Care Medicine
• Bereavement Studies
• Psychosocial Support

Background:

• Establishing a Bereavement Follow-up Service is crucial for supporting families after a patient's death in an intensive care unit (ICU).
• Understanding the experiences of next-of-kin is vital for improving end-of-life care and bereavement support.
• The early impact of bereavement on families requires systematic evaluation.

Purpose of the Study:

• To establish and assess the initial activities of a Bereavement Follow-up Service for ICU patients' next-of-kin.
• To quantify family experiences regarding the quality of intensive care and the early effects of bereavement.
• To identify areas for service improvement in critical care and bereavement support.

Main Methods:

• A cross-sectional prospective study utilizing structured telephone interviews.
• Conducted in a 14-bed adult general ICU at a tertiary university hospital.
• 99 next-of-kin of patients who died in the ICU were interviewed a median of 33 days post-death.

Main Results:

• 84% felt well-informed during intensive care; 76% understood the fatal events, though 19% desired more information.
• 77% reported positive comments on care quality (e.g., compassionate behavior), but 30% had negative feedback, often citing poor communication (13%).
• While most resumed normal activities (85%) and returned to work (40/47), sleep disturbances (58%) and financial difficulties (32%) were common. 21 individuals were referred to support agencies.

Conclusions:

• Contact was established with two-thirds of eligible next-of-kin, indicating potential for improved outreach.
• High satisfaction with overall care was reported, yet specific concerns about communication necessitate targeted interventions.
• Despite a general return to normalcy, prevalent sleep disturbances and financial challenges highlight the need for ongoing bereavement support services.