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Hospital-based bereavement services following the death of a child: a mixed study review
Leigh A Donovan1, Claire E Wakefield2, Vera Russell3
1Kids Cancer Centre, Sydney Children's Hospital (SCH), Randwick, NSW, Australia School of Women's and Children's Health, Faculty of Medicine, UNSW Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia Paediatric Palliative Care Service, Royal Children's Hospital (RCH), Herston, QLD, Australia leigh.donovan@health.qld.gov.au.
Insights
Hospital bereavement services support families after a child's death, easing grief and isolation. Evidence-based, family-centered care is recommended for optimal psychosocial impact.
Area of Science:
- Pediatric Healthcare
- Grief and Bereavement Studies
- Family Support Services
Background:
- Extensive research exists on parental grief after child loss.
- The specific role and impact of hospital-based bereavement services require clarification.
Purpose of the Study:
- Identify hospital bereavement services for perinatal, neonatal, and pediatric settings.
- Summarize the psychosocial impact of these services.
- Outline recommendations for best practice in hospital bereavement care.
Main Methods:
- Systematic review of qualitative, quantitative, and mixed-method studies.
- Searches conducted in MEDLINE, EMBASE, CINAHL, and PsycINFO.
- Methodological quality assessed using the Mixed Method Appraisal Tool.
Main Results:
- 14 qualitative, 6 quantitative, and 10 mixed-method studies were included.
- Families reported feeling supported, less isolated, and experiencing improved coping and personal growth.
- Bereavement services showed greatest effect for parents with complex mourning.
Conclusions:
- Hospital-based services play a crucial role in supporting families before and after a child's death.
- Evidence-based, theoretically driven care with continuity is recommended.
- Further mixed-methods research is needed to develop best practice guidelines.
Background:
There has been a breadth of research on the grief experience of parents following the death of a child. However, the role and impact of hospital-based bereaved services remain unclear.
Aim:
To identify services offered to bereaved families in perinatal, neonatal, and pediatric hospital settings and summarize the psychosocial impact of these services and published recommendations for best practice hospital-based bereavement care.
Design:
Systematic review of qualitative, quantitative, and mixed method studies guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist and methodological quality appraised in accordance with the Mixed Method Appraisal Tool.
Data Sources:
MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health, and PsychINFO were searched to find studies describing hospital-based bereavement services/interventions for parents, siblings, and grandparents.
Results:
In all, 14 qualitative, 6 quantitative, and 10 mixed method studies were identified. Nine descriptive articles were also included. Qualitatively, family members described feeling cared for and supported by staff, a reduction in sense of isolation, and improved coping and personal growth. Quantitatively, bereavement services have most effect for parents experiencing more complex mourning. It is recommended that bereavement services be theoretically driven and evidence based, offer continuity of care prior to and following the death of a child, and provide a range of interventions for the "whole family" and flexibility in service delivery.
Conclusions:
There is a role for transitional hospital-based services/interventions for families in the lead up to and following the death of a child. Further mixed method research is required to inform best practice bereavement care guidelines in the perinatal, neonatal, and pediatric hospital settings.
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