Bereavement care is considered an integral component of quality end-of-life care endorsed by the palliative care movement. However, few hospitals and health care institutions offer universal bereavement care to all families of patients who die. The current coronavirus disease 2019 pandemic has highlighted this gap and created a sense of urgency, from a public health perspective, for institutions to provide support to bereaved family members. In this article, drawing on the palliative care and bereavement literature, we offer suggestions about how to incorporate palliative care tools and psychological strategies into bereavement care for families during this pandemic.

This trial assessed the feasibility, acceptability, tolerability, and efficacy of an Internet-based therapist-assisted cognitive-behavioral indicated prevention intervention for prolonged grief disorder (PGD) called Healthy Experiences After Loss (HEAL). Eighty-four bereaved individuals at risk for PGD were randomized to either an immediate treatment group (n = 41) or a waitlist control group (n=43). Assessments were conducted at four time-points: prior to the wait-interval (for the waitlist group), pre-intervention, post-intervention, 6 weeks later, and 3 months later (for the immediate group only). Intent-to-treat analyses indicated that HEAL was associated with large reductions in prolonged grief (d=1.10), depression (d=.71), anxiety (d=.51), and posttraumatic stress (d=.91). Also, significantly fewer participants in the immediate group met PGD criteria post-intervention than in the waitlist group. Pooled data from both groups also yielded significant reductions and large effect sizes in PGD symptom severity at each follow-up assessment. The intervention required minimal professional oversight and ratings of satisfaction with treatment and usability of the Internet interface were high. HEAL has the potential to be an effective, well-tolerated tool to reduce the burden of significant pre-clinical PGD. Further research is needed to refine HEAL and to assess its efficacy and mechanisms of action in a large-scale trial.

Two studies were conducted to investigate aspects of the test effect in a tertiary education setting. During weekly tutorial sessions first year psychology students watched a psychobiology video (Phase 1), followed by different video-related activities (Phase 2). In the tutorial 1 week later, students took an unexpected test (Phase 3). In Phase 2 of Study 1, students completed a quiz in small groups (group quiz) or individually (individual quiz), highlighted the video transcript (re-study), or did nothing further (no-activity). Group quiz performance was superior to individual quiz in both Phase 2 and Phase 3. In Phase 3 individual quiz students performed better than no-activity students, but not better than restudy students. In exploring the individual testing effect further, Phase 2 of Study 2 included quiz (individual), restudy, and no-activity conditions. Quiz participants were presented with one (target) of two sets of questions, whereas restudy participants were presented with equivalent statements. During Phase 3, all participants answered both sets of questions (target and related). Quiz performance was superior to restudy and no-activity performance on both target and related material, supporting the retrieval-induced facilitation explanation of the testing effect. Implications of the current research for assessment practices in classroom settings are discussed, and directions for future research are indicated.

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Bereavement programs can both help bereaved individuals adapt to their loss, and positively impact hospitals by enhancing the reputation of the hospital within the community and providing an avenue for identifying opportunities for improvement in care processes. We recommend that all hospitals implement basic bereavement programs for families of all deceased patients as the standard of care.

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BACKGROUND:The loss of a child is associated with elevated grief severity, and sudden infant death syndrome (SIDS) is the leading cause of postneonatal mortality in the United States. The diagnosis of prolonged grief disorder (PGD) has gained broader acceptance and use. Little is known about PGD in mothers after SIDS.

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