General Practitioners’ experiences of bereavement care and their educational support needs: a qualitative study

Abstract

BackgroundGeneral Practitioners (GPs) are well-positioned to provide grief support to patients. Most GPs view the provision of bereavement care as an important aspect of their role and the GP is the health professional that many people turn to when they need support. We aimed to explore GPs’ understandings of bereavement care and their education and professional development needs in relation to bereavement care.MethodsAn in-depth qualitative design was adopted using a social constructionist approach as our aims were exploratory and applied. Nineteen GPs (12 women and 7 men) living in Western Australia were interviewed; 14 were based in metropolitan Perth and 5 in rural areas. GPs were invited, via a letter, to participate in a semi-structured interview. The interviews occurred within each GP’s workplace or, for the rural GPs, via telephone, and all interviews were digitally audio-recorded and transcribed.ResultsAnalysis was based upon constant comparison and began as soon as possible after each interview. The data revealed four tensions or opposing views concerning bereavement and bereavement care. These were (1) whether grief is a standardised versus an individual process, (2) the role of the GP in intervening versus promoting resilience, (3) the GP as a broker of services versus a service provider, and (4) the need for formal education and professional development versus ‘on-the-job’ experiential learning.ConclusionsGPs have a critical role in exploring distress, including grief. However, changes need to be made to ensure GPs have up-to-date knowledge of contemporary theories and approaches. GPs urgently need education both at the undergraduate and postgraduate degree levels, and in continuing professional development. Otherwise GPs will rely on out-dated theories and constructions of grief, which may be detrimental to patient care.

Conducting Research Interviews with Bereaved Family Carers: When Do We Ask?

“…This is consistent with findings that indicate better recall of details soon after an event. 15,26,27 It is also reflective of research on bereavement generally suggesting that people are expected to ''move on'' and that there are set time periods to grieve 37,38 and, although it is socially acceptable to talk about a death in the weeks following the death, after a few months it becomes more problematic. Casarett and coworkers' 29 finding that the timing of survey administration after death did not affect distress levels or response rates, even very soon after death, is also supported.…”

The Psycho-social Impact of fatal Child Drowning in Queensland and the Availability and Use of Support

“…As a result, people often go to their GP as the initial contact (Wiles et al 2002;O'Connor, Breen 2014)). The death of a child is associated with increased mortality in mothers and affects fathers similarly if the death was from unnatural causes (Jiong et al 2003).…”

“…Whilst the GP is the logical choice for health and emotional support, there is evidence to suggest that GPs may not have the skills to support people during their bereavement (Saunderson, Risdale 1999;O'Connor and Breen 2014). Carlton suggests a standardised bereavement protocol, which includes informing the bereaved person's GP of their loss.…”

“…Main (2000) suggested that GPs should offer a message of sympathy at the very least and be available to explain any outstanding questions that may present concerns or lack of closure for the bereaved. However, she identified studies in the UK which indicated many GPs do not have the skills to support their bereaved patients and often refer out to services such as counsellors, psychologists, psychiatrists or support groups (if known) (Main 2000;O'Connor and Breen 2014).…”

“…Resources in rural areas are more limited, resulting in the inability to provide post-bereavement services. The authors also identified the difficulties in accessing professional development (although they also recognised this as a national issue (Breen and O'Connor 2014). Costs of travel and time to travel when based in a rural area limited professional development, to which they suggested maximising the use of technology would help bridge some of these challenges.…”