Guidelines for the Psychosocial and Bereavement Support of Family Caregivers of Palliative Care Patients

Hudson, Peter; Remedios, Cheryl; Zordan, Rachel; Thomas, Kristina; Clifton, Diane; Crewdson, Michael; Hall, Chris; Trauer, Tom; Bolleter, Amanda; Clarke, David M.; Bauld, Catherine

doi:10.1089/jpm.2011.0466

Cited by 162 publications

(188 citation statements)

References 32 publications

(35 reference statements)

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“…Subsequently, intervening for at-risk family members may save valuable money and time and is also consistent with recommendations in palliative care guidelines. 39 In this study, a significant factor associated with ICU bereavement services was that the hospital has a palliative care service or another support service. The nurse leaders reported their members of ICU staff were able to call on such services to provide bereavement follow-up care.…”

Section: Characteristicmentioning

confidence: 83%

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Bereavement Services Offered in Adult Intensive Care Units in the United States

McAdam

Erikson

2016

American Journal of Critical Care

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Background Losing a loved one in the intensive care unit (ICU) is stressful for family members. Providing bereavement support to them is recommended. However, little is known about the prevalence of bereavement services implemented in adult ICUs. Objective To describe current bereavement follow-up services in adult ICUs. Method A cross-sectional prospective study design was used. ICU nurse leaders completed a 26-item online survey posted in the American Association of CriticalCare Nurses e-newsletter. The survey contained questions about current practices in bereavement care. Data were collected for 1 month and were analyzed by using descriptive statistics and binary logistic regression. Results A total of 237 ICU nurse leaders responded to the survey. Hospital and ICU types were diverse, with most being community (n = 81, 34.2%) and medical (n = 61, 25.7%). Most respondents reported that their ICUs (n = 148, 62.4%) did not offer bereavement follow-up services, and many barriers were noted. When bereavement follow-up care was offered, it was mainly informal (eg, condolence cards, brochures). Multiple logistic regression indicated that ICUs in hospitals with palliative care were almost 8 times (odds ratio, 7.66) more likely to provide bereavement support than were ICUs in hospitals without palliative care. Conclusions The study findings provide insight into what type of bereavement evaluation methods are being used, what barriers are present that hinder use of bereavement follow-up services, and potential interventions to overcome those barriers in adult ICUs in the United States.

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Section: Characteristicmentioning

confidence: 83%

“…Rather, the recommendation is that this type of care should be directed to those at high risk. 39 Further research is warranted in this area to ascertain which bereaved ICU family members would benefit most and what type of bereavement support they would use and find helpful.…”

Section: Characteristicmentioning

confidence: 99%

Bereavement Services Offered in Adult Intensive Care Units in the United States

McAdam

Erikson

2016

American Journal of Critical Care

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“…[12][13][14][15] Palliative care services are aimed at reducing CGs' distress and burden by educating and activating skills in problem solving, self-care, decision making, and symptom management. 16 Although the benefits of early concurrent oncology palliative care have been noted in patients with advanced cancer, 17 the impact of this earlier care on CGs has not been studied.…”

Section: Journal Of Clinical Oncology O R I G I N a L R E P O R T V Omentioning

confidence: 99%

Benefits of Early Versus Delayed Palliative Care to Informal Family Caregivers of Patients With Advanced Cancer: Outcomes From the ENABLE III Randomized Controlled Trial

Dionne‐Odom

Azuero

Lyons

et al. 2015

JCO

405

407

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Purpose To determine the effect of early versus delayed initiation of a palliative care intervention for family caregivers (CGs) of patients with advanced cancer. Patients and Methods Between October 2010 and March 2013, CGs of patients with advanced cancer were randomly assigned to receive three structured weekly telephone coaching sessions, monthly follow-up, and a bereavement call either early after enrollment or 3 months later. CGs of patients with advanced cancer were recruited from a National Cancer Institute cancer center, a Veterans Administration Medical Center, and two community outreach clinics. Outcomes were quality of life (QOL), depression, and burden (objective, stress, and demand). Results A total of 122 CGs (early, n = 61; delayed, n = 61) of 207 patients participated; average age was 60 years, and most were female (78.7%) and white (92.6%). Between-group differences in depression scores from enrollment to 3 months (before delayed group started intervention) favored the early group (mean difference, −3.4; SE, 1.5; d = −.32; P = .02). There were no differences in QOL (mean difference, −2; SE, 2.3; d = −.13; P = .39) or burden (objective: mean difference, 0.3; SE, .7; d = .09; P = .64; stress: mean difference, −.5; SE, .5; d = −.2; P = .29; demand: mean difference, 0; SE, .7; d = −.01; P = .97). In decedents' CGs, a terminal decline analysis indicated between-group differences favoring the early group for depression (mean difference, −3.8; SE, 1.5; d = −.39; P = .02) and stress burden (mean difference, −1.1; SE, .4; d = −.44; P = .01) but not for QOL (mean difference, −4.9; SE, 2.6; d = −.3; P = .07), objective burden (mean difference, −.6; SE, .6; d = −.18; P = .27), or demand burden (mean difference, −.7; SE, .6; d = −.23; P = .22). Conclusion Early-group CGs had lower depression scores at 3 months and lower depression and stress burden in the terminal decline analysis. Palliative care for CGs should be initiated as early as possible to maximize benefits.

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“…Franco (2014), diante deste contexto, destaca o quão importante os cuidados paliativos são para a prevenção de luto complicado, uma vez que o luto antecipatório pode ser trabalhado, respeitando e considerando o papel fundamental da famí-lia no processo de adoecimento e do luto. Conforme salientam Hudson et al (2012), há uma exigência atual de diretrizes relacionadas ao luto e suporte psicossocial nessa área em relação a orientação e educação sobre o luto para a unidade de cuidado. Ainda de acordo com este autor, garantir que as necessidades dos familiares sejam devidamente avaliadas está entre os dez marcadores de qualidade de fim de vida.…”

Section: A Vivência Do Luto No Contexto De Cuidados Paliativosunclassified

Profissionais Paliativistas e suas Contribuições na Prevenção de Luto Complicado

Braz

Franco

2017

Psicol. cienc. prof.

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Resumo: Os cuidados paliativos buscam qualidade de vida baseada principalmente na prevenção e alívio do sofrimento de pacientes que possuem doenças ameaçadoras de vida, englobando as esferas de ordem física, psicossocial e espiritual. Além disso, estende-se ao pós-morte do paciente, oferecendo suporte à família no processo de luto. Esta pesquisa qualitativa teve como objetivo compreender e analisar a formação dos profissionais em relação ao processo de morrer do paciente e as percepções daqueles em relação às suas contribuições para a prevenção de luto complicado da unidade de cuidado. A Teoria do Apego fundamentou teoricamente este estudo. Participaram voluntariamente profissionais de saúde que integram formalmente equipes de cuidados paliativos. Foi utilizado um questionário autoaplicativo para obtenção de dados acadêmicos, profissionais e de cursos realizados, e uma entrevista semiestruturada. A análise das informações colhidas nas entrevistas foi realizada através de transcrição e categorização das mesmas, seguida de análise de conteúdo. Os resultados confirmaram que a formação dos profissionais em relação ao processo de morrer é escassa. Ademais, observou-se que os profissionais de saúde que trabalham em cuidados paliativos possuem comportamentos de apego, os quais são identificados como naturais nesse contexto, o que acaba por dificultar a percepção de que são importantes contribuições para a prevenção de luto complicado da unidade de cuidado. Diante desses resultados, a presente pesquisa trouxe a relevância sobre a necessidade da inserção das temáticas morte e morrer na educação dos profissionais de saúde, o que pode contribuir para melhor assistência à unidade de cuidado nos seus processos de luto. Palavras-chave: Cuidados Paliativos, Unidade de Cuidado, Luto Complicado, Profissionais de Saúde.

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Guidelines for the Psychosocial and Bereavement Support of Family Caregivers of Palliative Care Patients

Abstract: The guidelines may prove valuable for the international palliative care community and for generalist health care providers who occasionally care for palliative care patients. Research is recommended to explore the uptake, implementation, and effectiveness of the guidelines.

Cited by 162 publications

References 32 publications

Bereavement Services Offered in Adult Intensive Care Units in the United States

Bereavement Services Offered in Adult Intensive Care Units in the United States

Benefits of Early Versus Delayed Palliative Care to Informal Family Caregivers of Patients With Advanced Cancer: Outcomes From the ENABLE III Randomized Controlled Trial

Profissionais Paliativistas e suas Contribuições na Prevenção de Luto Complicado

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