Background
Families confronting the death of a loved one in the intensive care unit (ICU) are at greater risk of experiencing complicated grief than families bereaved in other circumstances. The primary objective of this scoping review was to identify interventions that have been explored in the literature for supporting ICU bereaved families. Secondary objectives were to map the findings to a core outcome set (COS) developed to measure bereavement interventions for adults, and to identify existing knowledge gaps, with particular attention to considerations of equity, diversity, and inclusion (EDI).
Methods
We searched five electronic databases: Web of Science, CINAHL, EMBASE, APA PsycInfo, and MEDLINE. Primary research articles that described bereavement program(s) and/or support(s) for bereaved loved ones in the setting of an adult ICU were included. We extracted data on study aims, methods, setting, patient and bereaved loved one demographics, design, analysis, and results. Four reviewers independently screened references and performed data extraction.
Findings
We identified 11 bereavement interventions, including memorial services, condolence letters/sympathy cards, mementos, ICU diaries completed by staff or family, storytelling interventions, personalized/individual final wishes, information booklets/referrals to resources, meetings with ICU professionals, follow up telephone calls, training for staff, and other specific interventions. Most studies (35 out of 39) reported outcomes that aligned with a previously developed COS. Only three studies addressed cultural diversity in the development or implementation of bereavement interventions.
Conclusions
This scoping review summarizes the range of bereavement interventions described in the literature and highlights key areas for future development, including cultural inclusivity in the development and implementation of interventions, and the use of standardized outcomes for evaluation.
Registration
The protocol is registered on the Open Science Framework (https://osf.io/ue7t9).
Sarah Foran, Mah Rukh, Alison Knapp, Jennifer M O’Brien, Carol Brons, Janelle Glessman, Joann Kawchuk, Donna Goodridge, Sabira Valiani
Disease Category: Other
Disease Name:
Age Range: 18 - 100
Sex: Either
Nature of Intervention: Psychological & behavioural
- Patient/ support group representatives
- COS uptake study
- Systematic review
- This project was initiated by two Patient Family Partners (PFPs) with lived experience of ICU bereavement. Recognizing bereavement care as a major unmet need in their own experiences, they highlighted this gap to our research team and helped shape the study’s objectives, design (e.g. refining inclusion criteria, reviewing the core outcome set for relevance to bereavement in the ICU), and interpretation, ensuring alignment with the real-world needs and values of bereaved families. They participated in monthly virtual meetings throughout the project duration.