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Margetts, M., Cuthbertson, S., & Streat, S. J. (1996). Bereavement follow-up – its impact on practice. Ph.D. thesis, , .
Abstract: Since 1995 we have provided a bereavement follow-up service but the benefits of this to clinical care have not previously been reported . We reviewed the 1995 results, documentation methods, system design, discussed with reviewers their data collection, interview process and its effect on them and their practice. Next-of-kin of only 99/151 patients ( M87 age 14-88) were contacted 16-149 median 34 days after the death. Sleep disturbance (55/99) were the most common problems. We now give next-of- kin literature including a pamphlet which introduces our service and discusses these problems. Most next-of-kin (77/99) commented favorably on DCCM care, but 16/99 identified inadequate facilities and communication problems as service deficiencies. We have improved facilities (paint, furniture, telephone, drinks machine). We now notify patients general practitioners of every death and bring families back for meetings with staff when necessary. We changed systems of case identification and recording of next-of-kin information. Nurse interviewers (8) identified their needs for improved telephone skills, education about grief and research, debriefing after calls and their need for acknowledgement of participation in this service. Study days now address these issues. Interviewers difficulties with interview content have lead to changes. They suggested peer review of data forms to improve completeness which now occurs. Some found the interview process personally disturbing, but all reported positive changes in their practice with bereaved families.Within two years a bereavement service has led to improvements in facilities, communication, and staff expertise, it is now part of our holistic care
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Margetts, M., Cuthbertson, S., & Streat, S. J. (1995). Bereavement follow-up service after fatal critical illness. Ph.D. thesis, , .
Abstract: Fatal illness is often short. Communication between patient and family is impaired and how to best meet family needs is unclear. We began a follow-up service to determine current next-of-kins outcomes and remedy service deficiencies. A critical care nurse identified deaths from our data base and completed a structured telephone interview with the next-of-kin. There were 374 admissions from 1/1/95 – 17/5/95, 55 died. Next- of-kin of 52 patients (M29, age 19-88 median 52) were contactable 16-70 (median 33)days later. All (defacto/wives 18, husbands 9, mothers 9, daughters 8, others 8) consented to interview (5 -80, median 15 minutes). Forty-nine had resumed normal home activities and 23/25 workers had returned to work. Thirty-three still had disturbed sleep, three were taking hypnotics. Twenty-four had had contact with their general practitioner because of the death (six were prescribed sedatives or hypnotics). Nineteen had financial problems. Forty-seven described DCCM care positively, 35 specifically (nursing care and compassion 15, communication 8, flexible visitors policy8) but 13 had particular difficulties (communication 4 , waiting 2, facilities 4) and 4 serious non-DCCM issues. Forty-six considered themselves well informed and understood well the sequence of events. Forty-eight identified family and friends as primary support. Three requested information about another agency (counseling), 9 asked us to contact as further relative. A telephone bereavement service is well received by next-of-kin. Most families members resolve their early grief without external agencies but sleep and money are problems. We have improved our facilities and are addressing communication and cultural issues
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