Introduction
Methods
Identification and selection of studies
Study eligibility
Data extraction and risk of Bias assessment
Synthesis
Results
Study characteristics
Source | Hospital and ICU Settings and Types | Bereavement Intervention | Duration of Intervention | Follow-Up Timepoints | Patient Demographics (of those randomized) | Caregiver Demographics (of those randomized) |
---|---|---|---|---|---|---|
Barnato et al., 2017 [29] | 5 ICUs 1 trauma 1 cardiovascular 2 medical 1 mixed 3 hospitals 1 tertiary teaching 1 cancer center 1 community | Storytelling delivered via home visit or telephone call approximately 4 weeks following patient death that included: - non-judgmental elicitation of the story of the events leading up to the patient’s ICU admission - ICU experience and decision process - aftermath of the patient’s death | 1–2 h | Follow-up assessments conducted via telephone interview or by mail at: 3 months 6 months | Total N = 32 n, intervention = 18 age, 67.8 yr (SD 13.7) female, 50% n, control = 14 age, 72.0 yr (SD 10.2) female, 50% | Total N = 32 n, intervention = 18 age, 55.0 yr (SD 11.0) female, 61.1% n, control = 14 age, 55.9 yr (SD 12.6) female, 86.7% |
Kentish-Barnes et al., 2017 [28] | 22 ICUs 8 medical 11 general 1 surgical 1 nephrology 1 anesthesia-surgical 22 hospitals 11 academic 11 non-academic | Condolence letter prepared (hand-written) within 3 days after patient death and sent by standard mail 15 days after patient death that included: - recognition of the death - name of the decreased - mention of a personal impression - recognition of the family member - offer to help - express sympathy | Not reported | Follow-up assessments conducted via telephone interview by psychologists, sociologists, and research nurses blinded to study group at: 1 month 6 months | Total N = 242 n, intervention = 123 age, 61 yr (Rg. 54–71) female, 33.3% n, control = 119 age, 61 yr (Rg. 54–66) female, 37.0% | Total N = 242 n, intervention = 123 age, 57 yr (Rg. 46–65.5) female, 67.9% n, control = 119 age, 56 yr (Rg. 44–64.5) female, 71.7% |
Tawil et al., 2014 [30] | 4 ICUs 1 medical 1 neurosciences 1 trauma/surgical 1 PICU (> 17 yr eligible) 1 hospital 1 tertiary teaching | Family groups presence during brain death evaluation joined the evaluating physician at the patient’s bedside to observe the brain death evaluation including all brainstem reflex testing and the apnea test. The subjects were accompanied by a chaperone who could explain the process and answer questions during the evaluation. After the brain death evaluation was complete, the family members were notified of the results and given an opportunity to ask questions. | Average duration of brain death evaluation not stated | All family members sent hard copies of assessment surveys then telephoned by a trained research nurse who administered the surveys and recorded responses within 1- to 3-months after patient death | Total N = 17 n, intervention = 11 age, 41.7 yr (Rg. 19–67) female, 55% n, control = 6 age, 52.5 yr (Rg. 32–67) female, 33% | Total N = 58 n, intervention = 38 age, 41.7 yr (SD 14.4) female, 61.1% n, control = 20 age, 44.6 yr (SD 17.6) female, 85.7% |
Study | Random sequence generation | Allocation concealment | Blinding of participants, researchers | Blinding of outcome assessment | Incomplete outcome data2 | Selective reporting |
---|---|---|---|---|---|---|
Barnato et al., 2017 [29] | Low | Low | High | Low | High | Low |
Kentish-Barnes et al., 2017 [28] | Low | Low | High | Low | High | Low |
Tawil et al., 2014 [30] | Low | Low | High | Unclear | High | Low |
Outcome | Assessed By | Follow-Up Range | No. Studies | No. Caregivers1 | GRADE of Evidence2 |
---|---|---|---|---|---|
Ability to Cope with Grief | |||||
Negative and overwhelming grief | Decision Regret Scale | 6-month | 1 | 30 | Low |
Communication and connectedness | None | N/A | 0 | 0 | N/A |
Understanding, accepting and finding meaning in grief | Inventory of Complicated Grief | 1-month to 6-month | 2 | 220 | Moderate |
Finding balance between grief and life going forwards | None | N/A | 0 | 0 | N/A |
Accessing appropriate support | Single Yes/No Question | 3-month to 6-month | 1 | 30 | Low |
Quality of Life and Metal Wellbeing | |||||
Participation in work and/or other regular activities | General Health Questionnaire-12 | 1-month to 3-months | 1 | 58 | Low |
Relationships and social functioning | None | N/A | 0 | 0 | N/A |
Positive mental wellbeing | None | N/A | 0 | 0 | N/A |
Negative mental and emotional state | Impact of Event Scale; Impact of Event Scale-Revised; Hospital Anxiety and Depression-Anxiety; Hospital Anxiety and Depression-Depression; Hospital Anxiety and Depression-Total; Patient Health Questionnaire-9; Post-Intensive Care Syndrome-Family | 1-month to 6-month | 3 | 278 | Moderate |