54 Interventions and support for people bereaved through advanced progressive illness: a mixed-methods systematic review

Background Palliative care has an important role to play in addressing the bereavement needs of families. A small number of systematic reviews of bereavement interventions are available1 2 but these have typically been restricted to evidence from randomised controlled trials (RCTs) and provide little information on support specifically provided in palliative care settings.Aim This mixed method review identifies interventions and services providing bereavement support for adults bereaved through advanced progressive illness and looks at both the quantitative and qualitative evidence for their effectiveness and utility.Methods Key databases were searched for papers published between 1990 and 2016. Supplementary searches were also conducted. The review includes studies conducted in the UK or comparable countries reporting evaluations of interventions or services delivered to adults bereaved through advanced progressive illness. Study quality was assessed using appropriate checklists.Results Thirty-nine studies met the inclusion criteria for the review including seven RCTs. Evidence from the trials reported improvements in a range of physical and mental health outcomes. However the studies were generally of poor quality with heterogenous populations and outcomes. Evidence from qualitative studies identified a number of positive impacts for service users including facilitating loss and grief resolution restoration and moving on acquisition of coping strategies and social support.Conclusions Whilst the qualitative evidence suggests important benefits of bereavement care for service users this is not matched by strong trial-based evidence. Conclusions that may be drawn on effectiveness are therefore limited by lack of rigorous evaluation studies conducted in this area.