title: The desirability of an Intensive Care Unit (ICU) clinician-led bereavement screening and support program for family members of ICU Decedents (ICU Bereave).
abstract: OBJECTIVE
  Many bereaved family members (FMs) of intensive care unit decedents experience symptoms of complicated grief (CG) or social distress, but there is no standard screening or follow-up for these individuals. We determined the desirability and need for an intensive care unit-based bereavement screening and support program for these FMs.
  
  
  METHODS
  We surveyed bereaved FMs to measure symptoms of CG, prolonged grief disorder, and social difficulties and the desire for support; and staff physicians and nurses at 2 teaching hospitals in Toronto, Canada, to determine comfort and interest in providing routine bereavement support.
  
  
  RESULTS
  We could not contact 69% of FMs largely because of inaccuracies in the patient record. Of the 64 who were contacted, 32 (50%) agreed to be surveyed a mean (SD) of 7.4 (2.2) months after the loss of their relative. Among eligible staff, 57 (61%) of 94 completed the questionnaire. Nine (28%) FMs met subthreshold criteria for CG or prolonged grief disorder, and 7 (22%) met criteria for social distress. Only 10 (31%) had received professional support for emotional symptoms, and 2 (6%) received professional assistance for their social difficulties. Fifty-eight percent supported routine screening, and 68% wanted to receive (or receive more) support. Fifty-five percent of FMs expressed a strong willingness to meet with the medical team to review events surrounding the death of the patient, which was the type of support that the health care staff were most comfortable providing. Most staff (85%) reported providing emotional support at the time of death, but few provided any support afterwards. Fifty-six (98%) of 57 would be willing to support or participate in a formal bereavement screening and support program. Respondents cited the need for training and dedicated time to carry out such a program.
  
  
  CONCLUSIONS
  An ICU-based bereavement screening and support program for FMs of ICU decedents is both needed and desirable, although there are important needs and barriers. Future studies should evaluate the effectiveness for such a program at improving outcomes among bereaved FMs.
authors.affiliation: Divisions of Critical Care and Palliative Care, Department of Medicine, University of Toronto, Toronto, ON, Canada M5G 2C4. Electronic address: james.downar@utoronto.ca.
authors.forename: James
authors.initials: J
authors.lastname: Downar
authors.affiliation: Queen's University, Kingston, ON, Canada. Electronic address: rbarua@qmed.ca.
authors.forename: Reeta
authors.initials: R
authors.lastname: Barua
authors.affiliation: Department of Critical Care, Department of Medicine Sunnybrook Health Sciences Center and Interdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada M4N 3 M5. Electronic address: taz.sinuff@sunnybrook.ca.
authors.forename: Tasnim
authors.initials: T
authors.lastname: Sinuff
mesh_terms: D001293:Attitude to Death; D001601:Bereavement; D005190:Family / Q000523:psychology*; D005260:Female; D006117:Grief; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology*; D008875:Middle Aged; D020380:Needs Assessment; D009741:Nursing Staff, Hospital / Q000523:psychology*; D009864:Ontario; D011368:Professional-Family Relations; D013315:Stress, Psychological / Q000175:diagnosis* / Q000628:therapy; D011795:Surveys and Questionnaires
keywords: Adjustment disorders; Bereavement; Caregivers; Grief; Health surveys; Intensive care unit; Social support