Hospital-based bereavement services following the death of a child: a mixed study review.
BACKGROUND
There has been a breadth of research on the grief experience of parents following the death of a child. However, the role and impact of hospital-based bereaved services remain unclear.


OBJECTIVE
To identify services offered to bereaved families in perinatal, neonatal, and pediatric hospital settings and summarize the psychosocial impact of these services and published recommendations for best practice hospital-based bereavement care.


METHODS
Systematic review of qualitative, quantitative, and mixed method studies guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist and methodological quality appraised in accordance with the Mixed Method Appraisal Tool.


METHODS
MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health, and PsychINFO were searched to find studies describing hospital-based bereavement services/interventions for parents, siblings, and grandparents.


RESULTS
In all, 14 qualitative, 6 quantitative, and 10 mixed method studies were identified. Nine descriptive articles were also included. Qualitatively, family members described feeling cared for and supported by staff, a reduction in sense of isolation, and improved coping and personal growth. Quantitatively, bereavement services have most effect for parents experiencing more complex mourning. It is recommended that bereavement services be theoretically driven and evidence based, offer continuity of care prior to and following the death of a child, and provide a range of interventions for the "whole family" and flexibility in service delivery.


CONCLUSIONS
There is a role for transitional hospital-based services/interventions for families in the lead up to and following the death of a child. Further mixed method research is required to inform best practice bereavement care guidelines in the perinatal, neonatal, and pediatric hospital settings.
Kids Cancer Centre, Sydney Children's Hospital (SCH), Randwick, NSW, Australia School of Women's and Children's Health, Faculty of Medicine, UNSW Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia Paediatric Palliative Care Service, Royal Children's Hospital (RCH), Herston, QLD, Australia leigh.donovan@health.qld.gov.au.
Leigh A
LA
Donovan
Kids Cancer Centre, Sydney Children's Hospital (SCH), Randwick, NSW, Australia School of Women's and Children's Health, Faculty of Medicine, UNSW Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia.
Claire E
CE
Wakefield
Kids Cancer Centre, Sydney Children's Hospital (SCH), Randwick, NSW, Australia.
Vera
V
Russell
Kids Cancer Centre, Sydney Children's Hospital (SCH), Randwick, NSW, Australia School of Women's and Children's Health, Faculty of Medicine, UNSW Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia.
Richard J
RJ
Cohn
D000223:Adaptation, Psychological; D001293:Attitude to Death; D001601:Bereavement; D002648:Child; D002983:Clinical Competence; D003266:Continuity of Patient Care; D005190:Family / Q000523:psychology*; D005260:Female; D017051:Hospice Care / Q000592:standards*; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology; D012944:Social Support
Bereavement; child; death; hospitals—pediatric; systematic review