title: A scoping review of bereavement service outcomes.
abstract: This scoping literature review, through finding and assessing researched bereavement service outcomes, sought to determine the state of bereavement services evaluation, to catalogue service types, and to identify which service or services, if any, demonstrate clear evidence of effectiveness.
  
  
  
  Our methods included: (1) a literature search for published English-language research articles from 2005-2015; (2) critical appraisal of articles to identify findings; (3) compilation of findings; and (4) determination of the relevance of our findings.
  
  
  
  Some 38 papers were found, and all were retained to identify the outcomes researched and research findings. Many different outcomes were studied in the 18 quantitative, 11 qualitative, and 9 mixed-methods investigations undertaken worldwide. Ten studies focused on level of grief, six on stress/distress level, six on grief knowledge, six on level of depression, and five on somatization or physical symptoms. Most commonly, a group of bereavement services was evaluated as a whole, followed by group therapy, individual counseling, written information, and other less common services. No group of services or individual service was determined to yield clear and convincing evidence of effectiveness. Regardless, all but one service were shown to have value-most often related to gaining grief information and/or emotional support. Until high-quality research studies have repeatedly revealed evidence of effectiveness, it is possible that the positive outcomes of bereavement services will be largely based on bereaved people receiving helpful educational information and emotional support from organizations and people prepared to help them.
  
  
  
  This project outlines existing bereavement service types and the state of science in relation to determination of outcomes. It offers suggestions to advance the state of science to validate or refine bereavement services. It brings to light the issue that bereavement service outcomes need to be carefully researched so that evidence can drive service refinement and expansion. It also highlights the importance of effective bereavement services.
authors.affiliation: Faculty of Nursing,University of Alberta,Edmonton,Alberta,Canada.
authors.forename: Donna M
authors.initials: DM
authors.lastname: Wilson
authors.affiliation: Faculty of Nursing,University of Alberta,Edmonton,Alberta,Canada.
authors.forename: Nurin
authors.initials: N
authors.lastname: Dhanji
authors.affiliation: Faculty of Nursing,University of Alberta,Edmonton,Alberta,Canada.
authors.forename: Robyn
authors.initials: R
authors.lastname: Playfair
authors.affiliation: Faculty of Nursing,University of Alberta,Edmonton,Alberta,Canada.
authors.forename: Sahana Srinivas
authors.initials: SS
authors.lastname: Nayak
authors.affiliation: Faculty of Nursing,University of Alberta,Edmonton,Alberta,Canada.
authors.forename: Gideon L
authors.initials: GL
authors.lastname: Puplampu
authors.affiliation: HammondCare and Department of Palliative Care,University of Sydney,Sydney,New South Wales,Australia.
authors.forename: Rod
authors.initials: R
authors.lastname: Macleod
mesh_terms: D003863:Depression / Q000628:therapy; D006117:Grief; D017051:Hospice Care / Q000379:methods* / Q000592:standards*; D006801:Humans; D063868:Patient Outcome Assessment; D013315:Stress, Psychological / Q000628:therapy
keywords: Bereavement services; Evaluation; Grief and mourning; Literature review; Outcomes