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ABSTRACT Background Objectives Search Strategy and Selection Criteria Data Collection and Analysis Main Results Conclusions Ninety‐eight percent of neonatal deaths worldwide occur in low‐ and middle‐income countries (LMICs), yet there is little bereavement care guidance available for these settings.To explore parents', families' and healthcare professionals' experiences of care after neonatal death in healthcare facilities in LMICs.Four databases were searched for peer‐reviewed literature, meeting the inclusion criteria of qualitative studies exploring the experiences of people who provided or received bereavement care following neonatal death in a LMIC healthcare setting.Data were collected by two independent reviewers, collated through line‐by‐line coding and then reciprocal and refutational translation, and analysed through Noblit and Hare's seven‐step meta‐ethnography approach to create first‐, second‐ and third‐order themes.Seven first‐order themes extracted from the literature included emotional responses, social relationships, staff and systems, religion, connecting with the baby, coping strategies and economic concerns. From these data, three third‐order themes arose: The individual, the healthcare setting and the community/context.Overarching themes in bereavement care shape grief responses and are often similar across geographical locations. Analysing these similarities allows a deeper understanding of the important elements of bereavement care and may be helpful to inform the creation of high‐quality, bereavement care guidelines suitable for use in LMIC settings. [ABSTRACT FROM AUTHOR]

Abstract Background The death of a child is one of the most devastating events a family can face, resulting in significant physical and psychosocial morbidity. Bereavement support programs have been developed in high-income contexts to address this need. However, little is known about implementing bereavement programs in low-and middle-income countries (LMICs). Here, we describe the implementation of a bereavement program for parents whose children died due to cancer or other catastrophic illnesses. Methods We conducted a retrospective analysis to describe the implementation of a hospital-based End of Life (EoL) care and bereavement program. This program was developed in several stages, including an assessment of bereaved families, development program guidelines, staff training, piloting of the program, refinement, and standardization. The program was developed between 2019 and 2021 in a nonprofit, teaching hospital and referral center for southwestern Colombia. Results Several tools were developed as key components of the bereavement program: a virtual bereavement course; guidance for EoL and bereavement communication and care, memory making, and follow-up calls; a condolence letter template, and group support workshops. A total of 956 healthcare professionals were trained, 258 follow-up calls to bereaved parents were made, 150 individual psychological follow-ups to parents with complicated grief occurred, 79 condolence letters were sent, and 10 support group workshops were carried out. Challenges were identified and overcome, such as limited resources and staff, and cultural perceptions of death. In 2021, this program received an award by the hospital as the Best Strategy to Humanize Healthcare. Conclusions This study highlights the feasibility of developing and implementing EoL and bereavement care programs for parents and families within hospitals in LMICs. Lack of resources, staff, and training are some of the identified challenges to implementation. Utilizing methodological tools allows us to identify facilitator factors and deliverable outcomes of our EoL and bereavement program. This model provides a valuable framework for resource-limited settings.

Objectives: Relatives of patients who died after euthanasia or physician-assisted suicide (EAS) might need (specific) aftercare. We examined if and how physicians provide aftercare to bereaved relatives of patients who died after EAS, and which patient-, physician- and process characteristics are associated with providing aftercare. Methods: A cross-sectional questionnaire study was conducted among 127 physicians (general practitioners, clinical specialists, and elderly care physicians) in the Netherlands. Associations were examined using multivariable logistic regression analyses. Results: Most physicians had had at least one follow-up conversation with bereaved relatives (77.2%). Clinical specialists less often provided aftercare compared to GPs. Also, aftercare was more often provided when the deceased had a cohabiting partner. Topics addressed during aftercare conversations included looking back on practical aspects of the EAS trajectory, the emotional experience of relatives during the EAS trajectory and relatives' current mental wellbeing. A minority of aftercare conversations led to referral to additional care (6.3%). Conclusion: Aftercare conversations with a physician covering a wide-range of topics are likely to be valuable for all bereaved relatives, and not just for "at risk" populations typically targeted by policies and guidelines. [ABSTRACT FROM AUTHOR]

Aim: To explore relatives' needs in terms of bereavement care during euthanasia processes, how healthcare providers respond to these needs, and the degree of commonality between relatives' and healthcare providers' reports. Design: A phenomenological design was employed, utilising reflexive thematic analysis to examine interviews conducted with relatives (N = 19) and healthcare providers (N = 47). Results: Relatives' needs throughout euthanasia processes are presented in five main themes and several subthemes, with similar findings between both sets of participants. Although relatives infrequently communicated their needs explicitly to healthcare providers, they appreciated it when staff proactively met their needs. Healthcare providers aimed to assist with the relatives' grief process by tending to their specific needs. However, aftercare was not consistently offered, but relatives did not have high expectations for professional follow‐up care. Conclusion: Our research offers important directions for healthcare professionals, empowering them to provide needs‐based bereavement care during euthanasia processes. Moreover, it emphasises the importance of recognising the unique needs of relatives and proactively addressing them in the period before the loss to positively contribute to relatives' grief process. Implications for the profession and/or patient care: Insights into relatives' needs in the context of euthanasia. Good practices on how healthcare providers can attend to relatives' needs before, during and after the loss Impact: Current literature and guidelines on needs‐based bereavement care in the context of euthanasia and, more generally, assisted dying, are limited. These findings provide concrete directions for practice in supporting (nearly) bereaved relatives in the context of euthanasia, potentially mitigating adverse health outcomes. Reporting method: Standards for Reporting Qualitative Research (SRQR checklist). Patient or Public contribution: Relatives of deceased cancer patients were involved in the conduct of the study. [ABSTRACT FROM AUTHOR]

Background: The death of a child is one of the most devastating events a family can face, resulting in significant physical and psychosocial morbidity. Bereavement support programs have been developed in high-income contexts to address this need. However, little is known about implementing bereavement programs in low-and middle-income countries (LMICs). Here, we describe the implementation of a bereavement program for parents whose children died due to cancer or other catastrophic illnesses. Methods: We conducted a retrospective analysis to describe the implementation of a hospital-based End of Life (EoL) care and bereavement program. This program was developed in several stages, including an assessment of bereaved families, development program guidelines, staff training, piloting of the program, refinement, and standardization. The program was developed between 2019 and 2021 in a nonprofit, teaching hospital and referral center for southwestern Colombia. Results: Several tools were developed as key components of the bereavement program: a virtual bereavement course; guidance for EoL and bereavement communication and care, memory making, and follow-up calls; a condolence letter template, and group support workshops. A total of 956 healthcare professionals were trained, 258 follow-up calls to bereaved parents were made, 150 individual psychological follow-ups to parents with complicated grief occurred, 79 condolence letters were sent, and 10 support group workshops were carried out. Challenges were identified and overcome, such as limited resources and staff, and cultural perceptions of death. In 2021, this program received an award by the hospital as the Best Strategy to Humanize Healthcare. Conclusions: This study highlights the feasibility of developing and implementing EoL and bereavement care programs for parents and families within hospitals in LMICs. Lack of resources, staff, and training are some of the identified challenges to implementation. Utilizing methodological tools allows us to identify facilitator factors and deliverable outcomes of our EoL and bereavement program. This model provides a valuable framework for resource-limited settings. [ABSTRACT FROM AUTHOR]

In light of the COVID-19 pandemic, a pediatric hospice in Ottawa, Ontario, implemented a Virtual Bereavement Group Program, necessitating a reorganization of care delivery during the global crisis. This paper outlines the program and assesses the feedback of families who participated in the program following the death of a child or grandchild. Participants expressed high levels of satisfaction, indicating its potential as an effective approach for pediatric bereavement care beyond the pandemic. [ABSTRACT FROM AUTHOR]

The death of a child may be the most traumatic event a family can experience. Bereavement care for parents is essential for their physical and mental well-being and is a psychosocial standard of care. Childhood mortality is higher in low- or middle-income countries (LMICs); however, little is known regarding bereavement support or interventions for parents in LMICs. To identify programs, services, initiatives, or interventions offered to bereaved parents in LMICs in hospital settings. A systematic search was executed following the Preferred Reported Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles from LMICs describing interventions, programs, or resources provided to parents after the death of a child (0–18 years old) from any cause were included. Extracted data was categorized by demographics, study design, outcomes, and quality assessment using the McGill Mixed Methods Appraisal Tool (MMAT). We retrieved 4428 papers and screened their titles and abstracts, 36 articles were selected for full-text assessment, resulting in nine articles included in the final analysis. Most interventions described support for parents whose child died during the prenatal or neonatal period. The primary interventions included psychological counseling, creating mementos (such as photographs or footprints), and bereavement workshops. Only one paper described a fully established bereavement program for parents. Eight of the papers met high-quality criteria. Although bereavement care is crucial for parents whose child has died, only a few studies have documented bereavement interventions in LMICs. More research may help with bereavement program implementation and improved care for bereaved parents in LMICs. [ABSTRACT FROM AUTHOR]

Introduction Palliative care of children (PCC) is a philosophical and a structured approach to providing tailored care to children with life-threatening diseases. Understanding the role of nurses and empowering them to take up the role of palliative care nurse are imperative to strengthen these services and make the palliative care services more accessible to the patients. Method The literature search was done in two database, PubMed and Scopus, using keyword and Medical Subject Headings (MeSH) terms such as children, palliative care, end of life, hospice, bereavement, and nursing. Records were screened by authors and relevant articles were included in the review. Discussion PCC should start with the diagnosis of the illness continue through all the phases of illness. Bereavement support to the family is also a part of palliative care. Nurses are in a key position to play important role in the PCC team. Nurses play various roles such as direct care provider, communicator, patient advocate, respite nurse, and counselor. Conclusion PCC is aimed to improve the quality of life of the child and family. It is crucial to achieving universal health coverage. Role of nurse is vital in providing PCC. [ABSTRACT FROM AUTHOR]

Perinatal death results in long-lasting intense grief for bereaved mothers with a potential to negatively impact on their short- and long-term outcomes and quality of life if inadequately supported in coping with and managing their experience. This study aimed at exploring the lived experience of women, of care and support following perinatal death in South-Western, Nigeria. A qualitative methodology using Heideggerian phenomenology was used. Fourteen women who had experienced perinatal death in South-Western Nigeria within the last (5) five years were interviewed, and Van Manen's approach to hermeneutic phenomenology was used in data analysis. Four main themes were identified: "they did not tell me the baby died", "response of health care professionals after the baby died", "moving on from hospital", and "support from family". The physical health status of mothers determined how they were informed of perinatal death. Health care professionals were distant, rude, nonempathetic and did not offer emotional support, in some cases. Mothers were given opportunity to see and hold their babies. There was no routine follow-up support in the community, besides a postnatal check-up appointment offered to all mothers regardless of their birth outcome. Family provided emotional support for mothers on discharge. This study was the first to explore the lived experience of women of the care and support following perinatal death in South-Western, Nigeria. There is a need for healthcare systems to review bereavement care and support provisions for women who experience perinatal death. [ABSTRACT FROM AUTHOR]

Introduction: This study describes the end-of-life (EOL) care planning and bereavement practices among adult day services centers (ADSC) when an ADSC participant is dying or has died. Methods: Data are from the 2018 National Study of Long-term Care Providers' biennial survey of ADSCs. Respondents were asked about the following 4 practices: 1) honoring the deceased in some public way in this center; 2) offering bereavement services to staff and participants; 3) documenting in the care plan what is important to the individual at the end of life (EOL), such as the presence of family or religious or cultural practices; and 4) discussing spiritual needs at care planning conferences. ADSC characteristics included US Census region, metropolitan statistical area status, Medicaid authorization, electronic health records (EHR) use, for-profit status, employment of aides, services provision, and model type. Results: About 50% to 30% of ADSCs offered the EOL care planning or bereavement services. Honoring the deceased was the most common practice (53%), followed by bereavement services (37%), discussing spiritual needs (29%), and documenting what is important at EOL (28%). Fewer ADSCs in the West had EOL practices relative to the other regions. The EOL planning and bereavement practices were offered more often in ADSCs that used EHRs, accepted Medicaid, employed an aide, provided nursing, hospice, and palliative care services, and were categorized as medical models, compared with ADSCs without these characteristics. Conclusion: These results highlight the importance of understanding how ADSCs provide EOL and bereavement care to participants who are near EOL. [ABSTRACT FROM AUTHOR]

Objectives: Relatives of patients who died after euthanasia or physician-assisted suicide (EAS) might need (specific) aftercare. We examined if and how physicians provide aftercare to bereaved relatives of patients who died after EAS, and which patient-, physician- and process characteristics are associated with providing aftercare.Methods: A cross-sectional questionnaire study was conducted among 127 physicians (general practitioners, clinical specialists, and elderly care physicians) in the Netherlands. Associations were examined using multivariable logistic regression analyses.Results: Most physicians had had at least one follow-up conversation with bereaved relatives (77.2%). Clinical specialists less often provided aftercare compared to GPs. Also, aftercare was more often provided when the deceased had a cohabiting partner. Topics addressed during aftercare conversations included looking back on practical aspects of the EAS trajectory, the emotional experience of relatives during the EAS trajectory and relatives’ current mental wellbeing. A minority of aftercare conversations led to referral to additional care (6.3%).Conclusion: Aftercare conversations with a physician covering a wide-range of topics are likely to be valuable for all bereaved relatives, and not just for “at risk” populations typically targeted by policies and guidelines.

Objective: The goal of this scoping review was to assess the scope and nature of evidence concerning culturally sensitive grief treatment and support interventions, aiming to provide valuable insights for future research on grief intervention development. Introduction: Prolonged grief disorder (PGD), associated with adverse psychosocial outcomes, requires treatment. The norms of a person's culture influence grief expression, mourning rituals, and perspectives on death. Despite increasing interest in culturally sensitive grief interventions, a comprehensive synthesis of evidence is lacking. A scoping review was deemed fitting to address this gap. Inclusion criteria: This review included studies featuring participants experiencing clinically relevant grief and engaged in culturally sensitive psychosocial grief interventions. It included studies conducted in non-WEIRD contexts or those focusing on sociocultural (sub)groups distinct from the majority (in terms of age, religion, sexual orientation, etc). Methods: Following JBI methodology for scoping reviews, 13 databases were searched (Scopus, Embase, Cochrane, Sociological Abstracts, IBSS, PTSDpubs, PsycINFO, PsycArticles, PSYNDEX, MEDLINE, CINAHL, SocINDEX, and Web of Science). Limits included language (English and German), peer-reviewed articles and publication date (from 2000). The two-step screening process (titles and abstracts, full text) was piloted, and data were extracted and collated. Results: Eighteen studies were included, displaying diversity in geographical location, methodology, and target populations. Interventions targeted various forms of clinically relevant grief, lost relationships, and sociocultural groups. Cultural adaptation processes varied, with seven studies using a top-down approach. Sources of information for formative research involved theoretical models and empirical data, while local experts and qualitative research (e.g., key informant interviews) informed cultural adaptation. Outcome measures were diverse, with 15 studies showing significant pre-post intervention changes, while two did not. Conclusions: The review highlighted the emerging significance of culturally sensitive interventions for PGD, emphasizing the need for standardized approaches and further research. By shedding light on gaps and providing recommendations, it offers insights for future researchers in this field.

It is widely acknowledged that midwives are essential in providing care for mothers experiencing perinatal death. However, midwifery students lack the knowledge and skills needed to deal with perinatal death, and. There is limited research on perinatal bereavement care training for midwifery students. To investigate undergraduate midwifery students' experiential learning of perinatal bereavement care and serve as a reference for future perinatal bereavement care teaching and training. Qualitative descriptive design. University in Guangzhou, China. Undergraduate midwifery students at a university in Guangzhou, China. This research was conducted at a university in Guangzhou, China. The participants were recruited using purposeful sampling. Semi-structured, in-depth interviews were conducted with 11 midwifery students who participated in perinatal bereavement care training from May to June 2023. The Colalizzi 7-step data analysis method was used for data analysis. From the data, five themes emerged: 1) immersive experience of perinatal bereavement care, 2) formation of perspectives on perinatal bereavement care, 3) clarification of the service boundaries and internalization of the professional service spirit, 4) emotional impact and coping strategies, and 5)) factors influencing practice optimization. Experiential learning is an effective teaching strategy. However, participants continued to feel unprepared to provide perinatal bereavement care. Implementing relevant training, disseminating perinatal bereavement care knowledge and skills, and enhancing the ability of midwifery students to manage and cope with the psychological impact of perinatal death are important. • Undergraduate midwifery (MW) students' perinatal bereavement care (PBC) experience was analyzed. • The first study published regarding MW students' learning experiences in reformed education program in a Chinese university. • Study findings can facilitate MW educators with PBC teaching. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic hindered access to routine healthcare globally, prompting concerns about possible increases in pregnancy loss and perinatal death. PUDDLES is an international collaboration exploring the impact of the COVID-19 pandemic on parents who experience pregnancy loss and perinatal death in seven countries, including Aotearoa New Zealand. To explore parents' experiences of access to healthcare services and support following baby loss during the COVID-19 pandemic in Aotearoa New Zealand. We conducted in-depth, semi-structured interviews with 26 bereaved parents, including 20 birthing mothers, and six non-birthing parents (one mother and five fathers). Types of loss included 15 stillbirths, four late miscarriages, and one neonatal death. Participant ethnicities were broadly representative of Aotearoa New Zealand's multi-ethnic society. Data were analysed using Template Analysis. Analysis revealed five themes relating to pandemic impact on bereaved parent's experiences. These were: 'Distanced and Impersonal care'; 'Navigating Hospital Rules'; Exclusion of Non-birthing Parents; 'Hindered Access to Social Support'; and 'Continuity of Relational Care'. The COVID-19 pandemic exacerbated isolation of bereaved parents through perceived impersonal care by healthcare professionals and restrictions on movement hindered access to social and cultural support. Compassionate bending of the rules by healthcare professionals and community postnatal visits by continuity of care midwives following the bereavement appeared to be mitigating factors. Social isolation is an added challenge for parents experiencing baby loss during a pandemic, which may be mitigated by flexible and compassionate care from healthcare professionals, especially continuity of care midwives. [ABSTRACT FROM AUTHOR]

Children’s grief, in perinatal loss, can be misunderstood and overlooked. Parental behaviour while mourning infant loss and parental ability to respond to their own grief has a crucial role in the child’s grief. This study aimed to explore parental behaviour as a determining factor in siblings’ grief following perinatal death. Six mothers and two fathers experiencing perinatal loss were interviewed about their perception of the child’s experience of perinatal death. Thematic analysis allowed for identifying of relevant themes. The main themes related to parents’ expression of grief, insight and understanding of their children’s grief and communicating the death/anticipated death with their surviving children. Findings showed that children seek out information on their deceased sibling and need supportive parents to guide them through their grief. Our study highlights that supporting parents in their grief is a key factor for a healthy grieving process in children and must be considered when supporting families in perinatal death. [ABSTRACT FROM AUTHOR]

• Increased understanding of how actor-based simulation can enable students to make sense of the complexities of caring for bereaved parents for the first time. • Addressing the potential of using actor-based simulation in reducing students' anxieties and concerns in communicating and responding to the needs of bereaved parents prior to clinical placement. • Enhanced understanding of how transformational learning theory can illustrate changes in students' perspectives and learning about compassionate holistic care. Student midwives frequently encounter bereaved parents in clinical practice; however, the experience of caring for bereaved parents can be a significant source of traumatic stress. Although the use of simulation to teach bereavement care is considered a powerful experiential form of learning, evidence for its effectiveness as a transformative learning strategy is limited. To explore student midwives' lived experience of caring for bereaved parents experiencing perinatal loss using high-fidelity simulation. Students midwives participated in an actor-based bereavement simulated scenario. Data was collected using semi-structured interviews. Interpretative Phenomenological Analysis was conducted to gain a deep understanding of the meaning of the experience. Mezirow's Transformative Learning Theory was applied as an analytical framework to illustrate how the student midwives made sense of and learned from the experience of caring for bereaved parents experiencing perinatal loss. One BSc (Hons), 156-week undergraduate midwifery programme within a university in the Northwest of England. A purposeful sample of nine first-and second-year student midwives volunteered to participate in the study. One of the superordinate themes that emerged from the analysis (1) ' trying to console and making things easier' and the related subthemes (1a) 'what words can I say', (1b)' my instinct was to console the mum', (1c)'left to sort of pick up the pieces' captured the deep sense of powerlessness and the professional dilemmas experienced as students struggled to emotionally console and communicate the right words to say to the grieving parents. The study highlights the vital role of simulation as a defined model of bereavement education that equips students with the necessary knowledge, skills, and confidence to provide compassionate care to bereaved parents experiencing perinatal loss. The emotional toll of caring for bereaved parents is significant, and higher education institutions should adopt experiential forms of learning using actor-based simulation scenarios to emotionally prepare students to care holistically for parents affected by perinatal loss. [ABSTRACT FROM AUTHOR]

Problem: Miscarriage and stillbirth can severely impact maternal mental well-being., Background: In Japan, local municipalities must prepare systems to provide mental and social-spiritual support to women after miscarriage or stillbirth., Objective: To elucidate what spiritually supports the mental health of women who have experienced miscarriages and stillbirths., Methods: This analysis included 25 women who had experienced miscarriage or stillbirth at least one month previously and participated in self-help group meetings at least twice. Data were collected from March 2020 to March 2021 using two narrative interviews and questionnaires., Findings: The mothers led their lives "together" with their children. They derived spiritual support from others, such as "the presence of someone who is living now after having experienced anguish" and "others who acknowledge the presence of my child and me as a mother. " Further elements of the support included "resigning myself to face my grief" and "strong links to deceased children. " While facing their grief by accepting that this anguish cannot be replaced [with anything else] and resigning themselves to reality, their bond to their child is strengthened., Conclusion: What women perceive as support after a miscarriage or stillbirth will be an important clue to care.