Bereavement Care Research Articles

To explore midwives' experiences of providing psychosocial interventions to parents following perinatal bereavement in maternity care settings. A descriptive qualitative study. Twenty-two midwives were recruited from three maternity services in Ireland using purposive and snowball sampling. Semi-structured interviews were conducted between July and November 2024. Reflexive thematic analysis was used to analyse the data. Four themes were identified: (1) Building relationships as a foundation for psychosocial intervention delivery; (2) Psychosocial intervention as the core element of perinatal bereavement care; (3) Negotiating intervention delivery in a constrained system; and (4) Navigating emotional labour and professional growth. Midwives advocated provision of compassionate and relationship-based psychosocial interventions, but often faced systemic barriers, limited guidance, and insufficient training. Supportive structures and psychosocial intervention focused training were seen as critical to sustaining care quality and midwives' wellbeing. Applying the Socio-Ecological Model (SEM) revealed that midwives' delivery of PSIs to support grieving parents after perinatal bereavement is influenced by multi-level factors, underscoring the need for policy integration, institutional support, and contextually grounded, midwife-led approaches. Integrating SEM into intervention design can guide the development of multi-component PSIs that address multilevel influences and align with both parents' needs and midwives' capacities. This adds to the understanding of how midwives deliver psychosocial interventions in perinatal bereavement care. Midwives view the delivery of these interventions as central to their role, while acknowledging the need for the development of, and training in structured, midwife-led psychosocial interventions in perinatal bereavement care. COREQ. Patients and members of the public were involved in study design, data collection and validation of findings. Their contributions included reviewing protocols and recruiting materials, facilitating recruitment and participating in advisory groups, ensuring the relevance and sensitivity of the research.

ABSTRACT Background Existing literature acknowledges photography’s potential as a supportive psychosocial intervention for parents experiencing perinatal loss. However, empirical research that centres bereaved parents’ lived experiences remains limited. Methods To explore the meaning of photography in the context of perinatal loss, a qualitative approach was utilised, combining life story and semi-structured interviews with bereaved parents (seven interviews, including two dyadic; n = 9). Results Photography was described as one among several forms of memorabilia, yet distinguished by its tangibility and shareability. Parents discussed a spectrum of photographic representations – from raw to serene – shaped by factors such as the photographer’s professional background. The photographs fulfilled multiple functions, including sharing the child with the outside world, facilitating conversations, and connecting with peers. For some, engaging with photography fostered a more active and engaged role towards other bereaved parents. However, this engagement was not always met with social acceptance. Conclusion Our research shows the value of photography in the context of perinatal loss while also pointing to several recommendations at the level of bereavement care in hospital policies and practices (e.g. facilitating collaboration with professional photographers).

The aim of the research is to adapt the Perinatal Bereavement Care Confidence Scale (PBCCS) into Turkish and to test whether it is a valid and reliable measurement tool in Türkiye by assessing its psychometric features. The sampling of this methodological research involved 462 Midwives and Nurses working in the Maternity Unit-Gynecology Services of hospitals in Türkiye. Data were collected through a Google form and a face-to-face survey, facilitated by sharing the online survey link on social media. Additionally, the "Socio-demographic Information Form" and the "Perinatal Bereavement Care Confidence Scale" were utilized. The construct validity of the scale was conducted by confirmatory factor analysis (CFA). The reliability of the scale was examined by calculating the Cronbach's α coefficient. In Turkish version, the 43-item PBCCS was reduced to 35 items: Bereavement Support Knowledge (10 items, three subscale), Bereavement Support Skills (9 items, two subscale), Self-awareness (6 items, two subscale) and Organizational Support (10 items, two subscale). Confirmatory factor analysis demonstrated that the four scales in PBCCS had acceptable fit indices. Cronbach's α of the scale was ranging 0.70-0.87. PBCCS was found to be a psychometrically safe measurement tool for evaluating midwives' and nurses' confidence in providing perinatal bereavement care in Türkiye.

Perinatal loss can occur in as many as 31% of pregnancies. The difficult grief surrounding a fetal demise impacts nurses as well as the families. Perinatal bereavement programs (PBP) in obstetrical and emergency departments can offer the potential of more supportive workflow and work environments for patients and health care professionals. Organizational responses to meet the needs of bereaved families and protect nursing staff should include structured protocols and designated bereavement care teams. We evaluated the work system of a novel PBP to explore adaptation and dissemination efforts. In effort to better understand the interactions between various work elements and the function of the PBP, we conducted a work system analysis. The analysis established an example of an interdisciplinary approach to attending to all social, technical and environmental considerations when addressing psychosocial and physical risks to both patients and staff and can be an example for interventions targeting perinatal bereavement.

ABSTRACT Background Neurodivergent children and young people face unique challenges in grief, including exclusion from death-related rituals and pathologised grief responses. Limited understanding of their experiences has led to a lack of adapted art therapy interventions. This study was instrumental in re-evaluating a bereavement service for children and adolescents through a neuro-inclusive lens. Aims This research aims to explore neurodivergent grief from a family perspective and to inform relevant adaptations to art therapy practice, ultimately contributing to the development of neuro-inclusive bereavement services. Methods As part of a whole-family intervention model, the team conducted nine semi-structured interviews with parents whose children were receiving bereavement care at a hospice. These interviews were analysed using Interpretative Phenomenological Analysis (IPA). Results Analysis generated four main themes: (1) Interconnected grief and emotional experiences, (2) Communication and Advocacy, (3) Peer support and validation of parents and carers’ experiences, (4) Race and culture. Findings emphasise the need for adaptations to support services for bereaved neurodivergent children and their families, as well as a more nuanced understanding of neurodivergent grief. Conclusions This study reveals the complex nature of grief in neurodivergent youth and underscores the need for further research. Grounded in social constructionism, the research team co-created a trans-contextual perspective model with service-users, illustrating how grief and neurodiversity intersect across varied environments. Implications to practice The research informed the development of key adaptations to art therapy practice, including changes to the therapeutic environment, development of neuro-affirmative practitioner skills, and a conceptual framework to guide neuro-inclusive practice. Plain-language summary This paper explores the adaptations made for pre-and-post bereavement therapy, focusing on bridging gaps for support of neurodivergent children and young people in the Child and Adolescent Bereavement Service (CABS) at Harlington Hospice. Recognising the challenges faced by bereaved neurodivergent children and their families, the authors present their findings from qualitative research alongside their views on modifying art therapy approaches. Given the lack of research on bereavement experiences among individuals with neurodevelopmental conditions, their exclusion from death-related rituals, and the misunderstanding of neurodiverse grief responses, the authors propose a model that examines the connection between neurodiversity and grief.

Exploring reactivity effects of self-monitoring prolonged grief reactions in daily life: A randomized waitlist-controlled trial using experience sampling methodology

Witnessing a loss and the lived experiences of physicians, nurses, and midwives providing care in perinatal loss in Turkey: A phenomenological study.

Navigating grief Pedagogy in Midwifery: Insights from interviews with clinical midwifery educators.

Profiles of fluctuating prolonged grief disorder reactions using experience sampling data.

Nigeria has one of the highest rates of stillbirth in the world. Existing research about the state of bereavement care continues to paint a bleak picture. This study explores the stillbirth bereavement care practices of Nigerian midwives. Purposive sampling was employed to recruit a sufficient sample of 11 Nigerian midwives, who were subsequently interviewed using a semi-structured interview guide. Data were analyzed using the template analysis technique, which involved the use of a coding template to organize themes. Two main themes were identified: "Family-first, woman later" describes the practice of communicating stillbirth diagnoses to families before informing the woman; "Beliefs-driven care" describes the role of cultural values in facilitating some aspects of care, such as holistic care, while hindering other aspects such as memory-making. Cultural beliefs influence stillbirth bereavement care practices. Clear clinical guidelines are needed to support midwives in managing cultural issues associated with stillbirth bereavement.

Perinatal loss is a profoundly complex form of grief, often linked to heightened risk of prolonged bereavement and adverse mental health outcomes. Perinatal grief rooms-private, supportive spaces within healthcare settings-aim to help families process their loss, spend time with their baby, and create meaningful memories in a respectful environment. While bereavement care has received growing attention, the role of the physical environment in supporting grief remains underexplored. To synthesize current evidence on how dedicated physical spaces can support individuals and families after perinatal loss, and to identify priorities for research, design standards, and interdisciplinary collaboration. A narrative review was conducted in accordance with PRISMA-ScR guidelines. Literature searches were performed across PubMed, PsycINFO, Medline (OVID), Embase, ScienceDirect, SCOPUS, SciELO, and Google Scholar using terms, such as "perinatal grief rooms", "bereavement rooms", "angel suites", "butterfly suites", "snowdrop suites", "cloud rooms", "designated units for perinatal loss", and "birthing + bereavement suites". The review examined (1) the current role of physical spaces in the perinatal loss experience, and (2) how their availability and design may influence grief outcomes. Of the 17 articles meeting inclusion criteria, only 4 (24%) referenced bereavement rooms, and just 3 (18%) noted the need for formal protocols-without offering concrete examples. No studies evaluated implementation, design standards, or measurable impact on grief, mental health, or family well-being. This lack of empirical evidence and standardized guidance underscores a critical gap that limits integration of therapeutic environments into perinatal bereavement care. Despite increasing recognition of the importance of bereavement care, dedicated grief rooms remain under-researched and inconsistently implemented. Advancing this field will require rigorously designed studies, development of design standards, and collaborative partnerships among healthcare providers, researchers, policymakers, and design experts to ensure equitable access to therapeutic spaces for grieving families.

Objective:Bereavement support is recommended in specialised palliative care, but it is often underdeveloped. This study assessed palliative care professionals’ (PCPs’) skills in family care, their attitudes towards evidence-based practices, and their perceptions of a new, evidence-based bereavement care guidance before its implementation.Methods:A cross-sectional study was conducted between September and December 2023 in specialised palliative care services in two Swiss hospitals. Seven validated instruments were used to assess PCPs’ skills in family care (FNPS, EPCS, and ICS-Nurse), attitudes towards evidence-based practices (EBP-B), and perception of a newly developed, evidence-based bereavement care guidance (acceptability AIM, appropriateness IAM, feasibility FIM). The data were analysed using descriptive and nonparametric methods.Results:The 39 participants (response 63%; 28 nurses, 6 physicians, 5 others) rated their skills in family care as high (median ⩾75% of scale range) and had an open attitude towards evidence-based practices (median 64%). They perceived the bereavement care guidance as highly acceptable and appropriate (median 75%) and rather feasible (median 68%). A more favourable attitude towards evidence-based practices was associated with higher perceived acceptability (Spearman’s rho, p = 0.038), appropriateness (Spearman’s rho, p = 0.029), and feasibility (Spearman’s rho, p = 0.0019) of the guidance. Acceptability, appropriateness, and self-assessed skills (FNPS) depended on the local context (Mann-Whitney U test, p ⩽ 0.022).Conclusion:This study shows that PCPs rate their skills in working with families at the end of life as high and perceive evidence-based bereavement care as implementable. An open attitude towards evidence-based practices supports more favourable perceptions of new bereavement care guidance before its implementation.

ABSTRACT Many phrases about loss, grief and bereavement that I have routinely used in my work arrived as epiphanies. Reflection is a natural activity. To a greater or lesser extent, we all spend time going back over what we have heard, read, said or done. In this essay I share discernment of five of my core epiphanies used in my work in the hope they will prompt consideration of your own list or will lead each of us to deeper reflection about phrases frequently given voice in grief and bereavement care.

To synthesise evidence on the impact of pre- and post-loss family support interventions on bereavement outcomes and families' perceptions of their usefulness and benefits in specialist palliative care. A rapid mixed-methods systematic review drawing on JBI and Cochrane guidance. Study quality was appraised using the Mixed-Methods Appraisal Tool. Qualitative and quantitative data were analysed using a meta-aggregation and narrative analysis approach combined with narrative synthesis. We searched Medline, CINAHL, PsycINFO, Embase and Cochrane Library and included articles published between 2004 and 2024 that evaluated pre- and post-loss family support in specialist adult palliative care and assessed bereavement outcomes. The search yielded 3682 records. We included thirty-nine mostly moderate to high-quality studies (57% quantitative). Results suggest that pre-loss support, like family-focused interventions and communication during dying, may mitigate post-loss anxiety, depression and grief. Individual and group post-loss support interventions may reduce anxiety, distress and grief while improving well-being. Families desire individualised and comprehensive pre- and post-loss support, with few not needing or accepting it. Stigma associated with bereavement, support and barriers can hinder access. Included studies demonstrated mixed effects of pre- and post-loss family support interventions, suggesting they are beneficial when accessible and tailored to family needs. High-quality intervention research assessing a broader range of family bereavement outcomes is needed. Palliative care nurses and other health professionals should tailor their care to family needs, start family support before patient death and ensure equitable access to bereavement services. Our results may guide palliative care professionals in designing effective, personalised and accessible services and policymakers in allocating resources for bereavement care. Findings highlight research needs, including investigating barriers to care and accessibility of services. High-quality research is needed to understand who benefits the most from health-promoting bereavement support and why. We adhered to the PRISMA guideline. No Patient and Public Contribution. Open Science Framework https://osf.io/36jeu.

This study aimed to elucidate the grief experiences of Brazilian COVID-19 bereaved adults by exploring both helpful and unhelpful experiencesSemi-structured interviews were conducted with 10 participants, and the data were analyzed using Thematic Analysis. Four themes emerged: (1) healthcare experiences, (2) circumstances of death, (3) the grief experience, and (4) dissatisfaction with COVID-19 crisis management. The themes revealed that the quality of hospital care, including both positive and negative interactions with healthcare professionals, shaped perceptions of death. Experiencing the death as sudden and constraints on visitation and restrictions on farewell rituals were reported to negatively affect the grief experience. Many participants expressed dissatisfaction with political crisis management and believed the death could have been prevented. These findings highlight the potential impact of circumstances surrounding COVID-19-related deaths on the grief experience, underscoring the need for clinical interventions and public health policies to optimize end-of-life and bereavement care during pandemics.

Conservators' care for artworks extends throughout a work's ‘lifetime' as conservators manage change over time. The article follows from Martha Singer's work on ‘Palliative care for contemporary art conservation' to introduce a case study on a speculative prototype, Cyberdesk (1993), made in a polyurethane elastomer by the American industrial designer, Lisa Krohn. At present, 30 years after its conception, the work's aging trajectory poses significant questions about recognition, interpretation, and decline. Conducting a ‘care conversation’ with the artist demonstrated the need to recognise emotional reactions to negative change and to better understand theories of grief. In proposing ways for conservators to care through decline by translating practices from medical care to art conservation, this article engages with care literature and responds to a need for further development of social care practices in art conservation.

IntroductionFamily physicians (FPs) provide essential support during life’s most challenging moments, including experiences of grief and loss. After a patient’s death, FPs are expected to provide information and emotional support to bereaved family members. Prior research suggests that bereaved relatives expect follow-up contact from their FP, acknowledging it as part of the physician’s role. This study aims to explore the practices and attitudes of FPs towards bereaved family members.MethodsA cross-sectional, descriptive study was conducted through an online questionnaire, exploring participants’ perceived role in bereavement care, the type of support offered to families, available resources in primary care, as well as personal knowledge and approach on grief. This questionnaire was distributed via digital platforms to general and family medicine doctors.ResultsA total of 210 physicians participated (84.3% female; 53.8% in residency), with a median age of 32 years old. On average, each FP experienced five patient deaths, most often reported by family members. More than half (53.3%) contacted bereaved families in fewer than 25% of cases, typically within 7 days of the death, most commonly by phone (76.5%).ConclusionThis study highlights significant gaps in the bereavement follow-up practices of FPs in Portugal. Findings emphasise the need for integrated bereavement care guidelines in primary care, institutional policies and investment in targeted training programmes to enhance grief’s approach. The reported lack of grief training reinforces the need to integrate grief education into medical curriculum and continuous professional development. Structural improvements, such as the implementation of automatic death notifications within the healthcare system, are also critical for enabling timely and effective support.

A call for interdisciplinary bereavement care in miscarriage and stillbirth: a stepped-care model approach.

Faye Hill discusses Abigail's Footsteps' upcoming conference for student midwives, a 1-day event focusing on baby loss and bereavement care

Viewing the deceased person is an integral part of hospital-based bereavement care and support. To date, research to guide this practice is scarce. To describe and interpret the bereaved family lived experience of an in-hospital supported viewing service situated in an acute hospital facility in the UK. A specific objective was to uncover and examine personal reflections on the choices and care provided. A qualitative exploratory design involving telephone interviews with ten family members, bereaved of an adult relative. Data were subjected to interpretative phenomenological analysis. Three group experiential themes and seven subthemes were developed from the data. Thematic findings provide insights into the context of viewing and family care, informed choice and the reasons behind a decision to view, personal preferences, observations and reactions to viewing, the intimacy of the viewing experience and the hallmarks of quality care. The acute hospital, as a core provider of end-of-life care requires a workforce who are skilled to provide practical and relational care after death. The quality of care in preparing and presenting the deceased person for viewing, the ambience of the viewing facility and a compassionate, person-centred approach appeared central to a positive viewing experience. Consideration should be given to the supportive role of a specialist bereavement nurse and interprofessional team contributions to viewing practices and care.