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. 2021 Jun 30;5(3):BJGPO.2021.0008.
doi: 10.3399/BJGPO.2021.0008. Print 2021 Jun.

Supporting bereavement and complicated grief in primary care: a realist review

Caroline Pearce  1 , Geoff Wong  2 , Isla Kuhn  3 , Stephen Barclay  4
Affiliations

Supporting bereavement and complicated grief in primary care: a realist review

Caroline Pearce et al. BJGP Open. .

Abstract

Background: Bereavement can have significant impacts on physical and mental health, and a minority of people experience complicated and prolonged grief responses. Primary care is ideally situated to offer bereavement care, yet UK provision remains variable and practitioners feel uncertain how best to support bereaved patients.

Aim: To identify what works, how, and for whom, in the management of complicated grief (CG) in primary care.

Design & setting: A review of evidence on the management of CG and bereavement in UK primary care settings.

Method: A realist approach was taken that aims to provide causal explanations through the generation and articulation of contexts, mechanisms, and outcomes.

Results: Forty-two articles were included. Evidence on the primary care management of complicated or prolonged grief was limited. GPs and nurses view bereavement support as part of their role, yet experience uncertainty over the appropriate extent of their involvement. Patients and clinicians often have differing views on the role of primary care in bereavement. Training in bereavement, local systems for reporting deaths, practitioner time, and resources can assist or hinder bereavement care provision. Practitioners find bereavement care can be emotionally challenging. Understanding patients' needs can encourage a proactive response and help identify appropriate support.

Conclusion: Bereavement care in primary care remains variable and practitioners feel unprepared to provide appropriate bereavement care. Patients at higher risk of complicated or prolonged grief may fail to receive the support they need from primary care. Further research is required to address the potential unmet needs of bereaved patients.

Keywords: bereavement; community nursing; complicated grief; general practice; grief; primary health care.

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Figure 1.. Article selection process
Figure 2.
Figure 2.. Programme theory of supporting bereavement and complicated grief in primary care. CMOC = context–mechanism–outcome configurations
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References

    1. Nielsen MK, Carlsen AH, Neergaard MA, et al. Looking beyond the mean in grief trajectories: a prospective, population-based cohort study. Soc Sci Med. 2019;232:460–469. doi: 10.1016/j.socscimed.2018.10.007. - DOI - PubMed
    1. Kersting A, Brähler E, Glaesmer H, Wagner B. Prevalence of complicated grief in a representative population-based sample. J Affect Disord. 2011;131(1-3):339–343. doi: 10.1016/j.jad.2010.11.032. - DOI - PubMed
    1. World Health Organization ICD-11 for mortality and morbidity statistics (version: 09/2020). 6B42 Prolonged grief disorder. https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/118383.... [10 Mar 2021];
    1. King M, Lodwick R, Jones R, et al. Death following partner bereavement: a self-controlled case series analysis. PLoS One. 2017;12(3):e0173870. doi: 10.1371/journal.pone.0173870. - DOI - PMC - PubMed
    1. Guldin M-B, Ina Siegismund Kjaersgaard M, Fenger-Grøn M, et al. Risk of suicide, deliberate self-harm and psychiatric illness after the loss of a close relative: a nationwide cohort study. World Psychiatry. 2017;16(2):193–199. doi: 10.1002/wps.20422. - DOI - PMC - PubMed

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