End-of-life and immediate postdeath acute hospital interventions: scoping review.

Journal article


Green, L., Stewart-Lord, A. and Baillie, L. (2022). End-of-life and immediate postdeath acute hospital interventions: scoping review. BMJ supportive & palliative care. https://doi.org/spcare-2021-003511
AuthorsGreen, L., Stewart-Lord, A. and Baillie, L.
AbstractHospital remains the most common place of death in the UK, but there are ongoing concerns about the quality of end-of-life care provision in this setting. Evaluation of interventions in the last days of life or after a bereavement is methodologically and ethically challenging. The aim was to describe interventions at the very end of life and in the immediate bereavement period in acute hospitals, with a particular focus on how these are evaluated. A scoping review was conducted. Studies were restricted to peer-reviewed original research or literature reviews, published between 2011 and 2021, and written in the English language. Databases searched were CINAHL, Medline and Psychinfo. From the search findings, 42 studies were reviewed, including quantitative (n=7), qualitative (n=14), mixed method (n=4) and literature reviews (n=17). Much of the current research about hospital-based bereavement care is derived from the intensive and critical care settings. Three themes were identified: (1) person-centred/family-centred care (memorialisation), (2) institutional approaches (quality of the environment, leadership, system-wide approaches and culture), (3) infrastructure and support systems (transdisciplinary working and staff support). There were limited studies on interventions to support staff. Currently, there are few comprehensive tools for evaluating complex service interventions in a way that provides meaningful transferable data. Quantitative studies do not capture the complexity inherent in this form of care. Further qualitative studies would offer important insights into the interventions. [Abstract copyright: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.]
KeywordsSupportive care; Terminal care; Bereavement; Hospital care; Service evaluation
Year2022
JournalBMJ supportive & palliative care
ISSN2045-4368
Digital Object Identifier (DOI)https://doi.org/spcare-2021-003511
https://doi.org/10.1136/spcare-2021-003511
Publication dates
Online27 Jul 2022
Publication process dates
Accepted28 Jun 2022
Deposited22 Aug 2022
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Open
Page rangebmjspcare-2021-003511
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