Bereavement follow-up after critical illness

Objective: To describe the establishment and initial activity of a Bereavement Follow-up Service for next-of-kin of patients who died in an intensive care unit (ICU) and to quantify aspects of their experience including quality of intensive care service and the early impact on next-of-kin of their bereavement. Design: Gross-sectional prospective study, which was conducted by a structured telephone interview. Setting: A 14-bed adult general ICU in a tertiary university hospital. Subjects: A total of 99 next-of-kin of patients who died in ICU. Interventions: Referral to other agencies if requested. Measurements and Main Results: Attempts were made to contact the next-of-kin of all 151 patients who died in 1995, and 104 were contacted. Five declined to be interviewed. The results refer to 99 who consented to telephone interview a median of 33 days after the death. a total of 84 considered themselves well informed during the intensive care period, 76 understood the fatal sequence of events but 19 of them would have liked more information, a total of 77 had positive comments about the quality of care, most commonly about compassionate behavior (58), but 30 had negative comments, most commonly about poor communication (13). Only 7 were living alone, 85 had resumed normal activities, 40 of 47 workers had returned to work, 58 had sleep disturbance at some stage (still present in 44), but only 12 were taking sedatives or antidepressants. A total of 32 had financial difficulties and 21 were referred to other agencies, most commonly grief counselors. Conclusions: We were disappointed to contact only two thirds of next-of-kin, but results from these subjects demonstrated a high level of satisfaction with the care given. Nevertheless, some were dissatisfied with the quality of service they experienced. Most had resumed their normal activities, including work, and few were living alone. However, sleep disturbance and financial difficulty were common, and some requested help from other support agencies.