An intervention study on complicated grief in bereaved relatives, before and after the introduction of a new protocol in bereavement care
by nurses supporting the relatives during and after the death of a patient in the intensive care unit.

When a patient dies at the ICU, most of the relatives in the intensive care unit (ICU) need to make a rapid transition from aiming at recovery of their beloved one, to preparation for an unavoidable death. Bereaved relatives may develop complicated grief as a consequence of this burdensome situation. Complicated grief has been included in the Post Intensive Care Syndrome Family (PICS-F) and is characterized by intense symptoms of grief enduring for more than 6 months post-loss, separation distress, intrusive thoughts, and feelings of emptiness or meaninglessness. It could lead to negative health outcomes, advanced medical service utilization, and high economic costs. However, little is known on the true prevalence of complicated grief in bereaved relatives in the ICU.

Patients in Dutch hospitals die rapidly, resulting in a dignified death with a low burden of suffering and little signs of discomfort. It is therefore valuable to assess complicated grief and the experiences with quality of bereavement care in relatives in a Dutch ICU. This study aims to contribute in knowledge on complicated grief.

The introduction of the intervention may help to reduce the risks of presenting symptoms of complicated grief, depression, anxiety. Furthermore, it may improve the quality of experiences with bereavement care in the ICU.

Cohort 1, Patient died in 2018
Cohort 2, Patient died in 2019

Introduction of newly developed bundle of interventions in bereavement care, including an information leaflet on loss and grief, a condolence greeting card, material to make a memory, and follow-up call by nurses 6 weeks post-death.