Bereavement follow-up after critical illness

Objective: To describe the establishment and initial activity of a Bereavem ent 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 quali ty of intensive care service and the early impact on next-of-kin of their b ereavement. Design: Gross-sectional prospective study, which was conducted by a structu red 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-ki n of all 151 patients who died in 1995, and 104 were contacted. Five declin ed to be interviewed. The results refer to 99 who consented to telephone in terview a median of 33 days after the death. a total of 84 considered thems elves well informed during the intensive care period, 76 understood the fat al sequence of events but 19 of them would have liked more information, a t otal of 77 had positive comments about the quality of care, most commonly a bout compassionate behavior (58), but 30 had negative comments, most common ly 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 dist urbance at some stage (still present in 44), but only 12 were taking sedati ves or antidepressants. A total of 32 had financial difficulties and 21 wer e 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, inc luding work, and few were living alone. However, sleep disturbance and fina ncial difficulty were common, and some requested help from other support ag encies.