Bereavement Support on the Frontline of COVID-19: Recommendations for Hospital Clinicians
Bereavement Support on the Frontline of COVID-19: Recommendations for Hospital Clinicians
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DOI：
10.1016/j.jpainsymman.2020.04.024
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发表时间：
2020-08-01
影响因子：
4.7
通讯作者：
Koffman, Jonathan
中科院分区：
文献类型：
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作者：
Selman, Lucy E.;Chao, Davina;Koffman, Jonathan
因COVID-19死亡的风险因素可能导致亲属长期悲伤障碍、创伤后压力和其他不良的丧亲结果，以及前线员工的精神伤害和痛苦。在这里，我们回顾了相关的研究证据，并为医院临床医生提供循证建议和资源，以减轻丧亲之痛的结果和支持人员。对于亲属来说，丧亲风险因素包括在重症监护室死亡，严重呼吸困难，患者隔离或限制访问，严重的患者和家庭情绪困扰，以及亲属社会支持网络的中断。建议包括提前护理计划积极主动，敏感，并定期与家庭成员沟通，同时提供准确的信息;使家庭成员在可能的情况下亲自道别;支持虚拟通信;提供出色的症状管理和情感和精神支持;并提供和/或路标丧亲服务。为了减轻这种具有情感挑战性的工作对工作人员的影响，我们建议采取一种组织和系统的方法，包括获得非正式和专业的支持。(C)2020年美国临终关怀和姑息医学学院。爱思唯尔公司出版All rights reserved.
Deaths due to COVID-19 are associated with risk factors which can lead to prolonged grief disorder, post-traumatic stress, and other poor bereavement outcomes among relatives, as well as moral injury and distress in frontline staff. Here we review relevant research evidence and provide evidence-based recommendations and resources for hospital clinicians to mitigate poor bereavement outcomes and support staff. For relatives, bereavement risk factors include dying in an intensive care unit, severe breathlessness, patient isolation or restricted access, significant patient and family emotional distress, and disruption to relatives' social support networks. Recommendations include advance care planning proactive, sensitive, and regular communication with family members alongside accurate information provision; enabling family members to say goodbye in person where possible; supporting virtual communication; providing excellent symptom management and emotional and spiritual support; and providing and/or sign-posting to bereavement services. To mitigate effects of this emotionally challenging work on staff we recommend an organizational and systemic approach which includes access to informal and professional support. (C) 2020 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.