Family Bereavement Support Interventions in Specialist Adult Palliative Care: A Rapid Mixed-Methods Systematic Review

ABSTRACT Aim To synthesise evidence on the impact of pre- and post-loss family support interventions on bereavement outcomes and families' perceptions of their usefulness and benefits in specialist palliative care. Design A rapid mixed-methods systematic review drawing on JBI and Cochrane guidance. Study quality was appraised using the Mixed-Methods Appraisal Tool. Qualitative and quantitative data were analysed using a meta-aggregation and narrative analysis approach combined with narrative synthesis. Data Source We searched Medline, CINAHL, PsycINFO, Embase and Cochrane Library and included articles published between 2004 and 2024 that evaluated pre- and post-loss family support in specialist adult palliative care and assessed bereavement outcomes. Results The search yielded 3682 records. We included thirty-nine mostly moderate to high-quality studies (57% quantitative). Results suggest that pre-loss support, like family-focused interventions and communication during dying, may mitigate post-loss anxiety, depression and grief. Individual and group post-loss support interventions may reduce anxiety, distress and grief while improving well-being. Families desire individualised and comprehensive pre- and post-loss support, with few not needing or accepting it. Stigma associated with bereavement, support and barriers can hinder access. Conclusion Included studies demonstrated mixed effects of pre- and post-loss family support interventions, suggesting they are beneficial when accessible and tailored to family needs. High-quality intervention research assessing a broader range of family bereavement outcomes is needed. Impact Palliative care nurses and other health professionals should tailor their care to family needs, start family support before patient death and ensure equitable access to bereavement services. Our results may guide palliative care professionals in designing effective, personalised and accessible services and policymakers in allocating resources for bereavement care. Findings highlight research needs, including investigating barriers to care and accessibility of services. High-quality research is needed to understand who benefits the most from health-promoting bereavement support and why. Reporting Method We adhered to the PRISMA guideline. Patient and Public Contribution No Patient and Public Contribution. Protocol Registration Open Science Framework https://osf.io/36jeu