Evaluation of the bereavement program of the palliative care unit at St. Boniface General Hospital : a pilot study

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Hildebrandt, Tracy L.
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The period of bereavement has been linked with changes in physical and mental functioning of the individual, with the precipitation of illness or death, with the increase of health threatening behaviors such as drinking, smoking and drug use, and with the increased used of health services. The strain on the health status of the individual has implications for society and the health care system. Different types of interventions have been postulated to ameliorate the effects of bereavement such as mutual support groups, hospice programs, and psychotherapy. It is unclear which intervention is most effective. As competition for health care dollars increases, it is crucial that the most effective way to provide care for bereaved individuals be delineated. Therefore, it was proposed that the bereavement program at St. Boniface General Hospital be evaluated. The study used a quasi-experimental design with one experimental group and one non-equivalent control group. A pretest measure was taken within seventy-two hours of the patient being admitted to the institution to determine the presence of anticipatory grieving. Outcome measures were taken at six weeks and six and twelve months post death. The primary measurement tools used in the study were the Goldberg (1978) General Health Questionnaire and the Demi and Schroeder (1985) Bereavement Experience Questionnaire. The results of this quasi-experiment did not demonstrate a statistically significant difference between individuals who participated in a bereavement program and those who did not. Since a small sample size was used, the investigator had only a 51% chance of detecting a large difference between the groups. Therefore, the differences found between the groups were "clinically significant". At six-weeks post death the bereavement program appeared to decrease the intensity of the grieving response especially in the areas of anger, meaninglessness, yearning, and morbid fears. As the process of bereavement continues after the six week period, concrete recommendations with be withheld until the final measurements have been made.