The role of the Community Nurse in bereavement support

Abstract

Evidence from studies conducted in North America and Australia suggest that bereavement increases the risk of mental and physical health problems although in the United Kingdom the extent of this problem remains largely unknown. In the community the District Nurse Service plays a pivotal role in the provision of palliative care, however, little is known about nurses' views on bereavement support or their actual involvement. This thesis presents three studies that report bereavement from the primary care perspective in the United Kingdom. The first study describes a prospective exploratory case study which was conducted with 13 bereaved people, who were recruited through primary care practitioners and funeral directors, to measure the impact of bereavement on aspects of mental health. The second study reports a postal survey which aimed to ascertain the current practice and perceived role in supporting bereaved people from a representative sample of district nurses in the central southern coastal area of Britain. This achieved an overall response rate of 62% (323) following two reminders. The results of the postal survey led to the third study which reports a series of in depth audio-taped interviews with 22 district nurses. Using a qualitative methodology this explored in greater depth the perceived role, beliefs, value and motives of district nurses in bereavement support. The results suggest that greater clarification of the future role of the District Nurse Service in bereavement support is warranted. District nurses require better training and awareness of bereavement issues at pre and post registration and to improve their awareness of available bereavement support at both a local and national level. District nurses would be suited to a role in the assessment and referral of bereaved people to other services, although a specialist bereavement role does not appear to be welcomed by most district nurses. In the final chapter I critically explore and reflect on the difficulties experienced while attempting to perfonn research with bereaved people and provide evidence to suggest that my research has been affected by a fundamental shift in society'S view of bereaved people which may explain many of the difficulties experienced.

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