Palliative and End of Life Care Research Group, Population Health Sciences, Bristol Medical School, Bristol, UK.
Cardiff School of Dentistry, Cardiff University, Cardiff, UK.
Palliat Med. 2023 Apr;37(4):586-601. doi: 10.1177/02692163221133665. Epub 2022 Nov 6.
Voluntary and community sector bereavement services are central to bereavement support in the UK.
To determine service providers' perspectives on access to their support before and during the COVID-19 pandemic.
Mixed methods study using an explanatory sequential design: (1) Cross-sectional online survey of UK bereavement services; (2) Qualitative interviews with staff and volunteers at selected services.
SETTINGS/PARTICIPANTS: 147 services participated in the survey; 24 interviews were conducted across 14 services.
67.3% of services reported there were groups with unmet needs not accessing their services before the pandemic; most frequently people from minoritised ethnic communities (49%), sexual minority groups (26.5%), deprived areas (24.5%) and men (23.8%). Compared with before the pandemic, 3.4% of services were seeing more people from minoritised ethnic groups, while 6.1% were seeing fewer. 25.2% of services did not collect ethnicity data. Qualitative findings demonstrated the disproportionate impact of the pandemic on minoritised ethnic communities, including disruption to care/mourning practices, and the need for culturally appropriate support. During the pandemic outreach activities were sometimes deprioritised; however, increased collaboration was also reported. Online provision improved access but excluded some. Positive interventions to increase equity included collecting client demographic data; improving outreach, language accessibility and staff representation; supporting other professionals to provide bereavement support; local collaboration and co-production.
Service providers report inequities in access to bereavement support. Attention needs to be paid to identifying, assessing and meeting unmet needs for appropriate bereavement support. Identified positive interventions can inform service provision and research.
自愿和社区部门的丧亲服务是英国丧亲支持的核心。
确定服务提供者在 COVID-19 大流行之前和期间对获得支持的看法。
使用解释性顺序设计的混合方法研究：（1）对英国丧亲服务的横断面在线调查；（2）在选定的服务中对工作人员和志愿者进行定性访谈。
设置/参与者：147 家服务机构参与了调查；在 14 家服务机构中进行了 24 次访谈。
67.3%的服务机构报告称，在大流行之前，有一些群体的需求未得到满足，无法获得他们的服务；最常见的是少数民族社区（49%）、性少数群体（26.5%）、贫困地区（24.5%）和男性（23.8%）。与大流行前相比，有 3.4%的服务机构看到更多的少数民族群体，而有 6.1%的服务机构看到的少数民族群体减少了。25.2%的服务机构不收集种族数据。定性研究结果表明，大流行对少数民族社区造成了不成比例的影响，包括对护理/哀悼习俗的干扰，以及对文化上适当的支持的需求。大流行期间，外联活动有时被优先事项较低；然而，也有报道称合作增加了。在线提供服务改善了获取渠道，但排除了一些人。增加公平性的积极干预措施包括收集客户人口统计数据；改善外联、语言可及性和员工代表性；支持其他专业人员提供丧亲支持；地方合作和共同创作。
服务提供者报告称，在获得丧亲支持方面存在不平等现象。需要注意识别、评估和满足适当丧亲支持的未满足需求。确定的积极干预措施可以为服务提供和研究提供信息。
