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Background: The loss of a loved one through death is one of the most stressful life events and may result in major psychological changes requiring significant adjustment. In addition, alteration to health related behaviours such as appetite and sleep, altered immune response, elevated heart rate and blood pressure have been previously reported in bereavement, particularly in spouses or parents of deceased. While strong evidence of the effectiveness of bereavement interventions to reduce grief reactions is lacking, except in prolonged or complicated grief responses, to date no review exists evaluating the evidence for bereavement interventions to improve non-psychological outcomes during bereavement. Objective: The objective of this thesis is to present an integrative literature review of evidence to date reporting interventions related to non-psychological outcomes in an attempt to assess their effectiveness in bereavement. Method: A comprehensive search was conducted in PubMed, MEDLINE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO and the BioSciences Information Service of Biological Abstracts (BIOSIS) using combinations of the following key words: bereavement or grief, intervention, treatment, medication and counselling. No date limitations were applied to the search of literature. Studies were categorised by primary outcomes. Reference lists of categories included in the review were then hand searched to identify any additional literature. Results: Thirteen studies testing bereavement interventions were included for analysis in the review. The selected studies addressed three main areas: general health, sleep disturbance and immune function response following bereavement, and reported findings on the impact of psychological counselling intervention and pharmacological intervention. Four studies reported on general health following bereavement in which counselling interventions appears to be of most value in distressed parents, low social support spouses and bereaved with altered health status (such as immunosuppression) in improving or maintaining general heath. Sleep disturbance was addressed using counselling intervention in two studies and a pharmacological intervention (nortriptyline) tested in another two studies with both intervention approaches demonstrated significant improvement in self-reported sleep quality in bereaved individuals with complicated grief. Additionally, the four studies reported counselling intervention effects on immune function to date suggest that counselling interventions may be of some benefit bereaved individuals with altered health status (i.e. immunosuppression secondary to HIV) but lack evidence of benefit in individuals with normal immune function. Conclusion: Based on the findings of this review, bereavement interventions seem to have some value in both elderly, especially in those with complicated grief reactions and those with prior immune-compromised status in maintaining health status. Bereavement is universal and inevitable for most and further research is warranted to enhance physical well-being during this time of readjustment, while allowing normal grieving process to take its natural course.
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