Bereavement in haemodialysis units: a scoping review of the perspectives and experiences of patients and nursing staff and support strategies.

Abstract

Frequent haemodialysis creates close-knit communities within treatment units, where high patient mortality contributes to significant grief among patients and staff. Despite the emotional toll, support for grief and bereavement in these settings remains limited, and recent data are lacking. This scoping review aims to explore how patients and nursing staff within haemodialysis units experience and cope with bereavement, and to identify support strategies currently used or desired to inform future, culturally sensitive approaches, particularly in Australia. Scoping review conducted in accordance with the Joanna Briggs Institute methodology. A comprehensive search was conducted using the Clinical Information Access Portal, supplemented by grey literature and the Elicit AI Research Assistant tool. We included literature exploring patient and nurse perspectives on grief and bereavement in haemodialysis units. Studies outside the haemodialysis setting and non-English studies were excluded. There were no geographical or publication year limitations. Two reviewers independently screened titles, abstracts and full texts, with discrepancies resolved by consensus. A data extraction table was used to collect study characteristics and key findings. Thematic analysis was applied to synthesise data across studies. 17 publications from 1998 to 2021 were identified across five countries. Grief and bereavement following patient death profoundly shape haemodialysis unit dynamics. Patients form familial bonds and experience deep grief when peers die, while nurses face emotional stress and burnout. Reported support strategies include memorial services, peer and staff support, counselling and debriefing and spiritual care. This study describes grief experiences, support strategies and cultural implications in haemodialysis units, which serve a culturally diverse group of people. By consolidating available knowledge, this review provides a critical platform for future empirical work and calls for culturally sensitive support and larger, diverse samples in future research.