Morbidity and mortality associated with bereavement is an important public health issue, yet economic and resource investments to effectively implement and sustain integrated bereavement services are sorely lacking at national and global levels. Although bereavement support is a component of palliative care provision, continuity of care for bereaved individuals is often not standard practice in palliative and end-of-life contexts. In addition to potentially provoking feelings of abandonment, failure to extend family-centred care after a patient's death can leave bereaved families without access to crucial psychosocial support and at risk for illnesses that exacerbate the already substantial public health toll of interpersonal loss. The effect of inadequate bereavement care disproportionately disadvantages vulnerable groups, including those living in resource-constrained settings. We build on available evidence and previous recommendations to propose a model for transitional care, firmly establishing bereavement care services within health-care institutions, while respecting their finite resources and the need to ultimately transition grieving families to supports within their communities. Key to the transitional bereavement care model is the bolstering of community-based supports through development of compassionate communities and upskilling of professional services for those with more substantial bereavement support needs. To achieve this goal, interprofessional health workers, institutions, and systems must shift bereavement care from an afterthought to a public health priority.

中文翻译：

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将投资丧亲护理作为公共卫生优先事项

与丧亲之痛相关的发病率和死亡率是一个重要的公共卫生问题，但国家和全球层面严重缺乏有效实施和维持综合丧亲服务的经济和资源投资。尽管丧亲支持是姑息治疗的一个组成部分，但对丧亲者的持续护理通常不是姑息治疗和临终关怀的标准做法。除了可能引发被遗弃感之外，在患者去世后未能提供以家庭为中心的护理可能会使失去亲人的家庭无法获得重要的社会心理支持，并面临患病风险，从而加剧因人际关系损失而造成的公共卫生损失。丧亲关怀不足对弱势群体尤其不利，包括那些生活在资源有限环境中的群体。我们以现有证据和之前的建议为基础，提出过渡性护理模式，在医疗机构内牢固地建立丧亲护理服务，同时尊重其有限的资源以及最终将悲伤家庭过渡到社区内支持的需要。过渡性丧亲护理模式的关键是通过发展富有同情心的社区和提高为那些有更大丧亲支持需求的人提供专业服务的技能来加强基于社区的支持。为了实现这一目标，跨专业卫生工作者、机构和系统必须将丧亲护理从事后考虑转变为公共卫生优先事项。