Abstract â–¡ 142

A survey was distributed to 481 local authorities and city districts in Norway. The respondents, mainly community physicians, were invited to describe different aspects of the local care and assistance for parents bereaved by SIDS and children's accidents in particular, and for bereaved after sudden, unexpected death in general. The following aspects where covered by pre-coded questions: a) kind of assistance provided, b) care-givers involved, c) lines for responsibility and coordination, d) time-framing of the assistance, e) existing written routines, and e) existing assistance for children/siblings. Open questions provided an opportunity for respondents to present their own judgements of obstacles and facilitators for better bereavement services. In addition, respondents where invited to attach copies of any written routines. Pre-coded questions were treated quantitatively by univariat -, bivariat - and regression analyses, while documented routines and answers to open questions were analysed in accordance with qualitative concepts for categorization and condensation. Data show great variations between local authorities/city districts regarding content and framing of the bereavement services. Only 50% of local authorities reported care services designed for bereaved after SIDS/children accidents in particular. A minority of the local authorities reported bereavement support groups, active strategies for contact-establishment, specified time-frames for the follow-up, written routines and services for children/siblings. Structural and formal elements such as written routines and a local "crisis team" seemed the most reliable predictors for a broad spectered bereavement service including the mentioned elements. This supports respondents' own emphasis on written routines, explicit lines for coordination and responsibility, and more cross-professional co-operation as basic agents for improved bereavement support. Written routines and "crisis-team" might benefit a service by making it surveyable for both care-givers and clients. The effect of these elements diminishes in rural areas, where clearness is naturally given by demographic factors. However, document-analyses indicate that written routines are often generally formed with few operational descriptions. It is therefore argued that written routines and "crisis teams" are just indicators for a local authority's priority and consciousness of these bereavement groups needs. The latter is proposed as the real agent securing a service suited to capture these needs. The study shows the advantages of combining quantitative- and qualitative analysing tools.