Evaluation of the Bereavement Risk Index (BRI): a community hospice care protocol

Aim: To test the validity, reliability and feasibility of using a modified version of Parkes' (1993) Bereavement Risk Index (BRI) and bereavement support protocol in an Australian home hospice care setting. In addition, the study aimed to explore what types of family members are most likely to experience a more difficult grief reaction. Design: A prospective, descriptive study was used. One hundred and fifty bereaved family members participated. Bereaved family members were classified as high, medium or low risk and received a structured bereavement support protocol based on their level of risk as measured by the BRI. Findings: Results indicated that a shorter 4-item version of the BRI was more internally consistent than the longer version and demonstrated good predictive validity when correlated with outcome measures at 3 months following the patient's death. Conclusion: The modified 4-item BRI demonstrated acceptable reliability and validity and was brief and simple to use. Nurses were able to use the instrument with minimal training and were able to adhere to a matched bereavement support protocol.