Nursing care protocols for family members of patients in palliative care during the grieving process: a scoping review

Introduction: This study aimed to map nursing care protocols directed at supporting family members of patients in palliative care during the grieving process, identifying practices, guidelines, and gaps in both national and international literature. Methods: A scoping review was conducted following the Joanna Briggs Institute (JBI) guidelines. Searches were performed in eight scientific databases and grey literature, without restrictions on language or location. The selection was based on the Population, Concept, Context (PCC) model (Population: bereaved family members; Concept: nursing protocols; Context: all levels of healthcare). Studies addressing nursing interventions supporting grief were included, while those focused solely on psychological interventions or not centered on family members were excluded. Results: From 2,809 identified studies, 18 met the inclusion criteria. Most used a qualitative approach and focused on emotional support, active listening, and sensitive communication. Practices included assessing the risk of complicated grief, spiritual support, post-death care continuity, and family involvement. Although some protocols were based on international guidelines [such as the World Health Organization (WHO) and National Institute for Health and Care Excellence (NICE)], most lacked cultural sensitivity, robust clinical trials, and detailed demographic data. Barriers to implementation included team unpreparedness and the absence of specific public policies. Conclusions: The mapped protocols help reduce emotional suffering and promote resilience; however, they still lack integration of emotional, social, and cultural dimensions. The study highlights the urgent need to develop culturally appropriate, evidence-based guidelines, enhance professional training, and invest in rigorous research to consolidate effective bereavement care practices within palliative care.