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Table 4 Agreement reached for the outcome dimensions following rounds 1 and 2 of the Delphi survey and consensus day voting

From: Coping and wellbeing in bereavement: two core outcomes for evaluating bereavement support in palliative care

Emotional issues70%80%Shortlisted Consensus DayWellbeing70%80%Shortlisted Consensus DayHealth70%80%Shortlisted Consensus DaySupport70%80%Shortlisted Consensus Day
Feelings of loneliness and emptinessAbility to participate in worka Anxiety (feelings of tension, nervousness, panic and distress)Relationships with friends and family 
Preoccupation with thoughts of the deceased person Ability to participate in social or other activitiesDepression (a sense of hopelessness, pessimism, periods of crying)Relationships with health and social care professional(s)XX 
Avoidance of reminders of the deceased personXX Ability to perform daily tasks Related physical symptoms (e.g. pain or sickness)  Finding comfort, meaning or strength in religious or spiritual beliefsXX 
Avoidance and denial of distress, grief or other problems Involvement in home management and houseworkXX Problems with memory, concentration, making decisions, speech Accessing practical support if needed
Intensity of grief experienced around time of death Financial security and material wellbeing  Suicidal thoughts Accessing financial/material support if neededb 
Overwhelming thoughts and/or nightmares about loss Ability to function as part of a family Irritation and bad mood  Accessing emotional support if needed 
Hallucinations about the deceased personXX Sense of identity and role Sleep-related problems  Ability to express feelings openly and honestly 
Feelings of shame and/or stigmaXX Sense of meaning and purpose in lifeTiredness and fatigueb Accessing guidance if needed  
Feelings of detachment and distancing  Optimism and hopefulness Hyperactivity and inability to slow downc  Feeling understood by and connected with other bereaved peopleb
Feelings of blame, guilt, anger, bitterness, regret Satisfaction with home, neighbourhood and community environmentXX Paranoia or obsessive thoughtscX     
    Acceptance of grief experiences as normalSymptoms of phobiasXX     
    Acceptance of loss Behaviours such as eating disorders or substance abuse      
    Understanding and finding meaning of loss Self-esteem      
    Positive reminiscence and remembering of the deceasedaGeneral health problems (e.g. infections, blood pressure, loss of sex drive, other illness)b     
    Regulation and control of feelings and behaviours Use of health care servicesXX    
    Ability to find balance and channel grief        
    Ability to take control (e.g. look ahead and start to move forward with life)        
  1. aMet 80% threshold in service user sub-group in Delphi 1
  2. bMet 80% threshold in service user sub-group in Delphi 2. These items also needed to have been selected on consensus day or final feedback survey to be included
  3. cExceeded 70% in second round of the Delphi survey (service user sub-group)
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