Prolonged grief during and beyond the pandemic: factors associated with levels of grief in a four time-point longitudinal survey of people bereaved in the first year of the COVID-19 pandemic.
Prolonged grief during and beyond the pandemic: factors associated with levels of grief in a four time-point longitudinal survey of people bereaved in the first year of the COVID-19 pandemic.
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DOI：
10.3389/fpubh.2023.1215881
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发表时间：
2023
影响因子：
5.2
通讯作者：
Selman, Lucy E.
中科院分区：
文献类型：
--
作者：
Harrop, Emily;Mirra, Renata Medeiros;Goss, Silvia;Longo, Mirella;Byrne, Anthony;Farnell, Damian J. J.;Seddon, Kathy;Penny, Alison;Machin, Linda;Sivell, Stephanie;Selman, Lucy E.
COVID-19大流行是一场毁灭性和持久的大规模丧亲事件，此时丧亲之人经历了一系列独特的困难情况。然而，人们对这些经历的长期后果知之甚少，包括长时间悲伤障碍（PGD）和流行病受害者中其他疾病的流行。对2020年3月16日至2021年1月2日期间在英国失去亲人的人进行的纵向调查，在基线收集数据（n = 711），c.丧亲后8（n = 383）、13（n = 295）和25（n = 185）个月。使用长期悲伤障碍（PGD）（创伤性悲伤量表），悲伤脆弱性（成人对悲伤的态度量表）和社会支持（社会支持量表）的测量，该分析研究了参与者的特征，死者的特征和流行病相关的情况（例如，限制访问，社会孤立，社会支持）与悲伤的结果，重点是PGD的症状。基线时，628名（88.6%）参与者为女性，平均年龄为49.5岁（SD 12.9）。311人（43.8%）死于确诊/疑似COVID-19。样本人口统计学在各时间点相对稳定。34.6%的受试者在c时符合指定PGD的截止值。13个月丧亲，最终随访时为28.6%。在早期丧亲之痛中的社会孤立和孤独以及随着时间的推移缺乏社会支持强烈地导致了更高水平的长期悲伤症状，而在死亡后得到医疗保健专业人员的良好支持与长期悲伤症状的水平降低有关。与较低水平的长期悲伤症状密切相关的死者特征是较远的关系（例如，祖父母死亡），预期死亡和在护理院发生的死亡。与长期悲伤症状水平较高相关的参与者特征包括正规教育水平低和存在医疗条件。结果表明，与大流行前相比，PGD的水平高于预期，这对现在的丧亲政策、规定和实践具有重要意义（例如，加强社会和专家支持）以及为未来的流行病和大规模丧亲事件做好准备（例如，关于感染控制措施和快速支助反应的指导）。
The COVID-19 pandemic has been a devastating and enduring mass-bereavement event, with uniquely difficult sets of circumstances experienced by people bereaved at this time. However, little is known about the long-term consequences of these experiences, including the prevalence of Prolonged Grief Disorder (PGD) and other conditions in pandemic-bereaved populations. A longitudinal survey of people bereaved in the UK between 16 March 2020 and 2 January 2021, with data collected at baseline (n = 711), c. 8 (n = 383), 13 (n = 295), and 25 (n = 185) months post-bereavement. Using measures of Prolonged Grief Disorder (PGD) (Traumatic Grief Inventory), grief vulnerability (Adult Attitude to Grief Scale), and social support (Inventory of Social Support), this analysis examines how participant characteristics, characteristics of the deceased and pandemic-related circumstances (e.g., restricted visiting, social isolation, social support) are associated with grief outcomes, with a focus on symptoms of PGD. At baseline, 628 (88.6%) of participants were female, with a mean age of 49.5 (SD 12.9). 311 (43.8%) deaths were from confirmed/suspected COVID-19. Sample demographics were relatively stable across time points. 34.6% of participants met the cut-off for indicated PGD at c. 13 months bereaved and 28.6% at final follow-up. Social isolation and loneliness in early bereavement and lack of social support over time strongly contributed to higher levels of prolonged grief symptoms, while feeling well supported by healthcare professionals following the death was associated with reduced levels of prolonged grief symptoms. Characteristics of the deceased most strongly associated with lower levels of prolonged grief symptoms, were a more distant relationship (e.g., death of a grandparent), an expected death and death occurring in a care-home. Participant characteristics associated with higher levels of prolonged grief symptoms included low level of formal education and existence of medical conditions. Results suggest higher than expected levels of PGD compared with pre-pandemic times, with important implications for bereavement policy, provision and practice now (e.g., strengthening of social and specialist support) and in preparedness for future pandemics and mass-bereavement events (e.g., guidance on infection control measures and rapid support responses).
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