Bereavement rituals during the Covid-19 pandemic: Implications for mental health support, funerary practices and public health messaging

围绕死亡和临终的仪式允许“健康”地表达强烈的情感，葬礼被认为是悲伤过程中的一个支点。Covid-19大流行打乱了这些重要的仪式。他们的缺席很可能会扰乱“正常”的悲伤周期，导致一系列复杂的悲伤表现。来自以往传染病（埃博拉、非典型肺炎、中东呼吸综合征）的证据突出表明，一些人会破坏公共卫生信息，实施被认为对其亲属的照顾和埋葬至关重要的仪式。坊间证据表明，这些行为正在Covid-19大流行中得到反映。我们将开展一项定性研究计划，以：确定Covid-19后必要的心理健康支持的性质和程度，了解颠覆或遵守公共卫生信息的经验，并评估如何制定公共卫生信息，以支持丧亲者管理葬礼过程（例如制定替代仪式），在必须保持社交距离的情况下。我们将在两个时间点（间隔6个月）对30个丧亲家庭进行定性访谈，以探讨大流行期间丧亲之痛对心理健康和福祉的短期和长期影响。此外，我们将与葬礼承办人进行30次访谈，以了解他们在大流行期间的葬礼规划过程、服务变化以及他们与丧亲者的互动方面的经验。除了中期、最终报告和同行评议的开放获取论文外，我们还将开展一个“经验教训研讨会”。这将制定有关丧葬安排、提供丧亲支助和公共卫生信息传递的建议，并制定和商定特定行业的要求。

Rituals around death and dying allow 'healthy' expression of strong emotions, with funerals identified as a fulcrum in the grieving process. The Covid-19 pandemic has dislocated these significant rituals. Their absence is likely to disrupt 'normal' grief cycles, leading to a range of complex grief presentations.Evidence from prior infectious diseases (Ebola, SARs, MERs) highlighted that some individuals will subvert public health messages to deliver rituals perceived essential to their relative's care and burial. Anecdotal evidence suggests that these behaviours are being mirrored in the Covid-19 pandemic.We will carry out a qualitative research programme to: identify the nature and extent of mental health support necessary following Covid-19, understand the experience of subverting or adhering to public health messages, and assess how public health messages could be developed to support the bereaved in managing the funeral process (e.g. development of replacement rituals) when social distancing is essential.We will carry out qualitative interviews at two time points (six months apart) with 30 bereaved families to explore the short and longer-term impacts of bereavement during the pandemic on mental health and wellbeing. In addition, we will conduct 30 interviews with funeral directors to understand their experiences of the funeral planning process during the pandemic, change in services and their interactions with bereaved people.Along with interim, final reports and peer reviewed open access papers, we will carry out a 'lessons learnt workshop'. This will develop recommendations about funerary arrangements, bereavement support provision and public health messaging, developing and agreeing industry-specific requirements.