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能让人们“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。新冠肺炎的流行已经扰乱了这些重要的仪式。他们的缺席很可能会扰乱“正常”的悲痛周期，导致一系列复杂的悲痛表现。先前传染病(埃博拉、SARS、MERS)的证据突显出，一些人会颠覆公共卫生信息，传递被认为对亲属的照料和埋葬至关重要的仪式。坊间证据表明，这些行为正反映在新冠肺炎事件中。我们将开展一项定性研究计划，以确定新冠肺炎事件后需要的精神健康支持的性质和程度，了解颠覆或坚持公共卫生信息的经验，并评估在社会疏远必不可少的情况下，如何制定公共卫生信息来支持丧失亲人的人管理葬礼过程(例如制定替换仪式)。我们将在两个时间点(相隔六个月)对30个失去亲人的家庭进行定性访谈，以探讨大流行病期间丧失亲人之痛对精神健康和福祉的短期和长期影响。此外，我们将与殡仪承办人进行30次访谈，以了解他们在大流行期间的殡葬策划过程、服务的变化以及他们与死者的互动。我们将结合中期、最终报告和同行评议的开放获取文件，开展一个“经验教训工作坊”。这将制定关于葬礼安排、丧亲支助提供和公共卫生信息的建议，制定和商定行业具体要求。

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.