School of Psychology, Curtin University, Perth, Western Australia, Australia.
Department of Psychology, Christopher Newport University, Newport News, Virginia, USA.
J Pain Symptom Manage. 2021 Apr;61(4):e1-e4. doi: 10.1016/j.jpainsymman.2021.01.006. Epub 2021 Jan 18.
People bereaved from COVID-19 report higher levels of grief than people bereaved from natural causes. The full impact of this onslaught of grief will not be known for some time. Ensuring high-quality bereavement care in the context of COVID-19 presents unprecedented challenges to end-of-life care.
We aimed to determine how psychological symptoms explain functional impairment.
A sample of people bereaved through COVID-19 (N = 307) in the United States completed demographic questions and self-report measures of neuroticism; symptoms of depression, generalized anxiety, posttraumatic stress, separation distress, and dysfunctional grief; and functional impairment due to a COVID-19 loss.
Most participants' scores were in the clinical ranges for generalized anxiety, depression, dysfunctional grief, and functional impairment. Functional impairment scores were not associated with age, gender, and time since loss but were associated with being diagnosed with COVID-19, having received professional help with the loss, and a close relationship to the deceased. A logistic regression model showed that, after controlling for covariates, the odds of functional impairment significantly increased by 27% for higher scores in separation distress, 25% for higher scores in dysfunctional grief, and 13% for higher scores in posttraumatic stress.
People bereaved because of COVID-19 are at risk of functional impairment, especially if they have symptoms of separation distress, dysfunctional grief, and/or posttraumatic stress. Attention to identifying and treating functional impairment may be important in facilitating grieving persons' full participation in social and economic life during and after the pandemic.
因 COVID-19 而失去亲人的人比因自然原因而失去亲人的人报告有更高水平的悲痛。这种悲痛的全面影响还需要一段时间才能被知晓。在 COVID-19 背景下确保高质量的丧亲关怀，给临终关怀带来了前所未有的挑战。
我们旨在确定心理症状如何解释功能障碍。
在美国，一组因 COVID-19 而失去亲人的人（N=307）完成了人口统计学问题和神经质的自我报告测量；抑郁、广泛性焦虑、创伤后应激、分离痛苦和功能失调性悲伤的症状；以及因 COVID-19 丧失而导致的功能障碍。
大多数参与者的得分在广泛性焦虑、抑郁、功能失调性悲伤和功能障碍方面都处于临床范围。功能障碍得分与年龄、性别和失去亲人后的时间无关，但与被诊断为 COVID-19、因失去亲人而获得专业帮助以及与死者关系密切有关。逻辑回归模型显示，在控制了协变量后，分离痛苦得分较高者功能障碍的几率显著增加 27%，功能失调性悲伤得分较高者功能障碍的几率增加 25%，创伤后应激得分较高者功能障碍的几率增加 13%。
因 COVID-19 而失去亲人的人有功能障碍的风险，特别是如果他们有分离痛苦、功能失调性悲伤和/或创伤后应激的症状。在大流行期间和之后，关注识别和治疗功能障碍，可能对促进丧亲者充分参与社会和经济生活很重要。
