Division of Population Medicine, Marie Curie Research Centre, Cardiff University, Cardiff, United Kingdom.
School of Dentistry, Cardiff University, Cardiff, United Kingdom.
Front Public Health. 2023 Sep 19;11:1215881. doi: 10.3389/fpubh.2023.1215881. eCollection 2023.
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 ( = 711), c. 8 ( = 383), 13 ( = 295), and 25 ( = 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).
COVID-19 大流行是一场破坏性且持久的大规模丧亲事件，在此期间丧亲的人们经历了独特的困难情况。然而，人们对这些经历的长期后果知之甚少，包括在大流行中丧亲的人群中普遍存在的持续性创伤后应激障碍（PGD）和其他疾病。
对 2020 年 3 月 16 日至 2021 年 1 月 2 日期间在英国丧亲的人进行纵向调查，在基线（ = 711）、8 个月（ = 383）、13 个月（ = 295）和 25 个月（ = 185）时收集数据。使用持续性创伤后应激障碍（PGD）（创伤性悲伤量表）、悲伤脆弱性（成人悲伤态度量表）和社会支持（社会支持量表）等措施，本分析研究了参与者的特征、死者的特征和大流行相关情况（例如，限制探视、社交隔离、社会支持）如何与悲伤结果相关，重点是 PGD 症状。
在基线时，628 名（88.6%）参与者为女性，平均年龄为 49.5（SD 12.9）岁。311 名（43.8%）死亡是由于确诊/疑似 COVID-19。样本人口统计学特征在各个时间点相对稳定。34.6%的参与者在丧亲 13 个月时达到了 PGD 的指标，28.6%在最终随访时达到了指标。早期丧亲期间的社交隔离和孤独感以及随着时间的推移缺乏社会支持强烈导致更高水平的持续性悲伤症状，而在死者去世后得到医疗保健专业人员的良好支持与降低持续性悲伤症状水平相关。与较低水平的持续性悲伤症状最相关的死者特征是，与死者的关系较远（例如，祖父/母的死亡）、预期死亡和在养老院死亡。与更高水平的持续性悲伤症状相关的参与者特征包括低水平的正规教育和存在健康状况。
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、服务和实践以及为未来的大流行和大规模丧亲事件做好准备具有重要意义（例如，加强社会和专业支持），以及为未来的大流行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持反应的指南）。
