12  Grieving during COVID-19: exploring the lived experiences of people bereaved during the first two waves of the 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

“…Within our qualitative findings, as in other studies ( 15 ), the significance of meaning-making in mediating the effects of many of these circumstantial factors is also evident ( 21 , 24 , 58 ). Examples of pandemic-related difficulties finding meaning included anger and unanswered questions surrounding and preventing acceptance of the death, descriptions of grief feeling “unreal” without recourse to collective ritual, and lack of appropriate support and help with processing feelings ( 21 , 24 ).…”

“…“Dealing with my feelings around how my loved one died” was also the top-ranking need for support that we identified at baseline, with 60% of people experiencing high-level needs for help in this domain ( 21 ). These findings, the greater observed impact of feeling supported after the death, and examples in our interview data of some participants coming to terms with difficult end of life experiences ( 58 ), might therefore suggest that it is not just the circumstances of the death that are of importance, but also one’s ability to make sense of what happened ( 15 , 58 – 60 ). This again points to the importance of good communication and support from healthcare providers for mitigating the effects of stressful and traumatic experiences ( 60 ).…”

“…Most evidence to date on the grief and mental health consequences of pandemic bereavement is from studies conducted in China (12,13), North America (14-18), Holland (4, 19, 20) and the earlier qualitative and quantitative results from this UK-based study (21)(22)(23)(24)(25)(26). Several of these cross-sectional studies [including our baseline publication, (23)] indicate higher levels of grief and functional impairment among people bereaved during the pandemic, compared with pre-pandemic populations (14)(15)(16)(17)(18)(19)(20).…”

“…Of particular interest early on in the pandemic was whether COVID-19 deaths would be associated with worse grief experiences than other types of death. Higher levels of grief and other psychological conditions have been identified among those bereaved by COVID-19 than would be expected in non-pandemic populations (12)(13)(14)17), or compared with "natural" but not "unnatural" causes of deaths pre and during the pandemic (4, 18-20), with the "unexpected" nature of these deaths an explanatory factor (19, 20). However, other studies (including the baseline results from this study) have not found significant differences in grief and other psychological outcomes between COVID-19 and non-COVID-19 bereavement during the pandemic (15,23).…”

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

“…"Dealing with my feelings around how my loved one died" was also the top-ranking need for support that we identified at baseline, with 60% of people experiencing high-level needs for help in this domain (21). These findings, the greater observed impact of feeling supported after the death, and examples in our interview data of some participants coming to terms with difficult end of life experiences (58), might therefore suggest that it is not just the circumstances of the death that are of importance, but also one's ability to make sense of what happened (15,(58)(59)(60). This again points to the importance of good communication and support from healthcare providers for mitigating the effects of stressful and traumatic experiences (60).…”