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Dying, Death and Mourning amid COVID-19 Pandemic in Kashmir: A Qualitative Study
Abstract
Using a qualitative approach, this study aimed to examine the changing nature of death, dying and mourning among Muslims of Kashmir due to the COVID-19 pandemic. Telephonic Interviews were conducted with 17 participants, whose loved ones died after the outbreak of the COVID-19 in Kashmir. The findings of the study revealed that the deceased mostly died in isolation with no one around. Mourning the loss was also highly challenging with participants receiving less in-person support thus leading to mourning in isolation. The inability to perform last rites added yet another layer of grief which resulted in prolonged grief among the bereaved and impacted their overall wellbeing.
... Rituals are the behaviours that make up the rites, whereas rites are thought of as a more general category, such as rites of passage or healing (Mas'amah Adu et al., 2023). A study conducted in India by Hamid and Jahangir (2020) found that when families were unable to perform traditional rituals and rites after the death of a loved one, it had negative effects on their well-being. This prolonged their grieving process and diminished their overall health. ...
... Islamic customs require that bodies be wrapped in white fabric and buried without a casket so that the deceased might be placed on its right side and face the holy city of Mecca after the washing ritual and purification of the body. Before the burial, it is important to offer a Nimaz-e-Jinazah (Funeral prayer) for the deceased (Hamid & Jahangir, 2020). It is followed by the locals visiting the grieving families before and after the burial to help with the funeral customs and as a sign of the community's solidarity. ...
... In any event, women from the community who have come to participate in the grieving also weep, in addition to female members of the deceased's family (Bahadur, 2020). Women frequently show their tremendous grief by throwing themselves to the ground, hitting the ground, hurling away their headscarves, pulling out their hair, slapping their faces, banging their chests, and engaging in self-punishing behaviours (Hamid & Jahangir, 2020). ...
... The traditions and rituals, including changes to these practices, as a result of cultural influences, and the impacts of these changes, have also been widely explored across countries, continents and religions. For example, the cultural practices for Muslims mourning the dead in Kashmir, such as visiting the bereaved in their home and discussing routine affairs, are regarded as more important than the direct religious post-death rituals (Jahangir and Hamid, 2022). This demonstrates that the rituals of mourning go beyond a boundary of culture or religious intention, and at their core are social processes that are upheld by communities. ...
... An exploration of the experiences of Portuguese mourners (Aguiar et al. 2022) brought forth similar themes in the experience of funeral rituals as inadequate or unfulfilling, with a related focus on feelings of loneliness surrounding restricted mourning. Loss with limited support, and a lack of death rituals were also noted as particular challenges for Muslims of Kashmir during COVID-19 times (Hamid and Jahangir 2022), mirroring similar findings to the present study. In Peru, Moya-Salazar et al. (2022) explored the challenges faced by mourners who lost loved ones to COVID-19, with similar themes emerging in the experience of lost rituals. ...
... This paper makes several contributions: first, it adds to the limited literature surrounding the experience of Irish mourning and digitallymediated mourning during the pandemic. Recent literature has begun documenting the experiences of bereavement during COVID-19 in communities and cultures worldwide (Mortazavi et al. 2021;Jahangir and Hamid, 2022;Hernández-Fernández and Meneses-Falcón, 2022), however, the broader Irish experience of mourning during COVID-19 remains relatively unexplored. The importance of our findings also lies in providing accounts of the experiences of mourners in Ireland during the pandemic, as narrated through the mourners' own voices. ...
Physical restrictions in many countries during the COVID-19 pandemic affected almost all aspects of social life, including end-of-life rituals such as funerals. In Ireland, public health restrictions required mourners to adapt to alternative rituals to customary Irish mourning practices, which are traditionally community-focused and highly social. This period brought significant changes and challenges in the way Irish people and communities mourn, and in how events such as funerals were experienced through digital and online technologies. This paper reports on a qualitative study that contributes a better understanding of the experiences of mourners in Ireland during the COVID-19 pandemic, particularly regarding the use and role of digital tools during this period, and their continued use following the lifting of pandemic restrictions. Overall, the findings indicate that participants felt a sense of unfulfillment and faced a series of challenges in managing altered support mechanisms, while acknowledging the importance and utility of digitally-mediated experiences, such as participation in live-streamed funerals and in online books of condolences. The paper sheds further light in the experiences of use of technology during the pandemic and provides insights to inform the future design and use of end-of-life digital tools and services, as they remain widely used also after the end of the pandemic.
... Initially, it may be characterized by mild feelings of regret and anxiety, but as it persists and intensifies, it can give rise to disruptive disorders that cause mental and physical distress, profoundly impacting an individual's life. 1 The experience of bereavement is intricately linked to the immediate manifestation of death, often accompanied by funeral ceremonies that blend traditional, religious, and spiritual rites. 2,3 Although modern funeral practices have evolved into more personalized events, their fundamental purpose remains the same: to bid farewell to a loved one. These rituals mark a significant transition in the lives of those grieving, serving as a starting point for the healing process by acknowledging the reality of the loved one's death and facilitating acceptance. ...
... 14 When compounded with the death of a family member and the inability to conduct proper funeral rites, the bereavement process is disrupted, isolating individuals, and prolonging their grief. 3 Moreover, studies indicate that individuals mourning COVID-19related deaths exhibit higher levels of prolonged grief compared to those grieving natural causes, and they may also simultaneously develop mental health issues such as anxiety and depression. 15 We aimed to determine the relationship between symptoms of grief, anxiety and depression levels in relatives of patients who died from COVID-19 in Peru. ...
... 27 This increased intensity can be attributed to disruptions in funeral practices, which have disrupted the normal grieving process and potentially prolonged grief, thereby affecting the well-being of the bereaved. 3,28 Our study findings align with these observations, indicating that relatives of patients who died from COVID-19 experienced prolonged grief (76.5%) along with symptoms of anxiety (18.3%) and mild depression (47.8%), with a smaller percentage experiencing moderate depression (2.6%). These results parallel previous studies conducted in Peru during the initial outbreak, which highlighted the inability of relatives to perform customary funeral practices due to confinement measures. ...
Objective
Funeral practices have undergone significant changes during the COVID-19 pandemic. Thus, the death of a family member from this disease has altered the typical course of the bereavement process. Therefore, this study seeks to determine the relationship between the levels of grief, anxiety, and depression in relatives of patients who died from COVID-19 in Peru.
Methods
A total of 250 volunteers were obtained, but after applying the inclusion criteria and not being able to contact five of them, the sample consisted of 115 participants over 18 years of age who lost a family member to COVID-19 between 2020 and 2021. They developed the Prolonged Grief Questionnaire-13 and the Zung Anxiety and Depression Questionnaires, in virtual surveys using Google FormTM (Google, CA).
Results
Our analysis revealed that all cases of anxiety (18.3%) were present in individuals experiencing prolonged grief (76.5%), while 49.5% (57/115) of participants exhibited symptoms of depression. Furthermore, we identified a significant association between prolonged grief and both anxiety (p = 0.005) and depression (p < 0.001). Prolonged grief predominantly affected females (45.2%) and individuals aged 31–40 years (28.7%) (p < 0.001). Regarding predictors of anxiety symptoms, we found that both age group (p = 0.035) and grief (p < 0.001) played significant roles. Gender (p = 0.019) and grief (p < 0.001) emerged as predictors of depression, while gender alone predicted grief in relatives of individuals who succumbed to COVID-19 (p = 0.019).
Conclusion
Our results suggest a clear association between prolonged grief and mental health issues among relatives of COVID-19 patients who have passed away. Consequently, it is imperative to provide comprehensive psychological and spiritual support throughout the grieving process, aiming to mitigate the negative impact of traumatic events.
... The COVID-19 pandemic has added another complex layer of grief to the current loss, resulting in a threat to health among those affected by the loss. It has also increased the workload on the family members of the deceased (Hamid & Jahangir, 2020). ...
... Like other Muslim communities, people visit, mourn, and support the bereaved in large numbers, including neighbors, friends, relatives, and other acquaintances. They live with bereaved families who help the bereaved overcome their grief (Hamid et al., 2019;Hamid & Jahangir, 2020). However, the COVID-19 epidemic and social isolation measures have changed the whole structure of mourning everywhere (Hamid & Jahangir, 2020). ...
... They live with bereaved families who help the bereaved overcome their grief (Hamid et al., 2019;Hamid & Jahangir, 2020). However, the COVID-19 epidemic and social isolation measures have changed the whole structure of mourning everywhere (Hamid & Jahangir, 2020). A huge increase in deaths due to the COVID-19 outbreak has had a pervasive impact on cultural norms, rituals, and common social practices related to death and mourning and potentially exacerbated complex grief (Mayland et al., 2020). ...
Objective: The challenges of grief caused by the COVID-19 epidemic and how to deal with it are serious issues affecting people worldwide, including Iran. Accordingly, the present study aimed to explore the nature of mourning for those who lost their family members during the COVID-19 epidemic and identify the quality of strategies used to cope with it. Methods: This qualitative study was conducted using a grounded theory approach. The study participants were 20 survivors of COVID-19 in Tehran City, Iran, who were grieving the loss of their loved ones during the epidemic in 2021. The participants were selected using purposeful sampling. The data were collected through quasi-structured interviews with the participants. The collected data were analyzed using open, axial, and selective coding. Results: The results revealed three main categories: Underlying factors affecting grief (beliefs and attitudes toward death and the afterlife, the public reaction to grief, the specific position and role of the deceased), the nature and development of grief (including feelings of anger at the community and the medical staff, the nature of death due to COVID-19 and blaming oneself for the illness and death of the deceased), and coping and managing grief (coping the thought of death and the meaning of life, inducing life in oneself and other survivors, and changing the pattern of thinking and behaving towards others and life). Conclusion: The COVID-19 survivors who are grieving the loss of their loved ones can use this model to better understand and manage to cope with grief and adapt to it simultaneously. Ultimately, this process led to adaptation to mourning and adopting effective coping strategies in the COVID-19 survivors. The core category revealed in the study was “optimal coping with grief and loss during the COVID-19 epidemic”.
... Social distancing, lockdowns and restrictions in hospital visits are likely to affect grieving processes, as manifested in qualitative research (Mortazavi et al., 2021;Torrens-Burton et al., 2022). Grief researchers have argued that some of the implications of the pandemic correspond or contribute to certain previously established risk factors for PGD (Amy and Doka 2021;Diolaiuti et al. 2021;Djelantik et al. 2021;Eisma et al. , 2021Hamid and Jahangir 2022;Helton et al. 2020;Mayland et al. 2020;Menzies et al. 2020): These include reduced social contacts, restrictions on funerals, the loss of daily routines and distraction, and secondary stressors such as an increase of financial problems. To illustrate, low social support is a long-established risk factor for PGD. ...
... Thereby, we identified eight pandemic-associated risk factors: 1. Limited possibilities to visit and accompany a dying person (e.g. due to visiting restrictions in hospitals) Hamid & Jahangir, 2020;Mayland et al., 2020), 2. Absence of traditional grief rituals (e.g. due to official restrictions, limited number of attendees at funerals) (Eisma et al., , 2021Hamid & Jahangir, 2020;Mayland et al., 2020), 3. Traumatic circumstances of the death (e.g. ...
... due to visiting restrictions in hospitals) Hamid & Jahangir, 2020;Mayland et al., 2020), 2. Absence of traditional grief rituals (e.g. due to official restrictions, limited number of attendees at funerals) (Eisma et al., , 2021Hamid & Jahangir, 2020;Mayland et al., 2020), 3. Traumatic circumstances of the death (e.g. due to COVID-19, unexpected deaths, deaths in intensive care units) (Eisma et al., , 2021Mayland et al., 2020), 4. Lack of social support (e.g. ...
Background: Due to its high death toll and measures to curb the pandemic, COVID-19 has affected grieving experiences and may contribute to risk factors for Prolonged Grief Disorder (PGD). Persons at risk for PGD often seek support from grief counselling.
Objective: To explore whether pandemic-associated risk factors have become more important topics in counselling in a mixed-method design.
Method: German grief counsellors (n = 93) rated whether pre-defined risk factors had become more important in grief counselling and indicated additional important themes in an open format.
Results: The counsellors indicated that all pre-defined risk factors had become more important, though differing significantly in their frequency. Most frequently endorsed risk factors were lack of social support, limited possibilities to accompany a dying loved one and absence of traditional grief rituals. Qualitative analysis identified three additional themes: the societal impact of the pandemic, its impact on bereavement support and health care, and a chance for personal growth.
Conclusions: The pandemic has affected bereavement experiences and grief counselling. Counsellors should monitor grief processes and specific risk factors to provide the best possible care for bereaved people when needed.
... In total 424 studies were selected, 28 articles were included (see Figure 1). Out of the total number of 28 studies, 16 articles reported qualitative data (Becqué et al., 2021;Cardoso et al., 2020;De Leon Corona et al., 2021;Guité-Verret et al., 2021;Hamid & Jahangir, 2020;Helton et al., 2020;Hernández-Fernández & Meneses-Falcón, 2021;Kentish-Barnes et al., 2021;Menichetti Delor et al., 2021;Mohammadi et al., 2021;Moore et al., 2020;Mortazavi et al., 2021;Motamedzadeh et al., 2021;Selman et al., 2021;Testoni et al., 2021), 10 articles were quantitative studies (Carson et al., 2021;Chen & Tang, 2021;Eisma & Tamminga, 2020;Eisma et al., 2021;Lee et al., 2021;Schloesser et al., 2021;Ş imşek Arslan & Buldukoglu, 2021;Tang & Xiang, 2021;Wang et al., 2021), and two articles van Schaik et al. ...
... Finally, bereaved relatives reported feelings of guilt, associated with fears of having transmitted COVID-19 to their family members and therefore, causing their death (Mohammadi et al., 2021). The deceased did not die with dignity, in the views of the relatives, because cultural or religious practices could not be performed (Hamid & Jahangir, 2020). ...
... A final characteristic related to how COVID-19 has changed grief concerns the influence of cultural and societal differences surrounding death. Some studies, for example, the ones conducted in Kashmir and Iran, report stigmatization followed by a COVID-19 related loss (Hamid & Jahangir, 2020;Mohammadi et al., 2021). In some communities people were terrified of interacting with bereaved families and stayed away from them because they feared getting infected (Mohammadi et al., 2021). ...
The COVID-19 pandemic has disrupted grief experiences of bereaved relatives and altered accustomed ways of coping with loss. To understand how bereaved relatives experienced grief during COVID-19, a review, using the overview method, was conducted. An overview of empirical data about this subject has been lacking and therefore, PubMed and CINAHL databases were searched for empirical studies published from January 1, 2020 until December 31, 2021. 28 articles were included in the review. Thematic analysis showed different emotional responses, changes in grief, the effect of absence during final moments, a lack of involvement in the caring process, the impact on communities and social support systems and the alteration of funerals among bereaved relatives. During COVID-19, death is characterized by poor bereavement outcomes and health implications, but bereaved also show signs of resilience and coping. Directions for future research about cultural and societal differences in grief and support methods are suggested.
... 10,12,14,16,17,23 Residual feelings of guilt stemming from an unsatisfactory farewell as families were unable to physically accompany patients in their last moments, were also pervasive. 2,11,12,[14][15][16][17]19,23,24 Families were also concerned about their own exposure to COVID-19 where logistical barriers to screening left them feeling abandoned by the healthcare system. 2,21,22 The families' grief was accentuated during the immediate post-death and mourning period as a result of inconsistencies in the burial ceremonies, which caused anger at times. ...
... 13,15 They were either altered to "abnormal or unreligious burials" that lacked meaning, or worse, absent altogether. 11,[14][15][16]19,21,22,24 Families thought these "incomplete ceremonies" were the product of "unjustified government policies" dehumanising their loved ones. 2,14,19,21 They were critical of the government for treating their loved ones as statistics in a system rather than as human beings. ...
... 14,21 The loneliness of mourning in isolation, the desolation from multiple losses of family members dying in quick succession, and an inability to fully commit towards work and family, translated to a lack of closure. 13,15,16,19,20,22,24 The cancellation of social events, and difficulty in accessing formal counselling services denied people of outlets for their emotions, further prolonged this grieving process. 15,16,18,20 Beyond this, families were worried about their future. ...
Introduction:
The COVID-19 pandemic has brought about multiple losses to various groups, namely patients, families and healthcare professionals. Grief, which is the reaction to these losses, could cause strain on these individuals' physical and mental health if not identified and managed early. This scoping review analysed loss, grief and how they were managed among these groups during the pandemic.
Method:
This scoping review utilised the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement extension for Scoping Reviews (PRISMA-ScR) and the Joanna Briggs Institute framework for scoping reviews. Only qualitative studies relating to loss and grief and their management were included. Of 166 studies screened, 69 were included in the study. Qualitative analysis and data coding of each record were conducted through qualitative data analysis software.
Results:
Losses included the death of family members, patients, colleagues and others. They also included the loss of usual routines, lifestyles and physical health. The grief experienced was multidimensional, affecting mainly the emotional, physical, social and existential realms. Anger, guilt and fear resulted from unsatisfactory farewells, issues with funerals, social isolation, financial strain and stigmatisation. Management strategies could be categorised into 5 themes: communication, finance, counselling, education and spiritual care.
Conclusion:
Loss and grief identification and management among patients, family members and healthcare professionals are critically important during this COVID-19 pandemic. Current operating guidelines have proven insufficient in managing loss and grief. Innovative strategies are essential to tackle the many dimensions of loss and grief. Nevertheless, further research is necessary to better understand the effectiveness of implemented policies.
... On the one hand, these restrictions effectively halted the spread of COVID-19, but on the other, they altered the entire death, dying, and mourning landscape in Kashmir (Hamid & Jahangir, 2020). Earlier studies, particularly by Hamid and Jahangir (2020), have explored the changing nature of death practices in Kashmir amidst the pandemic. ...
... On the one hand, these restrictions effectively halted the spread of COVID-19, but on the other, they altered the entire death, dying, and mourning landscape in Kashmir (Hamid & Jahangir, 2020). Earlier studies, particularly by Hamid and Jahangir (2020), have explored the changing nature of death practices in Kashmir amidst the pandemic. The present study looks at COVID-19 deaths only via personal interviews with the deceased's family members. ...
... The present study looks at COVID-19 deaths only via personal interviews with the deceased's family members. Individual interviews allowed researchers to undertake an in-depth analysis of the attitudes, beliefs, desires, and experiences of research participants to obtain a deeper understanding of them without undermining the benefits of the study conducted by Hamid and Jahangir (2020). Since interviews allow for the collection of non-verbal data, they can be more advantageous than phone conversations (Barrett & Twycross, 2018). ...
This study examined the changing character of the last honours of those who died of COVID-19 in Kashmir and the life experiences of the families of the deceased. A semi-structured interview schedule was used to collect information from 21 participants. Using qualitative data analysis approaches, five key themes were identified vis-à-vis the impact of COVID-19 on burial rituals and customs; effects on bereaved families, shades of grief, bereavement care, community response, and coping with loss. Based on examining the pandemic-induced changes related to customs and rituals around death, the study found that the bereaved family members were in danger of marginalization, economic burdens, psychological traumas, and overall reduced quality of life. This study would be a credible addition to the existing literature on death practices as there is a shortage of research on funeral rituals during the post-pandemic period in Kashmir.
... The study by Hamid & Jahangir (2020) describes these feelings in several cases of patients dying not only alone but away from their families, and how families feel helpless for going through these difficult moments with their loved ones, providing them calm and reassurance at the time of their departure. These situations have become very common in families of people who have died from COVID-19, and it is clear to see how they can affect the bereaved in the immediate future, becoming a public health problem. ...
... Peru, a middle-income country in Latin America, has implemented the longest and most inefficient quarantine in the region to control the spread of the first SARS-CoV-2 outbreak during political, economic and social crises in 2020. It is possible that during this period, social restriction policies such as strict isolation, lack of public transport mobilisation, fear and lack of information played a significant role in the mourning process (Hamid & Jahangir, 2020;Mortazavi et al., 2020;Carr et al., 2020). ...
... The increase in deaths and confinement has made it impossible to say goodbye to those who have died of COVID-19. This situation is not exclusive to COVID-19 because all families who lost a family member have been affected by the national lockdown (Hamid & Jahangir, 2020). The families of patients who died of COVID-19 have been more damaged as they have lived through a progressive drama mixed with fear, uncertainty and grief. ...
Due to the massive deaths and high level of contagion brought about by COVID-19, burial practices and the way we bury our dead are being affected by SARS-CoV-2 confinement and control measures. Here, we aimed to examine the changing of death, dying, and mourning during the first wave and quarantine applied in Peru with the arrival of COVID-19 in 2020. Using a qualitative approach, 15 participants who lost a family member because of COVID-19 were interviewed by telephone and video call. Our results revealed that death in isolation, the loss of rituals, and the farewell to relatives have dramatically affected family members. Peruvian funeral practices were altered by health provisions, making it a challenge to accompany relatives at the end of life. This way of coping with death can affect family wellbeing, for which no interventions have yet been proposed to improve the quality of life during bereavement.
... Considering social distancing rules, only close family members were allowed to attend funerals. In some cases, the relatives of the deceased were not allowed to attend the burial, and the officers carried out the burial ceremony by wearing protective clothing (Hamid & Jahangir, 2020;Lazzerini & Putoto, 2020;Government of Canada, 2021;Government of Turkey, 2021;O'Mahony, 2020;Omonisi, 2020;Public Health England, 2021). ...
... In this process, individuals might not have the opportunity to say goodbye to the person they lost, as any loss experienced by the individual was fast and sudden. Not being with them at the last moment, not being able to touch them for the last time, and not saying goodbye have made the mourning process, which is already difficult to cope with, more destructive for individuals (Aguiar et al., 2020;Hamid & Jahangir, 2020;Omonisi, 2020;Wallace et al., 2020). Besides, after the loss, individuals need the moral support of their loved ones and be together with them. ...
... Besides, it helps individuals accept the reality of death, provide an environment where they can express their feelings and thoughts comfortably, and give meaning to the loss they experience (Castle & Phillips, 2003;Reeves, 2011). However, ceremonies in mosques, churches, temples, and synagogues or other rituals that bring people together have been restricted or entirely prohibited during the pandemic (Hamid & Jahangir, 2020;Lazzerini & Putoto, 2020;O'Mahony, 2020;Omonisi, 2020). In other words, rituals, ceremonies, and traditions related to mourning and grief have changed with the pandemic in the countries affected by the virus. ...
The measures, restrictions, and death-related rituals in the COVID-19 pandemic have affected the mourning-related routines of individuals. Moreover, mourning processes have been affected by the restriction of death-related cultural rituals, funeral ceremonies performed only by the officials, and the prohibition of visiting graves. This study aims to investigate the experiences of individuals who lost their loved ones in Turkey during the COVID-19 pandemic. For that purpose, the phenomenological method is employed in the design of the study. Individual interviews were conducted with nine participants who lost their relatives during the COVID-19 pandemic. Data were collected through semi-structured interview forms prepared by the researchers. The study participants described the various factors contributing to the grief and mourning process in the COVID-19 pandemic. These factors were categorized into three following main categories: grief and mourning responses of the individuals lost loved ones, including cognitive, emotional, and behavioral responses; risk factors including the expectation of harm, unfinished business, and restriction of death-related religious-cultural rituals; and protective factors including relative support (i.e.
... Thus, rituals, which, according to the author, could offer some explanation and meaning for the death and provide social support for the expression of grief, were mechanically performed, not allowing people to assign meaning to their loss. As described by Hamid and Jahangir [50] and Hanna et al. [51], the impossibility of signifying farewell during a funeral and burial is apparent. Family members resented not only the distance from their loved ones during hospitalization but also not being able to see their bodies after death. ...
... Family members resented not only the distance from their loved ones during hospitalization but also not being able to see their bodies after death. At the most challenging moment of the pandemic, families received their deceased wrapped in plastic bags, not dressed, and with sealed coffins, factors perceived as a dehumanization of the deceased [45,46,50]. This raised questions about whose body was being mourned, leading to doubts about whether it was truly the family member in that coffin. ...
(1) Background: Brazil has been severely affected by the COVID-19 pandemic, with over 700,000 deaths and, consequently, a drastic increase in the number of bereaved individuals. This study aims to understand the emotional suffering after the COVID-19 pandemic in Brazilian adults whose family members have died due to COVID-19. (2) Methods: A clinical–qualitative, cross-sectional, descriptive–exploratory study with a sample composed of 10 bereaved family members was used. Data collection took place in July 2021 through individual semi-structured interviews conducted via video call. The interviews were fully transcribed and subjected to thematic analysis. The corpus was analyzed based on Parkes’ theory of mourning, in dialog with research conducted in the pandemic context. (3) Results: The results were organized into three categories: Living the anticipation of loss in an unknown world; Living through grief in a changed world; and Glimpsing a new possibility of living. (4) Conclusions: The rupture of the presumed world in times of the pandemic, the impossibility of bidding farewell to deceased loved ones, and low levels of social support hindered the process of mourning during the health crisis.
... The pandemic made it clear that physical proximity was no longer guaranteed, highlighting the significance of being physically present during someone's final moments and the impact it had on the experience of bereavement when that choice was not available. Relatives reported regret and a sense of forsaking the dying individual, as their loved ones passed away in isolation [66,67]. The inability to be physically there at the time of death had a significant impact on the interpretation of the deceased person's death by grieving family members. ...
... The individuals perceived their farewell as inadequate, due to the prohibition of physical contact or proximity with their beloved [69]. In certain instances, this resulted in refusal to acknowledge the loss [66]. ...
The COVID-19 pandemic significantly interrupted the grieving experiences of bereaved families and drastically changed their ways of dealing with loss. Our study aims to gain an in-depth understanding of the experience of bereaved relatives of patients who died in palliative care units during the COVID-19 pandemic. The phenomenological research design included sixteen family members of hospitalized palliative patients who died from November 2021 to June 2022. The study involved conducting qualitative in-depth semi-structured interviews with family members 12-24 months after the death of their loved ones. The interviews aimed to gather information about the experiences of the families both before and after the death. The COREQ guidelines were applied in the study. Participants were mainly female (n = 13) with a mean age of 47.25 (SD = 12.58). Data were analysed using the Interpretative Phenomenology Analysis (IPA). The following three categories were identified: (1) navigating loved ones' final weeks and days (troubled deaths); (2) the last farewell was robbed; (3) looking for adjustment after loss. One overall main theme emerged, which was as follows: "Struggling between stolen moments and painful losses to get back into the flow of life". This study provides novel insights into end-of-life care and bereavement from the perspectives of family. Our findings suggest that developing and promoting family-centred culture can lead to compassionate palliative care focused on a myriad ways of affirming that their loved one matters.
... Existing literature on the changing nature of death, dying, and mourning among Muslims due to the COVID-19 pandemic suggests that mourning was highly challenging for participants because they received less in-person support (Hamid & Jahangir, 2022). Moreover, the inability to perform customary rites has added another layer of grief, leading to prolonged grief among the bereaved and has impacted their overall well-being (Hamid & Jahangir, 2022). ...
... Existing literature on the changing nature of death, dying, and mourning among Muslims due to the COVID-19 pandemic suggests that mourning was highly challenging for participants because they received less in-person support (Hamid & Jahangir, 2022). Moreover, the inability to perform customary rites has added another layer of grief, leading to prolonged grief among the bereaved and has impacted their overall well-being (Hamid & Jahangir, 2022). A study in Portugal underlines that individuals were not allowed to have physical or current spiritual support or even to receive the affection of family members and friends (Aguiar, Pinto, and Duarte, 2020). ...
This pilot study aims to explore the experiences of grief and mourning practices of bereaved adults during the pandemic. Eleven adults who have lost a loved one since March 2020 participated in a semi-structured interview exploring the experiences of grief and mourning. Data were analyzed through Thematic Analysis. Participants experienced contrasting psycho-emotional reactions to loss, and they highlighted the restriction of being physically present to the dying loved one as the hardest aspect of losing someone during COVID-19. Moreover, they identified challenging factors during the funeral practices: the small number of mourners during ceremonies, abstinence from hugging and touching each other as a form of consolation, and wearing masks, which further made the ceremony impersonal. Finally, the alteration of the paying respects process has contributed to the mourners' experienced stress and sorrow. Findings are discussed per the current literature and recommendations based on cultural diversities are proposed.
... Whereas rites are considered a broader category, such as rites of healing or passage, rituals are the actions that make up the rites (Cardoso et al., 2020). A study in India found that the inability to perform rites and rituals negatively impacted bereaved families, prolonged their grief, and reduced their wellbeing (Hamid & Jahangir, 2020). Funeral ceremonies were also forbidden in Italy during the first year of the pandemic, making the grieving process more difficult for families (Ingravallo, 2020). ...
... This finding also supports findings in previous literature (Burrell & Selman, 2020;Hamid & Jahangir, 2020;Ingravallo, 2020) that the funeral protocol prevented bereaved families from performing the cultural and religious funeral rituals they considered necessary. As previous literature has highlighted (Gabay & Tarabeih, 2022), care professionals have an important role in providing the basic right of a peaceful and dignified death to patients and in supporting the family through their grieving and bereavement, such as among religious minorities -Muslim families in Israel in the Gabay & Tarabeih (2022) study. ...
Deaths caused by COVID-19 have affected bereaved family members in several ways, including the inability to perform funeral rites and rituals. Understanding the dynamics and experiences of death and funerals of bereaved families and mortuary workers can lead to improvements in funeral services and the provision of social support for the affected families and mortuary workers. This study aimed to capture the experiences of mourning family members in Indonesia who lost a loved one due to COVID-19 and of mortuary workers who performed funerals according to COVID-19 protocols. Ten family members and 12 mortuary workers living in West Timor, Indonesia, were interviewed using a semistructured interview approach. Findings of the study show that mortuary workers were able to strictly implement the new funeral protocols. However, the rushed nature of these funerals led to resistance from families and prevented bereaved families from performing the usual cultural and religious funeral rituals. This, combined with stigma from their neighbors, led these families to have poor psychological wellbeing.
... The nature of the pandemic affected how people experienced and managed death, as well as the support they received during the grieving process. This ultimately changed the way people dealt with grief (Hamid & Jahangir, 2022;Helton et al., 2020;Jordan et al., 2022). Although grief is a normal response after the death of a loved one, people grieving from deaths due to or during COVID-19 reported more severe acute grief than those mourning deaths due to other natural causes (Breen et al., 2021;Tang & Xiang, 2021). ...
The COVID-19 pandemic amplified the emotional impact of losing a loved one, deteriorating well-being, and increasing dysphoric symptoms in mourners. This study evaluated the efficacy of COVID Grief, a self-applied online cognitive-behavioral intervention for Mexican adults facing grief during the pandemic. We conducted a randomized clinical trial, enrolling 1,109 participants, 45 of whom completed the full intervention, and 69 of whom completed the waiting list control (WLC). Between-subject analysis showed that intervention group (IG) participants reported significantly higher satisfaction with life and quality of life and a reduction in depression, anxiety and stress levels compared to those in the WLC. Within-subjects analysis showed that IG presented no significant changes in satisfaction with life, whereas the quality of life was increased, and levels of depression, anxiety, and stress were reduced after treatment. For WLC, satisfaction with life and quality of life were significantly decreased, and symptoms of depression and anxiety -but not stress symptoms- increased after the waitlist. Completer’s opinions of the treatment were highly positive, although they only represent 5% of participants who accessed the intervention. High dropout rates should be addressed in future studies.
... Penelitian-penelitian sebelumnya yang telah dilakukan mengenai topik kedukaan dalam konteks pandemi Covid-19 mayoritas membahas mengenai dampaknya pada masyarakat secara luas (Hamid & Jahangir, 2020;Hanna et al., 2021). Penelitian mengenai kedukaan dalam konteks Covid-19 pada populasi kelompok lanjut usia, umumnya hanya memberikan gambaran mengenai potensi gangguan kesehatan fisik dan mental yang dapat terjadi pada kelompok tersebut (Goveas & Shear, 2021;Wang et al., 2022). ...
Penelitian kualitatif berbasis studi kasus ini bertujuan untuk mengeksplorasi pengalaman dan pemaknaan atas kedukaan yang dialami kelompok lanjut usia dalam menghadapi kematian anggota keluarga terdekat yang disebabkan oleh pandemi Covid-19. Partisipan penelitian ini adalah dua orang lansia perempuan yang kehilangan anggota keluarga terdekat akibat pandemi Covid-19. Hasil studi ini menunjukkan bahwa peristiwa kedukaan yang dialami individu dapat dimaknai secara berbeda. Pengalaman, pemaknaan dan strategi koping yang digunakan juga berubah seiring dengan penambahan usia. Hasil studi ini dapat dirangkum dalam tiga tema besar yaitu, individu lanjut usia cenderung fokus pada restoration orientation pada tahap awal kematian terjadi, perasaan menyesal yang muncul atas peristiwa kematian yang terjadi di situasi Covid-19, dan kepercayaan atas ajaran agama membantu pemaknaan kematian secara adaptif. Penelitian ini diharapkan dapat membantu meningkatkan pemahaman masyarakat dalam menghadapi fenomena kedukaan yang terjadi secara masif akibat pandemi Covid-19 secara spesifik pada kelompok yang paling rentan yaitu kelompok lanjut usia.
... Little previous research has documented the importance of the size of funerals, but a number of studies on the abbreviation of funerals due to COVID-19 restrictions suggest that restriction of funeral attendance tends to upset families who wanted to invite more friends and relatives [17][18][19][20]. ...
Background: Previous research shows that grief causes medical and psychological problems for a substantial minority of the bereaved, which places stress on modern medical and social welfare systems. Other research demonstrates that funeral dissatisfaction correlates with medical and psychological problems, but does not address what aspects of funerals cause greatest satisfaction or dissatisfaction. We examined anonymized survey responses describing aspects of funerals causing the greatest anxiety or relief to bereaved Japanese individuals—and in turn affecting medical/welfare costs for the entire society. Method: A research team centered at Kyoto University collected over 1400 questionnaires from recently bereaved Japanese, of whom more than 300 volunteered anonymous comments about their funeral experiences. This article categorizes and analyses these qualitative data. Results: We classified their comments into 10 themes: Hospital Interaction; Pre-arrangement; Timing good-byes; Attendance; Friends/relations; Rituals; Crematorium; Ceremonial meals; Costs; Follow-up. Conclusions: The greatest disappointment appeared in attendance, connection to friends and relations and rituals. When lacking, insufficient, or ill-handled, these leave long-standing bad memories and dissatisfaction that aggravate mourners’ psychological and physical ailments. Our research highlights the psychological effects of cremation, and the value of itemization and explanation of funeral costs. Funeral directors can significantly reduce dissatisfaction by awareness of and sensitivity to these issues, thus contributing to national health and welfare.
... However, the instances of hospital collapses increased as the pandemic progressed. This collapse was not limited to care but extended to postmortem services: forensic work, morgues, funeral services, and cemeteries [8][9][10][11]. ...
In this paper, we examine the epidemiological model B-SIR, focusing on the dynamic law that governs the transmission rate B. We define this dynamic law by the differential equation B′/B=F⊕−F⊖, where F⊖ represents a reaction factor reflecting the stress proportional to the active group’s percentage variation. Conversely, F⊕ is a factor proportional to the deviation of B from its intrinsic value. We introduce the notion of contagion impulsef and explore its role within the model. Specifically, for the case where F⊕=0, we derive an autonomous differential system linking the effective reproductive number with f and subsequently analyze its dynamics. This analysis provides new insights into the model’s behavior and its implications for understanding disease transmission.
... CBI: Core Bereavement Items in Turkey and the social aspect of these engagements can support resilience against challenging life events (Aydogdu et al., 2021), as a social support buffer. In the case of losing a loved one, in particular, culture-specific rites and rituals are suggested to pave the way to accepting and acknowledging death, while helping the bereaved seek and receive social support (Hamid & Jahangir, 2022), reducing the grief experienced during bereavement. In Islam, the death rituals such as looking upon the face of the deceased, cleansing and shrouding the body, and the funeral ceremonies guided by the Imam help not only achieve one's religious duties but also enable closure and provide means to process and cope with grief (Mohamed Hussin et al., 2018). ...
The current study examined whether disruption to performing Islamic death rituals could be linked to core bereavement and post-traumatic stress disorder (PTSD) symptoms in Turkish-Muslim individuals who lost their close relatives to COVID-19. Participants (n = 52) completed a Demographic Information and Bereavement Experience (DIBEF) form with items probing demographics, attendance to rituals, receiving social support, and perceived disruption to bereavement via COVID-19 restrictions. The Core Bereavement Items (CBI) and the Post-traumatic Stress Disorder Checklist-Civilian Version (PCL-C) were used to measure symptomatology. The results showed that 92.3% of the participants did not receive condolence visitors, 98.1% failed to say goodbye, and 78.8% could not practice their religious duties. Importantly, perceived disruption score was significantly linked to the CBI (but not PCL-C) scores. The potential role of perceived disruption to bereavement in aggravating the grief response is discussed in relation to the dual process model of coping with bereavement. ARTICLE HISTORY
... [1][2][3][4][5][6] Infectious disease control measures led to visiting restrictions that caused separation between patients and families [7][8][9][10][11][12] limited care by HCPs, [12][13][14] communication difficulties between patients, their families and HCPs, 11 12 15 16 and patient isolation. [17][18][19] It has been suggested that the high workload for HCPs affected the quality of end-of-life care, prioritising urgent physical care over emotional, social and spiritual aspects. 12 The management of bodies after COVID-19 deaths also emerged as a significant social issue during the pandemic. ...
Background
During the COVID-19 pandemic, numerous issues regarding end-of-life care for COVID-19 patients have been discussed. Among these issues, challenges related to the use of body bags following the death of COVID-19 patients have been suggested. This study aimed to identify the challenges faced by healthcare professionals (HCPs) when using body bags after the death of patients infected with COVID-19 in medical settings.
Methods
We conducted a qualitative descriptive study with semistructured in-depth interviews using inductive thematic analysis. From August to December 2021, we interviewed nurses and doctors who provided end-of-life care to COVID-19 patients focusing on their experiences with the use of body bags for the deceased.
Results
Of the 25 interviewees who mentioned body bag use, 14 were nurses (56%) and 13 were women (52%). The mean interview length was 52.0 min (SD 9.6 min). Challenges associated with body bag use were classified into four themes with eight categories: preserving the dignity of the deceased, consideration for the bereaved saying a final goodbye to a loved one in a body bag, the physical and emotional impact on HCPs, and diverse opinions on body bag use.
Conclusion
Our findings include ethical concerns about the dignity of the deceased, empathy for the grief of bereaved families, and the emotional and physical distress experienced by HCPs struggling with the recommendation to use body bags based on limited evidence. The diverse perspectives of HCPs in this study highlight potential issues that developers should consider when formulating more appropriate and acceptable guidelines/guidance and policies.
... Societies usually have agreed upon ways and expectations of how certain important aspects of social life are planned, organized and executed, including burial rites and funerals. Similar to other studies [8,[17][18][19] across Africa, our results revealed that the COVID-19-related death and burial protocols were deemed to be 'uncultural' as they violated customary traditional culture and even religious rituals for the dead. However, missing in these earlier studies are the cultural contextual nuances in the nature of resistances to the COVID-19 burial protocols. ...
Background
Despite the large volume of scientific evidence on the rapid spread of the COVID-19 pandemic and associated high morbidity and mortality, little is known about the sociocultural disruptions which ensued. The current study explored the nuanced navigation of the COVID-19-related death and burial protocols and its impact on traditional burial and funeral rites in Ghana.
Methods
This qualitative study was based on the ‘focused’ ethnographic design. Data were collected using key informant interviews from nineteen COVID-19-related bereaved family members and public health officials involved in enforcing adherence to COVID-19-related death and burial protocols in the Cape Coast Metropolis of Central region of Ghana. Recursive analysis was conducted to generate the themes and sub-themes from the data.
Results
The overarching theme was “Uncultural” connotations ascribed to the COVID-19-related death and burial protocols. The COVID-19-related death and burial protocols were ubiquitously deemed by participants to be ‘uncultural’ as they inhibited deep-rooted indigenous and eschatological rites of separation between the living and the dead. This was fueled by limited awareness and knowledge about the COVID-19 burial protocols, resulting in fierce resistance by bereaved family members who demanded that public health officials release the bodies of their deceased relatives. Such resistance in the midst of resource limitation led to negotiated compromises of the COVID-19-related death and burial protocols between family members and public health officials.
Conclusions
Insensitivity to socio-cultural practices compromised the implementation of the COVID-19 pandemic control interventions, particularly, the COVID-19-related death and burial protocols. Some compromises that were not sanctioned by the protocols were reached to allow health officials and families respectfully bury their dead. These findings call for the need to prioritize the incorporation of sociocultural practices in future pandemic prevention and management strategies.
... Carr and her colleagues remarked that certain aspects of COVID-19 deaths-namely, dying in isolation or in overcrowded and overwhelmed healthcare facilities, overreliance on mechanical ventilation for breathing, difficulty in breathing-amplify the pain of loss amid the pandemic. Their characterization of bad deaths amid the COVID-19 pandemic seems to be pertinent and widespread (see Hamid and Jahangir 2020;Walsh 2020), and it bears close resemblance to the Philippine case. ...
The Coronavirus disease (COVID-19) pandemic claimed thousands of lives in the Philippines in 2020. Due to the extended lockdowns, COVID-19 health protocols, and social restrictions, Filipinos were prevented from engaging in prepandemic mourning practices and rituals, leading to the disenfranchisment and compounding of their grief. This paper examines the stories of grief and mourning of Filipinos during the first eight months of the COVID-19 pandemic. Through online storytelling sessions, it presents and chronicles the ways that Filipinos have inventively and bravely adapted to the restrictions and the lack of opportunities to come together and mourn. These include the use of various technologies to come up with modified versions of traditional rituals, and the appropriation of Facebook and its affordances, turning it into a site of mourning, commemoration, and remembrance. These attempts by bereaved Filipinos to reinvent prepandemic mourning practices and develop digital mourning practices on Facebook may be seen as their effort to “enfranchise” their grief amid a highly constricting climate.
... In turn, secondary and concurrent factors can make grief more difficult to overcome at this time, such as unexpectedly high mortality rates worldwide, isolation measures to prevent infections, intrahousehold tensions, worries about possible contagion and the availability of health care, the absence of farewell rituals, or the stigma surrounding COVID-19 patients and their families. These circumstances have generated instability in many domains, including social networks and relationships, finances, work, autonomy, safety, social roles, plans, recreation, and personal freedom, among others [4,[8][9][10]13,[22][23][24][25]. In the face of these deaths and secondary losses, the need for interventions to treat grief is evident [4]. ...
Background: The death of a loved one was a challenge many people faced during the COVID-19 pandemic within the context of extraordinary circumstances and great uncertainty. Grief is an unavoidable part of life, and for most people, feelings of grief decrease naturally over time. However, for some people, grieving can become a particularly painful process with clinical symptoms that may require professional help to resolve. To provide psychological support to people who had lost a loved one during the COVID-19 pandemic, an unguided web-based psychological intervention was developed.
Objective: The main objective of this study was to evaluate the efficacy of the web-based treatment, Grief COVID (Duelo COVID in Spanish; ITLAB), in reducing clinical symptoms of complicated grief, depression, posttraumatic stress, hopelessness, anxiety, and suicidal risk in adults. The secondary aim was to validate the usability of the self-applied intervention system.
Methods: We used a randomized controlled trial with an intervention group (IG) and a waitlist control group (CG). The groups were assessed 3 times (before beginning the intervention, upon completing the intervention, and 3 months after the intervention). The intervention was delivered on the web in an asynchronous format through the Duelo COVID web page. Participants created an account that could be used on their computers, smartphones, or tablets. The evaluation process was automated as part of the intervention.
Results: A total of 114 participants were randomly assigned to the IG or CG and met criteria for inclusion in the study (n=45, 39.5% completed the intervention and n=69, 60.5% completed the waitlist period). Most participants (103/114, 90.4%) were women. The results indicated that the treatment significantly reduced baseline clinical symptoms in the IG for all variables (P<.001 to P=.006), with larger effect sizes for depression, hopelessness, grief, anxiety, and risk of suicide (all effect sizes ≥0.5). The follow-up evaluation showed that symptom reduction was maintained at 3 months after the intervention. The results from the CG showed that participants experienced significantly decreased levels of hopelessness after completing the time on the waitlist (P<.001), but their suicidal risk scores increased. Regarding the usability of the self-applied intervention system, the results indicated a high level of satisfaction with the Grief COVID.
Conclusions: The self-applied web-based intervention Grief COVID was effective in reducing symptoms of anxiety, depression, hopelessness, risk of suicide risk, posttraumatic stress disorder, and complicated grief disorder. Grief COVID was evaluated by the participants, who reported that the system was easy to use. These results affirm the importance of developing additional web-based psychological tools to help reduce clinical symptoms in people experiencing grief because of the loss of a loved one during a pandemic.
Trial Registration: ClinicalTrials.gov NCT04638842; https://clinicaltrials.gov/ct2/show/NCT04638842
... The loss of a loved one to COVID-19 has been particularly challenging for the bereaved living through this global health crisis (Breen, 2020;Goveas & Shear, 2020;Hamid & Jahangir, 2020). The current study sought to add to our understanding of this unique form of loss, by examining the dysfunctional grief symptoms of Salvadorans who lost loved ones to COVID-19. ...
Thousands of people have died of COVID-19 in El Salvador. However, little is known about the mental health of those who are mourning the loss of a loved one to COVID-19. Therefore, the objective of this study was to examine the dys-functional grief associated with COVID-19 death among Salvadoran adults. A sample of 435 Salvadorans (M = 29 years; SD = 8.75) who lost a family member or loved one to COVID-19 completed a digital survey using the Google Forms platform, during April 2 and 28, 2022. The results revealed that 35.1% reported clinically elevated symptoms of dys-functional grief and among those mourners, and 25.1% also exhibited clinical levels of coronavirus anxiety. A binary logistic regression revealed that predictor variables such as COVID-19 anxiety (p = .003), depression (p = .021), and COVID-19 obsession (p = .032) were significant (χ 2 = 84.31; Nagelkerke R 2 = .242) and predict a 24.2% chance of dys-functional bereavement.
... and Tamminga, 2020), we identified features in the narratives that are strictly related to the pandemic experience: the dynamics, conditions, and medical management of the COVID-19 infection, the sense of guilt about having infected a loved one, the patients' experience of isolation in intensive care units, the relatives' experience of isolation at home and inability to see and speak with the loved one, the lack of final farewell associated with the end of life of the loved one, and the absence or disruption of funerary rites (Hamid and Jahangir, 2022;Hernández-Fernández and Meneses-Falcón, 2022). Several authors have argued that these circumstances negatively affected the grief process for losses experiencing during the pandemic, leading to the development of enduring grief reactions or complicated bereavement (Diolaiuti et al., 2021;Nakajima, 2018) that likely require a longer and more targeted intervention model compared to the one employed in the current study. ...
Background:
The SARS-CoV-2 pandemic compromised the mental health of COVID-19 patients and their family members. Due to social distancing and lockdown measures, a remote, tele-psychotherapy program for former or current COVID-19 patients and their relatives was implemented.
Objective:
The primary goal of this project was to evaluate intervention feasibility. The secondary aim was to assess the impact of the intervention by means of pre-post psychological changes.
Methods:
After a phone-based eligibility screening and remote neuropsychological testing, participants completed online self-reports assessing baseline COVID-related psychopathology. Next, participants attended eight tele-psychotherapy sessions. After treatment, the online self-reports were completed again.
Results:
Of 104 enrolled participants, 88 completed the intervention (84.6 % completion rate). Significant pre-post improvements were observed for generalized anxiety (d = 0.38), depression (d = 0.37), insomnia (d = 0.43), post-traumatic psychopathology (d = 0.54), and general malaise (d = 0.31). Baseline cluster analysis revealed a subgroup of 41 subjects (47.6 %) with no psychopathology, and a second subgroup of 45 subject (52.3 %) with moderate severity. Thirty-three percent of the second group reached full symptom remission, while 66 % remained symptomatic after treatment.
Conclusions:
Remote brief tele-psychotherapy for COVID-19 patients and their first-degree relatives is feasible and preliminary efficacious at reducing COVID-related psychopathology in a subgroup of patients. Further research is needed to investigate distinct profiles of treatment response.
... A significant rise in non-COVID-19 deaths was also observed in Canada throughout the pandemic (Statistics Canada, 2022) contributing to an unprecedented number of individuals at risk for disturbed grief. In additional to increased deaths, the circumstances of the pandemic have introduced several factors that may interfere with the grief process and consequently intensify grief symptoms for the larger population of bereaved individuals, including death occurring in isolation or missing the last moments of the deceased, reduced opportunity for mourning rituals due to social distancing measures, co-occurrence of multiple secondary stressors (e.g., social isolation, financial strain), and reduced access to social support and therapeutic services Hamid & Jahangir, 2020;World Health Organization, 2020). For example, in Ontario, government mandates limited the number of people permitted at indoor and outdoor funeral services (10-50 people, respectively) during lock down periods (e.g., March-July 2020 and September-March 2021), forcing individuals to cancel, delay or find alternative solutions, such as virtual services. ...
The COVID-19 pandemic has presented a global challenge for anticipating the support and treatment needs of bereaved individuals. However, no studies have examined how mourners have been coping with grief and which strategies may buffer negative mental health consequences. We examined the various coping strategies being used and which strategies best support quality of life. Participants completed self-report measures of demographic and loss-related characteristics, grief symptoms, quality of life (QOL), and coping strategies used. Despite help-seeking being one of the least endorsed coping strategies used, help-seeking was the only coping strategy that buffered the impact of grief on QOL for individuals with high grief severity. Results support predictions that grief may become a global mental health concern requiring increased accessibility and availability of grief therapies and professional supports for bereaved individuals during and in the aftermath of the pandemic.
... In turn, secondary and concurrent factors can make grief more difficult to overcome at this time, such as unexpectedly high mortality rates worldwide, isolation measures to prevent infections, intrahousehold tensions, worries about possible contagion and the availability of health care, the absence of farewell rituals, or the stigma surrounding COVID-19 patients and their families. These circumstances have generated instability in many domains, including social networks and relationships, finances, work, autonomy, safety, social roles, plans, recreation, and personal freedom, among others [4,[8][9][10]13,[22][23][24][25]. In the face of these deaths and secondary losses, the need for interventions to treat grief is evident [4]. ...
BACKGROUND
The death of loved ones during the COVID-19 pandemic was a challenge people faced in this historical period. Although grief for most people is a natural process that resolves itself, for some, it becomes a painful process with clinical correlates that may require professional help for its resolution. We developed an unguided online psychological intervention to provide psychological support to people who lost a loved one during the COVID-19 pandemic.
OBJECTIVE
The main objective of this study was to evaluate the efficacy of online treatment in reducing clinical symptoms of complicated grief, depression, post-traumatic stress, hopelessness, anxiety, and suicidal risk in adults.
METHODS
We used a randomized controlled trial with an intervention group and a waiting list control group. The groups were assessed three times (before entering, after finishing the intervention, and three months later). As a secondary aim, we evaluated the usability of the system.
RESULTS
For the intervention group, the results indicated that treatment significantly reduced baseline clinical symptoms for all variables, with larger effect sizes for depression, hopelessness, grief, anxiety, and risk of suicide (all effect sizes ≥ 0.5). The participants in the control group significantly decreased hopelessness levels after the waiting list but increased their suicidal risk scores. The follow-up evaluation showed that symptom reduction was maintained. Participants rated the intervention as a highly usability system.
CONCLUSIONS
These results show the importance of developing online psychological tools to reduce clinical symptoms in people going through a grief process derived from the loss of a loved one in times of pandemic.
CLINICALTRIAL
Trial Registration: The study is registered in Clinical trials (NCT04638842).
... Similar studies have been published sharing experiences of those bereaved during the COVID-19 pandemic. 15,22,31,34,35 These studies stress the importance of open communication from healthcare providers, allowing the opportunity to 'say goodbye', and provision of bereavement support. This study is the first step towards understanding the impact that COVID-19 restrictions had on experiences of loss, grief and bereavement in Aotearoa New Zealand, in an effort to raise awareness of the needs of those bereaved during this time, so the necessary supports can be provided. ...
Introduction
Restrictions imposed to eliminate the spread of the coronavirus disease 2019 (COVID-19) virus had significant implications on peoples’ experiences of caring for family/whānau at the end of life, and on their own bereavement process.
Aim
This qualitative research explored the impact of COVID-19 lockdown restrictions on experiences of loss, grief and bereavement in Aotearoa New Zealand.
Methods
This qualitative narrative research used semi-structured interviews with 10 participants who experienced the loss of a loved one during Levels 3 or 4 lockdown in Aotearoa New Zealand (23 March–13 May 2020). Interviews were coded using NVivo software and inductive thematic analysis was used to evaluate the data.
Results
Results were grouped into three themes: death experience; mourning in isolation; and availability of support. These themes provide insight into the challenges and difficulties participants faced when they experienced the death of a loved one during a COVID-19 lockdown, and the impact of these restrictions on their experiences of grief and bereavement.
Discussion
The findings from this research suggest there is an increased risk of prolonged grief among those bereaved during lockdown. Primary care professionals need to be aware of this increased risk in order to identify need and provide access to bereavement support.
... Current studies showed that using cyberspace to heal from grief and express emotions can occur through online memorial pages, sharing photos, voices, and texts from the deceased beyond geographical boundaries (Fakhruroji, 2021;Mojarad et al., 2021;Sofka, 2020). Virtual communication with the bereaved people can be an important way to show care, support, help, and increase a sense of perceived social support (Hamid & Jahangir, 2020), which are vital during the process of grief (Chen, 2020). Another issue that has received more attention is how to deal with the remaining online pages of the deceased. ...
The impact of digitalization on the topic of death and dying seems to be accelerated in recent years. This study aimed to explore the online ways people used to overcome grief and used the COVID-19 restrictions as an example. Thirty-two bereaved participants were interviewed and the data were analyzed using the constructive grounded theory method. Three main themes were extracted from the data: 1) an online way to remember; 2) digitalization of social support, and 3) continuing the bonds. Findings highlighted the important and inevitable role of the digital world in the grief process when there is a restriction in holding usual ceremonies.
... As reported by the Daily Samakal, a female worker Nasima (25) died of COVID-19 in a hospital on 31 May while both the locals of the Tajpur village at Badalgachi of Naogaon district and the relatives of the deceased protested and did not allow to bury at the family graveyard ("None share graveyard", None share graveyard, Police arranged burial at the bank of river, 2020). In many cases, the deceased mostly died in isolation with no one around (Hamid & Jahangir, 2020), even the relatives are not allowed to see the face of the deceased body for the last time due to the fear of deadly coronavirus. These tragic incidents are contributing to the emotional distress of the family (Rao et al., 2020). ...
The global spread of COVID -19 accompanied with the behavioral, psychosocial, and structural elements of social stigma engendered social and bio-medical complexity due to the COVID -19 syndemic. The study aims to explore the process of stigmatization and the extent of social vulnerabilities affected COVID -19 people of Bangladesh. The study used purposive sampling, where a total of 15 different cases were selected from 11 online newspapers in Bangladesh. Results revealed that infected and suspected patients were largely stigmatized through local hatred and eviction, forced quarantining, impeding burial process, hospital and local administration’s mistreating, family-negligence, relatives’ avoidance, and the land owners’ disgracing. The excessive media coverage of maintaining lockdown, quarantining, and physical distance were the major causes of increasing rumor where the poor-income group, female workers, and employees of health-care services were seriously vulnerable. The study findings recommend several guidelines forrecognizing practicability and capability for combatting COVID 19 syndemic.
... The conditions that surrounded Mrs S's EOL phase predispose her to exacerbation of anxiety, fear, distress, and possible guilt. 17,18 ...
COVID-19 has taken 1 million lives as of March 22, 2022. The restrictions and enforced social distancing imposed because of the COVID-19 pandemic adversely affected the way people die, often alone in hospitals without their family members or loved ones by their side. Religious and cultural beliefs predominantly influence every aspect of people's lives, especially during the end of life (EOL). Islam is the fastest growing religion worldwide after Christianity and the third most practiced religion in the United States. The Islamic religion specifies how Muslim practice health and wellness, death, and EOL care. Islamic teachings provide a roadmap on EOL practices and death rituals that must be followed by the practicing individual. Scarce empirical studies exist on practices and rituals of Muslims near death and dying. Therefore, the aim of this case report is to provide a practical framework for health care practitioners to understand essential Islamic EOL practices and provide resources to guide clinical practice.
... In Iran, mourning ceremonies are comprised of specific sequence of customs, namely funeral procession, burial of the deceased in presence of his/ her friends and relatives, the relatives' gathering in the deceased's home to console the bereaved family, hosting a religious ceremony, and doing charity on behalf of the deceased. At the same time, in Iran, like in other countries, newly enforced policies and instructions regarding the management of corpses, funerals, burials and attending other customary rites are being implemented (9). As a consequence of the imposed restrictions, families who have lost loved ones have often been deprived of the chance to attend the person's bedside before his/her death, hence missing the opportunity to bid farewell to the deceased. ...
Background: The way one mourns varies across different cultures. As such in each society, the mourning rituals in accordance with the culture of that society can alleviate the grieving process. During the coronavirus (COVID-19) pandemic, in many parts of the world, restrictions have been imposed on hosting different ceremonies and events to control the spread of the virus. Since the enforced regulations have made changes to the way mourning is done in these times, an investigation of the experiences of people of different cultures in coping with loss during the current crisis seems to be of importance. The purpose of this study was to investigate the mourning experiences in north-east of Iran during COVID-19. Methods: This is a qualitative study which was conducted by using content analysis. The participants were 11 individuals who had lost a family member due to COVID-19 in Bojnurd in 2020. Sampling was purposive and continued until reaching data saturation. Semi-structured interviews and note-taking were utilized for data collection. The interviews were recorded and the notes were then evaluated. Results: After analyzing the collected data and forming semantic units, three main categories and nine sub-categories of unexpressed grief were extracted. Unexpressed bereavement, effects on mental health, and dissatisfaction with services comprise the main categories while lack of farewell opportunity, the emotional burden of COVID-19, strange burial, fear and social stigma, lack of adequate psychological support, emotional trauma and shock, reducing the motivation for life, lack of professional principles in the death announcements, and finally lack of equipment and non-compliance with hygiene standards make up the 9 subcategories. Conclusion: The collected evidence concerning the unexpressed grieving experience ensuing from the COVID-19 induced death of a family member reveals such issue to be one of the most important mental health issues during the spread of the virus, which requires the necessary investigation and intervention of the experts in this field.
... In Indian Kashmir, the Buddhist tradition suggests that seeing the face of the dead is useful in recognizing the reality of loss since it removes any doubt about death. The customary burial practices and rituals help the bereaved to accept the reality, express the loss, and reorganize life without the deceased (Hamid & Jahangir, 2020). During the peak of the pandemic, dead bodies were cremated or buried often by nonfamily members. ...
Cultures across the globe have evolved time-tested rituals to honor those who die and offer solace and support to survivors with the goal of helping them to accept the reality of the death, cope with the feelings of loss, adjust to life without the deceased, and find ways to maintain a connection to the memory of the deceased. The COVID-19 pandemic has disrupted these rituals and brought significant changes to the way we mourn. Specifically, public health responses to COVID-19 such as social distancing or isolation, delays or cancellations of traditional religious and cultural rituals, and shifts from in-person to online ceremonies have disrupted rituals and thus made it more difficult to access support and complete the psychological tasks typically associated with bereavement. This paper conceptualizes the common bereavement tasks including emotion-focused coping, maintaining a connection to the deceased, disengagement and reframing death and loss, and problem-focused coping. It provides examples of how the COVID-19 pandemic has altered mourning rituals across several cultures and religions and contributed to prolonged grief disorder as defined by the ICD-11 that includes depressive symptoms and post-traumatic stress. Early evidence suggested that the suddenness of loss, the social isolation, and the lack of social support often associated with COVID-19-related death are salient risk factors for complicated grief. As a consequence, psychological assessments, grief counseling, and mental health support are needed by families of patients who died from COVID-19. These services must be essential components of any comprehensive public health response to the pandemic.
... The bodies of people with COVID-19 who died in isolation are immediately discarded without funerals. Due to these unexpected casualties, bereaved individuals cannot adequately mourn for their loved ones (Hamid & Jahangir, 2020;Neimeyer & Lee, 2022). According to Goveas and Shear (2020), unexpected death during COVID-19 is a PGD risk factor for the bereaved; COVID-19 deaths have triggered grief and aggravated psychological distress such as suicidal ideation and substance use to cope with loss (Lee & Neimeyer, 2020;Gang et al., 2022). ...
This study aims to investigate the psychometric properties, stability, and predictive validity of the PG-13-K. Two subsamples were used: the first subsample (N = 153), participated at Time 1 only, and the second subsample (N = 184) participated at both Time 1 and Time 2. At each time point, reliability, test-retest reliability, and validity were adequate, and the hypothesized two-factor model indicated good to excellent fit. Moreover, the PG-13-K was able to predict the correlation between prolonged grief disorder (PGD) and negative psychological factors. The PG-13-K is a useful and valid instrument for measuring PGD symptoms in Korean settings.
This study aims to explore the differences in prolonged grief (PDG), posttraumatic stress (PTSD), and depression symptoms (MDD) following the loss of a loved one before and after the COVID-19 pandemic. Using a cross-sectional design, 888 bereaved individuals were classified on different groups according to the cause of death. Results indicate that participants who experienced a loss during the pandemic, regardless of the cause, presented higher levels of prolonged grief, posttraumatic stress and depression when compared to those who lost a loved one before the pandemic. This study sheds light on the environmental influences (ex: the COVID-19 pandemic) on the grieving process, emphasizing the need to take the context into account when tailoring interventions in bereavement and mental health care.
Transgender persons are one such group of people who have been marginalized and excluded from general society and the COVID-19 pandemic has amplified these socio-cultural problems for them. Therefore, it is imperative to protect such vulnerable populations from this pandemic particularly considering they are at an increased risk for a wide range of issues. Telephonic Interviews were conducted with 20 participants, from April 1, 2021, to May 12, 2021. The findings of the study revealed that their lived experiences as transgenders made it apparent that they had been socially excluded and marginalized at many stages of their lives from performing normal social functions and roles and the COVID-19 pandemic has added to their miseries. Due to this health crisis, transgender people are struggling to manage the financial, mental, physical, and social issues it has created for this vulnerable group. Using a qualitative approach, this study aimed to examine the changing nature of the socio-cultural implications of COVID-19 on transgenders in Kashmir. Besides it is important to address the special needs of transgender people during this pandemic of COVID-19 and beyond.
COVID-19 has complicated grieving experiences. Rich qualitative description of these experiences is lacking. We interviewed 10 bereaved relatives (mainly daughters) 2-3 times each: shortly after their relative died in the first wave of COVID-19 pandemic, and after 12 and 18 months (29 interviews in total). Analyses took place according to inductive content analysis. Losses were threefold: the loss of the loved one; of the (desired) way to say farewell, and of social support. We identified five ways in which the three COVID-19 related loss experiences interacted: overshadowed grief, cumulative grief, triggered grief, derailed grief, and conciliatory grief. This study demonstrated that pre-COVID-19 diagnoses and understandings of grief are not sufficient to picture grief during and after the COVID-19 pandemic. These grief experiences are more complex and deserve further exploration.
This study explored the perception of Cremation from psychology students who have finished taking clinical psychology. It explores their views of Cremation and the factors behind those views. At the same time, provide an intervention plan. The study was primarily anchored by the Constructivist Theory of Perception by Richard Gregory (1970) and supported by the Mere Exposure Effect by Robert Zajonc (1968) and the Gateway Belief Model by Van der Linden (2019). In this qualitative study, a phenomenological research design was applied. The sixteen (16) participants were selected using the purposive sampling technique. The researcher used a semi-structured questionnaire with an open-ended interview to gather data. The qualitative data were analyzed thematically through transcription of interviews, coding, significant statements, formed meanings, clustering themes, and emerging themes. Based on the analyzed data, it resulted in nineteen (9) emergent themes, which were divided into two (2) that offered results from the sub-problems. For the participants' views on Cremation, the emerging themes are Facial and Body Deformation, Expensive Process Fees, Clean Process, and Double Killing. For the factors that affect the participants; views on Cremation, the emerging themes are Lack of Knowledge on Cremation, Influence of Status Symbols, Influence of Religion and Tradition, Family and Financial Conflict, and Before Funeral Promise. This study's conclusions and recommendations were used to help the crematorium homes and the potential client. Thus, to further explore the cremation practice in the Philippines and how it affects an enormous scope and to make a more strategic action plan.
The grief experiences of healthcare professionals have both short- and long-term effects. This qualitative study was conducted between December 2022 and January 2023 to examine the grief experiences of nurses who lost their first-degree relatives to COVID-19. In this study, 22 nurses working in hospitals in Turkey were selected through a snowball sampling process. Data were collected with the "Nurse Information Form" and "Semi-Structured Interview Form." Nurses were interviewed individually approximately 30 minutes. Collaizzi's phenomenological analysis and MAXQDA 2020 software were used to analyze the data. A COREQ Statement Checklist was followed in the preparation of this study. The following five themes were identified: (1) Complex and deep feelings, (2) An inevitable end, (3) An innocent death, (4) Secluded funerals and rituals that could not be performed, and (5) Endless mourning. It is recommended to plan methods to protect nurses' psychosocial health and maintain their hopes during the grieving process.
Background:
Kidney and liver transplant recipients may be at a high risk of contracting acute COVID-19 due to chronic immunosuppression and comorbidities. These patients receive combinations of immunosuppressive drugs, altering their innate and adaptive immunity, thus, rendering them more susceptible to bacterial and viral infections and higher mortality. Kidney and liver transplant recipients frequently exhibit one or several risk factors, increasing the risk for unfavorable outcomes.
Methods:
This qualitative study explores perceptions of religious rituals and practices relating to COVID-19 deaths among Muslim kidney and liver transplant recipients during the first, second, third, and fourth waves, focusing on their tendency to unlawfully refuse to be hospitalized due to their objection to certain guidelines that prevent or restrict religious practices and traditions. A qualitative study based on interviews with 35 older, religious Muslim liver and kidney transplant recipients was conducted face-to-face and on Zoom.
Results:
Our findings indicated the absence of acceptable and respectful death rites for the deceased in the event of death from COVID-19, spurring the refusal of older, religious Muslim transplant recipients in Israel to be hospitalized after contracting COVID-19.
Conclusions:
To address these concerns, health authorities and religious leaders must collaborate to find solutions that satisfy the requirements of both the health system and the religious Muslim community.
This is an extensive editorial of the special issue of photographies "Everyday Mourning and Photography in the 21st Century"
Background
The death of a loved one was a challenge many people faced during the COVID-19 pandemic within the context of extraordinary circumstances and great uncertainty. Grief is an unavoidable part of life, and for most people, feelings of grief decrease naturally over time. However, for some people, grieving can become a particularly painful process with clinical symptoms that may require professional help to resolve. To provide psychological support to people who had lost a loved one during the COVID-19 pandemic, an unguided web-based psychological intervention was developed.
Objective
The main objective of this study was to evaluate the efficacy of the web-based treatment, Grief COVID (Duelo COVID in Spanish; ITLAB), in reducing clinical symptoms of complicated grief, depression, posttraumatic stress, hopelessness, anxiety, and suicidal risk in adults. The secondary aim was to validate the usability of the self-applied intervention system.
Methods
We used a randomized controlled trial with an intervention group (IG) and a waitlist control group (CG). The groups were assessed 3 times (before beginning the intervention, upon completing the intervention, and 3 months after the intervention). The intervention was delivered on the web in an asynchronous format through the Duelo COVID web page. Participants created an account that could be used on their computers, smartphones, or tablets. The evaluation process was automated as part of the intervention.
ResultsA total of 114 participants were randomly assigned to the IG or CG and met criteria for inclusion in the study (n=45, 39.5% completed the intervention and n=69, 60.5% completed the waitlist period). Most participants (103/114, 90.4%) were women. The results indicated that the treatment significantly reduced baseline clinical symptoms in the IG for all variables (P
The COVID-19 pandemic has led to a public health crisis, with increases in the number of deaths. As a result, the number of bereaved people has increased significantly. In addition, the measures adopted to control the spread of virus have triggered changes in the subjective and collective bereavement experiences. This systematic literature review aims to summarize and reinterpret the results of qualitative studies on the experience of losing family members during the pandemic by a thematic synthesis. The searches were performed in the Web of Science, Scopus, PubMed/MEDLINE, CINAHL, PsycINFO, and LILACS databases. Among 602 articles identified, 14 were included. Evidence was assessed using the Critical Appraisal Skills Programme tool. Two descriptive themes related to the objective were elaborated in addition to one analytical theme, namely: “Pandemic grief: lonely and unresolved”. These themes proved to be interrelated and indicate that experiences of loss in this context were negatively impacted by the imperatives of physical distance, restriction of hospital visits, technology-mediated communication, and prohibition or restriction of funerals. These changes resulted in experiences marked by feelings of loneliness and helplessness, which should be considered when planning intervention strategies that favor communication between family members with the afflicted loved one and with the health care team, enabling welcoming and creating alternatives for farewell rituals. The findings may support further research to test intervention protocols, especially to guide public policies and promote psychological support to bereaved family members after their loss.
The fear of contracting the disease, introduction of practices such as quarantine, social isolation, and curfew to prevent its transmission, and effects of experiencing a loss due to this disease are experienced differently by different people. The empirical phenomenological approach will be used to describe, explain, and analyze the experiences of the family members of individuals who lost their lives due to COVID-19. This study was created in accordance with COREQ Statement Checklist. The themes obtained from the interviews are “death in isolation”, “changing cultural–religious practices that cannot be performed”, “not being able to say goodbye”.This transformed grieving process caused by the pandemic may create unique psychosocial needs among family members. To meet these needs, planning and organizing complex grief therapy, speech therapies, expressive supportive counseling, and grief recovery programs is recommended.
RÉSUMÉ
La Covid‐19 a entraîné dans plusieurs pays des mesures sociosanitaires inédites, notamment des restrictions majeures aux rituels funéraires. Ces empêchements ont concerné tant les rites pré‐mortem, péri‐mortem que post‐mortem. À partir d'une étude longitudinale débutée en mars 2021 auprès de 955 personnes francophones canadiennes endeuillées d'un proche pendant la pandémie, cet article propose de décrire la réalité vécue de ces empêchements. Par une analyse des données quantitatives et qualitatives recueillies, il est possible d'identifier l’écart entre les rituels funéraires souhaités et réalisés pendant la première année de la pandémie de Covid‐19. Les résultats montrent d'importantes privations des différents rites souhaités, mais également une certaine créativité rituelle et symbolique de la part des personnes endeuillées.
Background
The COVID-19 pandemic has put various restrictions on grief rituals. Literature suggests that the restrictions on funerals and grief rituals may increase the chance of developing symptoms of prolonged grief (PG). In this study, we explored the possible impact of the pandemic on aspects of the funeral and grief rituals and examined their relationship with PG symptoms.
Method
Bereaved individuals from different countries, who lost a loved one in the year prior to the pandemic (n = 50) or during the pandemic (n = 182), filled in an online questionnaire, including a rating of the impact of COVID-19 restrictions, five aspects of the funeral service, five aspects of grief rituals, and a measurement for PG symptoms.
Results
Participants bereaved during the pandemic rated the impact of the restrictions on the experience of the funeral and grief rituals as negative. Nevertheless, no differences were found in attendance and evaluation of the funeral and grief rituals for people bereaved prior to vs. during the pandemic. Attendance and evaluation of the funeral services were related to levels of PG symptoms, whereas the performance and helpfulness of grief rituals were not related to these symptoms. Although not related to PG symptoms, half of the participants used helpful alternative rituals to cope with their loss.
Discussion
Our study suggests that bereaved people respond resiliently to the COVID-19 pandemic, for example by creating alternative rituals to cope with their loss. Furthermore, it stresses the importance of looking beyond symptom levels when studying the importance of funeral and grief rituals.
Background
Acute grief appears more severe after COVID-19 deaths than natural deaths. Prolonged grief disorder (PGD) also appears prevalent following COVID-19 deaths. Researchers hypothesize that specific loss characteristics and pandemic-related circumstances may precipitate more severe grief following COVID-19 deaths compared to (other) natural deaths. Systematic research on these hypotheses may help identify those most at risk for severe grief reactions, yet it is scant.
Objective
To compare loss characteristics, loss circumstances, and grief levels among people bereaved due to COVID-19, natural, and unnatural causes.
Methods
Adults bereaved through COVID-19 (n = 99), natural causes (n = 1006), and unnatural causes (n = 161) completed an online survey. We administered self-report measures of demographic variables (i.e., age, gender), loss characteristics (i.e., time since loss, relationship with the deceased, intensive care admission, expectedness of death), loss circumstances (i.e., saying goodbye appropriately, COVID-19 infection, quarantine, financial setbacks, social support satisfaction, altered funeral arrangements, funeral satisfaction), and prolonged grief symptoms.
Results
COVID-19 deaths (vs. other deaths) more often were parental deaths and less often child deaths. COVID-19 deaths (vs. natural deaths) were more often unexpected and characterized by an inability to say goodbye appropriately. People bereaved due to COVID-19 (vs. other deaths) were more often infected and quarantined. COVID-19 deaths (vs. other deaths) more often involved intensive care admission and altered funeral arrangements. COVID-19 deaths yielded higher grief levels than natural deaths (but not unnatural deaths). Expectedness of the death and the inability to say goodbye appropriately explained this effect.
Conclusions
Bereavement due to COVID-19 is characterized by a unique set of loss characteristics and circumstances and elevated grief levels. Improving opportunities to say goodbye before and after death (e.g., by means of rituals) may provide an important means to prevent and reduce severe grief following COVID-19 deaths.
The COVID-19 pandemic is one of the worst public health crises in a century, with an expected amount of deaths of several million worldwide and an even bigger number of bereaved people left behind. Although the consequences of this crisis are still unknown, a significant number of bereaved people will arguably develop Complicated Grief (CG) in the aftermath of this emergency. If the current pandemic is unprecedented, the grief following the coronavirus outbreak is likely to share features with grief related to natural disasters and after Intensive Care Unit (ICU) treatment. The aim of this paper is to review the most prominent literature on CG after natural disasters, as well as after diseases requiring ICU treatment. This body of evidence may be useful for helping bereaved people during the acute phase of the COVID-19 pandemic and for drawing clinical attention to people at risk for CG.
COVID-19 fatalities exemplify “bad deaths” and are distinguished by physical discomfort, difficulty breathing, social isolation, psychological distress, and care that may be discordant with the patient’s preferences. Each of these death attributes is a well-documented correlate of bereaved survivors’ symptoms of depression, anxiety, and anger. Yet the grief experienced by survivors of COVID-related deaths is compounded by the erosion of coping resources like social support, contemporaneous stressors including social isolation, financial precarity, uncertainty about the future, lack of routine, and the loss of face-to-face mourning rituals that provide a sense of community and uplift. National efforts to enhance advance care planning may help dying patients to receive care that is concordant with the preferences of them and their families. Virtual funeral services, pairing bereaved elders with a telephone companion, remote counseling, and encouraging “continuing bonds” may help older adults adapt to loss in the time of pandemic.
The COVID-19 pandemic is anticipated to continue spreading widely across the globe throughout 2020. To mitigate the devastating impact of COVID-19, social distancing and visitor restrictions in healthcare facilities have been widely implemented. Such policies and practices, along with the direct impact of the spread of COVID-19, complicate issues of grief that are relevant to medical providers. We describe the relationship of the COVID-19 pandemic to anticipatory grief, disenfranchised grief, and complicated grief for individuals, families, and their providers. Further, we provide discussion regarding countering this grief through communication, advance care planning, and self-care practices. We provide resources for healthcare providers, in addition to calling on palliative care providers to consider their own role as a resource to other specialties during this public health emergency.
Sheds light on the concepts, actions, and rituals connected with al-maut, or death in rural Egyptian society. Fundamentally, the study is concerned with death and funeral rituals that reveal the fallahin's beliefs and attitudes toward death, in general, and the dead, in particular. Also, the relationship between men and women, as implicitly and explicitly shown in death rituals and beliefs, is discussed. The paper aims to show that death rituals reflect some fundamental themes in rual Muslim) Egyptian culture. -from Authors
The Pandemic has a long history, but the term of “pandemic” is still not been defined by many medical texts. There have been many significant pandemics recorded in human history, and the pandemic related crises have caused enormous negative impacts on health, economies, and even national security in the world. This article will explore the literature for the concept and history of pandemics; summarises the key features of a pandemics, and discusses the negative impacts on health, economy, social and global security of pandemics and disease outbreaks.
Folklorists and theologians have maintained an interest in the cultural and theological aspects of death and burial-funeral customs; popular beliefs about death, dying and the afterlife; the folklore of forewarnings of death; and so on. Death is not only a natural reality but also a social and cultural fact. As one of the most important events of the life, a great number of beliefs, customs, tradition, ceremonies, rites, pattern behaviors, transactions have been grouped around death. The forms and contents of these beliefs, customs, tradition, ceremonies, rites, pattern behaviors connected with death may differ in terms of time, society and culture. Turkey has very rich folkloric traditions, which have been kept alive for centuries. There is a special place of the folkloric traditions connected with death in Turkish culture. Such beliefs, customs, transactions, ceremonies and pattern behaviors, which accumulated around the death, are categorized under three groups: pre-death, during death and after death. Most of Turkish people are Muslims. Their folkloric traditions are impressed by Islamic values. But, in fact, Turkish death traditions are composition of pre-Islamic customs, Islamic principles and other traditions. In this article, we discuss the comprehension of the Muslim Turkish people about the death as a physical and spiritual matter. They mirrored the understanding of death in the decease customs. But, on the other hand, like other traditions, death customs are affected by globalization.
Purpose
To investigate death-related traditional and religious practices in Narlıdere, a district of Izmir province in Turkey.
Methods
A descriptive design was used (n = 181). The interview form was composed of 28 open-ended questions. The data were collected through face-to-face interviews by the researchers. Descriptive statistics and chi-square significance test were conducted.
Results
Of all the participants, 36.5% described death as the end of life. Praying took place first among the religious practices following death. A total of 42.0% said that relatives and friends who joined the burial ceremony shovel some soil into the pit over the corpse in order to express that they would not claim any rights from the deceased person thereafter, and 55.2% stated that they visited the deceased person's home to give social support to his or her relatives.
Conclusion
We recommended that nurses and physicians be closely acquainted with the prevailing traditions and religious beliefs in the communities where they served.
The aim of this study was to explore cultural factors affecting burial rituals in Poland. Thirty-four university
students collected data from their relatives and created written narratives about deaths in their families or community. Ten additional interviews were conducted with community members, a priest, and medical personnel as part of theoretical sampling and verifi cation of emerging theories. The qualitative material was administered with NVivo and analysed using the Grounded Theory techniques to produce a complex description of folk beliefs, superstitions, as well as symbolic and psychological meaning ascribed to traditional customs. Some of the practices were found susceptible to extinction due to industrialisation, globalisation, and cultural development.
Thematic analysis is a poorly demarcated, rarely acknowledged, yet widely used qualitative analytic method within psychology. In this paper, we argue that it offers an accessible and theoretically flexible approach to analysing qualitative data. We outline what thematic analysis is, locating it in relation to other qualitative analytic methods that search for themes or patterns, and in relation to different epistemological and ontological positions. We then provide clear guidelines to those wanting to start thematic analysis, or conduct it in a more deliberate and rigorous way, and consider potential pitfalls in conducting thematic analysis. Finally, we outline the disadvantages and advantages of thematic analysis. We conclude by advocating thematic analysis as a useful and flexible method for qualitative research in and beyond psychology.
A multicultural Swedish grave quarter and three immigrant funerals are used as vantage points to elucidate how funerals and graveyards are employed as communicative symbolic actions for construction of ethnic and cultural identity. The theoretical perspective draws on ritual studies (Driver, 1991; Durkheim, 1915/1965; Myerhoff, 1984; van Gennep 1960), Goffman's (1967) notion of self-presentation, and studies of ethnicity (Barth 1971; 1994). The study focuses on situations in which ethnicity is actualised and brought to the fore as essential traits of individual or collective identity. Comparison between immigrant ritual practices and mainstream Swedish practices indicate that death rituals can be employed to enhance, subsume, or to fuse social boundaries. In the latter case, the rituals play a part in constructing new social groups. The study further elucidates how multicultural cemeteries reflect and construct a new multicultural Sweden.
This study explores the bereavement process and continuing bond in Pakistani Muslims with the focus on how culture and religion influence these processes. Ten participants were interviewed and their transcribed interviews were analyzed using a grounded theory approach. Three main domains were identified from the narratives expressed by the participants: death and the process of grieving, continuing the link with the deceased, and influencing agents. The findings indicated that Pakistani Muslims maintained their link with the deceased through cultural and religious rituals, such as performing prayers, reciting holy verses, talking and dreaming about the deceased, doing charity, visiting graves, and arranging communal gatherings. The prime purpose of many of these practices was the forgiveness of the deceased. Grief reactions seemed to be determined by the nature of death, prior relationships with the deceased, reaction of society and gender of the bereaved. Religion provided a strong basis for coping and adjustment of the bereaved, through rationalizing and accepting the death. This study has important implications for counselors and family therapists who can use religious affiliations to reduce the impact of loss and complicated bereavement.
The grief and mourning of Muslim citizens in Israel are considered. First, a series of mourning customs spanning the period from notification of death until post-mourning are presented from 3 perspectives: (a) the requirements of the Islamic Sunni tradition; (b) the manner in which Islamic mourning rituals are practiced; and (c) the authors' interpretative perspective. Next, a synopsis of the personal experiences of two adult children to the death of their elderly father illustrates Muslim bereavement from a narrative point of view. Lastly, the concluding section continues a consideration of the distinction between the Islamic religious emphasis on return to functioning and the myriad ways in which the memory and relationship to the deceased are experienced. The article demonstrates how belief system, Islamic mourning rituals, and the power of loss create an experiential blend that is neither monolithic nor stereotypical.
The 2020 COVID-19 pandemic, declared by the World Health Organization (WHO) in January 2020 as a Public Health Emergency of International Concern, has led to global upheaval, causing over a million deaths as well as considerable social and economic disruption.
The COVID-19 pandemic has posed an extreme threat to global health and become a leading cause of death worldwide. Loss, as a more encompassing theme, interweaves many aspects of people’s life in this challenging time. Failure to address the pressing needs of those experiencing loss and grief may result in poor mental and physical health. Recognizing the uniqueness of each individual and their loss and grief will provide opportunities to develop tailored strategies that facilitate functional adaptation to loss and promote mental health and wellbeing in this crisis.
The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has already taken on pandemic proportions, affecting over 100 countries in a matter of weeks. A global response to prepare health systems worldwide is imperative. Although containment measures in China have reduced new cases by more than 90%, this reduction is not the case elsewhere, and Italy has been particularly affected. There is now grave concern regarding the Italian national health system's capacity to effectively respond to the needs of patients who are infected and require intensive care for SARS-CoV-2 pneumonia. The percentage of patients in intensive care reported daily in Italy between March 1 and March 11, 2020, has consistently been between 9% and 11% of patients who are actively infected. The number of patients infected since Feb 21 in Italy closely follows an exponential trend. If this trend continues for 1 more week, there will be 30 000 infected patients. Intensive care units will then be at maximum capacity; up to 4000 hospital beds will be needed by mid-April, 2020. Our analysis might help political leaders and health authorities to allocate enough resources, including personnel, beds, and intensive care facilities, to manage the situation in the next few days and weeks. If the Italian outbreak follows a similar trend as in Hubei province, China, the number of newly infected patients could start to decrease within 3–4 days, departing from the exponential trend. However, this cannot currently be predicted because of differences between social distancing measures and the capacity to quickly build dedicated facilities in China.
From the instance a person passes away, the funeral, mourning, and memorial ceremonies follow sets of religious principles and procedures in every society. However, at the same time, these ceremonies and practices are influenced by the cultural patterns that people endorse. Mourning practices among Muslims of Kashmir also derive from such a religious-cultural amalgamation. This study aims to highlight mourning practices from two standpoints: (a) the prerequisites of the Islamic tradition and (b) the way mourning is actually practiced in Kashmir. To compare the general mourning practices with the actual Kashmiri Muslim mourning practices, different secondary sources were used and in-depth interviews were conducted with 11 participants (6 women, 4 men, and 1 Islamic scholar). The study revealed that mourning practices followed by Muslims of Kashmir are influenced by traditions outside the religion of Islam.
Using a grounded theory approach, this qualitative study aimed to highlight the evolving technological dimensions of death and mourning practices and its transfer from a set physical setting to virtual and open space. The study was carried on 30 participants from Kashmir. Data was collected using in-depth face-to-face interviews and field notes were also used to capture non-verbal communication. The results of the study revealed that a considerable shift is being witnessed so far as death and mourning practices in Kashmir are concerned. The physical space is shrinking and giving way for virtual spaces to play their role in practices related to death and mourning.
This study aims, first, to compare normative Islamic practices toward death and dying and actual practices of Moroccan Muslim women. Second, it seeks to compare the views and practices of middle-aged and elderly women. Qualitative empirical research was conducted with 30 middle-aged and elderly Moroccan Muslim women living in Antwerp (Belgium) and with 15 experts in the field. Our study shows that religious beliefs and worldview have a great impact on Muslims' practices surrounding death and dying. More specifically, practices are strongly shaped by their eschatological beliefs. The rituals are perceived as preparations for the hereafter, entailing purification of both soul and body, and demonstrate the belief in a continued existence of the soul. We found striking similarities between our participants' views and normative Islamic views. We did not find a more secular understanding of death and dying among the middle-aged women.
Funeral mourning is an essential rite of passage in many societies. While there are differences among those aspects peculiar to each culture, there are certain motifs common to mourning in all cultures. Among such common motifs are the sociological functions which in most cultures are served by funeral mourning rituals. Hence this study examines the sociological functions that funeral mourning serves in the Old Testament and in Africa. The fact that mourning serves certain functions in the society has an implication for theology in Africa.
This article discusses the circumstances surrounding death and bereavement amongst Bengali families in East London. Based on fieldwork amongst Bengali elders in the Spitalfields area the article suggests that death and some of the rituals surrounding it are rapidly moving from the private to the public domain within Britain. Whilst ‘traditionally’ in Sylhet most deaths involve the mobilisation of locally based social networks for support and ritual, material and social factors mean that in London death often takes place within hospitals and hospices rather than homes. Combined with this, rituals of bereavement are often carried out in Bangladesh, where bodies are returned for burial. This can mean that some members of the family, especially widows who do not usually accompany their husbands’ bodies to Sylhet, are excluded from important processes of ritual grieving. Many widows are also far more socially isolated in Britain than Stereotypic images of Bengali extended families might suggest. The situation is not, however, static. Within the context of rapid social and cultural change and the ‘Islamisation’ of some parts of London's East End, Muslim cemetaries are becoming established, and the ritual centre increasingly moving from Bangladesh to Britain.
1. The Classification of Rites2. The Territorial Passage3. Individuals and Groups4. Pregnancy and Childbirth5. Birth and Childhood6. Initiation Rites7. Betrothal and Marriage8. Funerals9. Other Types of Rites of PassageConclusions
Part 1: Ritual and grief in the time of COVID-19
- K M Adams
Adams, K. M. (2020, April 13). Part 1: Ritual and grief in the time of COVID-19. The
conversation project. https://theconversationproject.org/tcp-blog/ritual-and-grief-in-th
e-time-of-covid-19
Mourning: Grief is lingering in the air like the viral aerosols
- S Afshana
Afshana, S. (2020, May 10). Mourning: Grief is lingering in the air like the viral aerosols.
Greater Kashmir. https://www.greaterkashmir.com/news/opinion/mourning/?fbclid=
IwAR3ss2CpAjJ7zfH2XXwMdfu85SL1OLLa3VLcxkCCJXlBOhnK3PmsIBczbrM
Injured law student dies as Kashmir hospitals flip on Covid protocol
- N Dharma
Dharma, N. (2020, July 01). Injured law student dies as Kashmir hospitals flip on Covid
protocol. The Kashmir Monitor. https://www.google.com/amp/s/injured-law-studentdies-as-kashmir-hospitals-flip-on-covid-protocol/amp/
Change in death rituals: The case of the ritualistic wailing in the Amazigh Culture
- F Gaddar
Gaddar, F. (2013). Change in death rituals: The case of the ritualistic
wailing in the Amazigh Culture. World Journal of Islamic History and Civilization,
3(2), 57-61.
Digital bereavement: Articulating the unheard utterances. https://uncommon ground4500.blogspot.com/ Government of Canada
- E Getty
- J Cobb
- M Gabeler
- C Nelson
- E Weng
- J T Hancock
Getty, E., Cobb, J., Gabeler, M., Nelson, C., Weng, E., & Hancock, J. T. (2010, April
28). Digital bereavement: Articulating the unheard utterances. https://uncommon
ground4500.blogspot.com/
Government of Canada. (2020). Interim guidance: Death care services and handling of
dead bodies during coronavirus disease (COVID-19) pandemic. https://www.canada.ca/
en/public-health/services/disease/2019-novel-coronavirus-infection/guidance-docu
ments/death-care-services-handling-dead-bodies.html
Government of India, Ministry of Health and Family Welfare. (2020). COVID-19:
Guidelines on dead body management. https://www.google.com/url?sa=t&source=
web&rct=j&url=https://www.mohfw.gov.in/pdf/1584423700568_COVID19Guidli
nesonDeadbodymanagement.pdf&ved=2ahUKEwjUqO6ZupqAhXLSH0KHcliCZ
EQFjAAegQIAhAB&usg=AOvVaw1NFmG1Wo_s5c6LPccHUM6t&cshid=15955
10789171
Social uses of funeral rites
- D G Mandelbaum
Mandelbaum, D. G. (1959). Social uses of funeral rites. In F. Herman (Ed.), The meaning
of Death (pp. 189-217). McGraw Hill.
Virtual care connects patients and families during COVID-19 pandemic
Massachusetts General Hospital. (2020, May 06). Virtual care connects patients and families during COVID-19 pandemic. https://www.massgeneral.org/news/coronavirus/vir
tual-care-connects-patients-and-families
Death rituals and practices of the Hill Saora of Orissa
- S B Mohanty
Mohanty, S. B. (2003). Death rituals and practices of the Hill Saora of Orissa [Doctoral
dissertation, Utkal University].
Families able to see loved ones in hospital during coronavirus pandemic using video calling technology
- Northern Devon Healthcare
Northern Devon Healthcare. (2020, April 27). Families able to see loved ones in hospital
during coronavirus pandemic using video calling technology. https://www.northdevonh
ealth.nhs.uk/2020/04/families-able-to-see-loved-ones-in hospital-during-coronaviruspandemic-using-video-calling-technology/
Doctor among 12 die in JK: 489 more cases in 24 hrs, tally 18
- M Peer
Peer, M. (2020, July 28). Doctor among 12 die in JK: 489 more cases in 24 hrs, tally
18,879. Rising Kashmir. https://epaper.risingkashmir.com/
COVID-19: Guidance for managing a funeral during the coronavirus pandemic
- Public Health England
Public Health England. (2020, July 09). COVID-19: Guidance for managing a funeral
during the coronavirus pandemic. https://www.gov.uk/government/publications/
covid-19-guidance-for-managing-a-funeral-during-the-coronavirus-pandemic/covid-19-guidance-for-managing-a-funeral-during-the-coronavirus-pandemic
Ease lockdown, let other critical patients get treatment: Hospitals
- D Rajagopal
- T Thacker
Rajagopal, D., & Thacker, T. (2020, April 23). Ease lockdown, let other critical patients
get treatment: Hospitals. The Economic Times. https://m.economictimes.com/indus
try/healthcare/biotech/healthcare/ease-lockdown-let-other-critical-patients-get-treat
ment-hospitals/articleshow/75310740.cms
COVID-19: Wrongful deaths at a hospital and misrule in Anantnag of Kashmir
- H I Rashid
Rashid, H. I. (2020, May 05). COVID-19: Wrongful deaths at a hospital and misrule in
Anantnag of Kashmir. The Economic Times. https://www.googole.com/amp/s/m.eco
nomictimes.com/news/politics-and-nation/covid-19-wrongful-deaths-at-a-hospitaland-misrule-in-anantnag-of-kashmir/amp_articleshow/75546053.cms
Grieve but in Isolation: How covid-19 has upturned the way we mourn, handle death
- P Sen
Sen, P. (2020, May 03). Grieve but in Isolation: How covid-19 has upturned the way we
mourn, handle death. Outlook. https://www.google.com/amp/s/www.otlookindia.
com/website/amp/opinion-grieve-but-in-isolation-how-covid-19-has-upturned-howwe-moun-handle-death/351989
Johns Hopkins helps patients and families stay connected when COVID-19 prohibits visits
- M Shapiro
Shapiro, M. (2020, May 11). Johns Hopkins helps patients and families stay connected
when COVID-19 prohibits visits. https://www.hopkinsmedicine.org/coronavirus/
articles/stay-connected.html
Everyone included: Protecting vulnerable groups in times of global pandemic
The Hindu. (2020, July 06). Ordeal of people with 'false' COVID-19 positive cases in
Kashmir.
https://www.google.com/amp/s/www.thehindu.com/news/national/otherstates/ordeal-of-people-with-false-covid-19-positive-cases-in-kashmir/article32004052.
ece/amp/
United Nations. (2020). Everyone included: Protecting vulnerable groups in times of global
pandemic. https://www.un.org/development/desa/undesavoice/highlights/2020/04#49113
Grief and COVID-19: Saying goodbye in the age of physical distancing
- K Weir
Weir, K. (2020, April 06). Grief and COVID-19: Saying goodbye in the age of physical
distancing. American Psychological Association. https://www.apa.org/topics/covid-19/
grief-distance
Interim guidance: Death care services and handling of dead bodies during coronavirus disease (COVID-19) pandemic
- Canada Government Of
COVID-19: Guidelines on dead body management
- India Government Of
Awareness, attitude and practice of rural people in Kashmir towards COVID-19: A sample survey
- B A Bhat
- S S Ashraf
- A Ali
- Nusrat
- N Nazim
- M M Sultan