‘It was brutal. It still is’: a qualitative analysis of the challenges of bereavement during the COVID-19 pandemic reported in two national surveys

  1. Anna Torrens-Burton
  2. Silvia Goss
  3. Eileen Sutton
  4. Kali Barawi
  5. Mirella Longo
  6. Kathy Seddon
  7. Emma Carduff
  8. Damian J.J. Farnell
  9. Annmarie Nelson
  10. Anthony Byrne
  11. Rhiannon Phillips
  12. Lucy E. Selman
  13. Emily Harrop

Reviewed by

Read the full article

Listed in

Log in to save this article

Abstract

The COVID-19 pandemic has been a devastating, mass bereavement event characterised by high levels of disruption to end-of-life, grieving and coping processes. Quantitative evidence is emerging on the effects of the pandemic on grief outcomes, but rich qualitative evidence on the lived experiences of people bereaved during these times is lacking.

Methods:

We analysed qualitative data from two independent UK-wide online surveys to describe the experiences of 881 people bereaved during the pandemic. We analysed the data in two phases, conducting an inductive thematic analysis and then applying Stroebe and Schut’s Dual Process Model (DPM) and concepts of loss-oriented and restoration-oriented coping (1999; 2010) as an analytic lens to further contextualise and interpret the data.

Results:

We identified six main themes: troubled deaths; mourning, memorialisation and death administration; mass bereavement, the media and the ongoing threat of the pandemic; grieving and coping; work and employment; and support from the health and social care system. Examples of loss-oriented stressors included being unable to visit and say goodbye at the end of life and restricted funeral and memorialisation practices. Associated reactions were feelings of guilt, anger, and problems accepting the death and beginning to grieve. Examples of restoration-oriented stressors and reactions were severely curtailed support-systems and social/recreational activities, which impacted people’s ability to cope.

Conclusion:

Study results demonstrate the exceptionally difficult sets of experiences associated with pandemic bereavement, and the utility of the DPM for conceptualising these additional challenges and their impacts on grieving. Our analysis builds and expands on previous use of the DPM in explicating the impact of the pandemic on bereavement. We make recommendations for statutory, private and third sector organisations for improving the experiences of people bereaved during and following this and future pandemics.

Article activity feed

  1. Version published to 10.1177/26323524221092456
  2. ScreenIT

    SciScore for 10.1101/2021.12.06.21267354: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Strengths, limitations and implications for research: Both surveys benefit from the longitudinal nature of their design: the BeCOVID project is the first to longitudinally investigate peoples’ experiences of bereavement support during the Covid-19 pandemic in the UK and the COPE study is one of the largest in-depth studies of public experiences and perceptions during the UK pandemic. The COPE survey was restricted in the number of questions relating to bereavement due to the module being only one of many within the overall survey. We were therefore unable to collect as much detailed information related to when and where the deaths occurred, experiences at the end of life and perceptions of bereavement support among COPE participants, and the data were not as comprehensive or detailed as in the BeCOVID study. Although both study sample sizes are large the COPE study recruited most participants through HWW, under-representing other UK nations. In addition, people from minority ethnic backgrounds and men are underrepresented in both data sets. Recruitment was predominantly online which meant we were less likely to reach the very old or other digitally marginalised groups. Understanding the experiences of these groups, who are likely to have experienced greater vulnerability and challenges during their bereavement, is an important area for future research. This paper has focused on the challenges of pandemic bereavement. Forthcoming publications will focus on what has helped bere...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2021.12.06.21267354v1 on medRxiv