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N Engl J Med ; 384(6): 494-495, 2021 Feb 11.
Artículo en Inglés | MEDLINE | ID: mdl-33567481
Global Health ; 17(1): 19, 2021 02 11.
Artículo en Inglés | MEDLINE | ID: mdl-33573673


BACKGROUND: Deaths by COVID-19 have left behind nearly 12 million recent bereaved individuals worldwide and researchers have raised concerns that the circumstances of COVID-19 related deaths will lead to a rise prevalence of prolonged grief disorder (PGD) cases. However, to date, no studies have examined the prevalence of PGD among people bereaved due to COVID-19. This study aimed to estimate the prevalence of PGD and investigated demographic and loss-related factors associated with prolonged grief symptoms among Chinese individuals bereaved due to COVID-19. METHODS: This was a cross-sectional online survey conducted between September 1 and October 3, 2020. A total of 422 Chinese participants (55.5% males; 32.73 [9.31] years old) who lost a close person due to COVID-19 participated in the study. Demographic and loss-related information was collected, and self-reported prolonged grief symptoms were measured by a 13-item International Prolonged Grief Disorder Scale (IPGDS: 1-65) and a 17-item Traumatic Grief Inventory Self Report (TGI-SR: 1-85). Multiple linear regression analysis was used to determine the associated factors of levels of grief symptoms. RESULTS: Prevalence of PGD was 37.8% screened by IPGDS and 29.3% by TGI-SR. No difference was found in levels of grief symptoms between participants whose close one died more than 6 months ago and those who experienced the loss less than 6 months ago. More severe prolonged grief symptoms assessed by IPGDS was associated with losing a close person by COVID-19 rather than complications (B: 5.35; 95% CI: 0.54-10.05), losing a partner (B: 7.80; 95% CI: 3.24-12.37), child (B: 8.15; 95% CI: 1.03-15.26), and parent (B: 5.49; 95% CI: 1.49-9.48) rather than losing a relative or a person with other relationship, feeling more traumatic about the loss (B: 1.71; 95% CI: 0.52-2.90), being closer with the deceased (B: 1.60; 95% CI: 0.34-2.86). Moreover, Losing a grandparent (B: 6.62; 95% CI: 0.53-12.71) and having more conflicts with the deceased (B: 1.05; 95% CI: - 0.008-2.11) were related to higher levels of grief symptoms assessed by TGI-SR. CONCLUSIONS: Echoing researchers' concerns, the prevalence of PGD is high among people bereaved due to COVID-19. Individuals with a higher risk of developing PGD should be identified and bereavement support should be offered as early as possible.

Trastornos de Adaptación/epidemiología , Pesar , Adulto , Aflicción , China/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Prevalencia , Factores de Riesgo
J Med Internet Res ; 23(2): e26254, 2021 02 03.
Artículo en Inglés | MEDLINE | ID: mdl-33468449


BACKGROUND: The COVID-19 pandemic is affecting people with dementia in numerous ways. Nevertheless, there is a paucity of research on the COVID-19 impact on people with dementia and their care partners. OBJECTIVE: Using Twitter, the purpose of this study is to understand the experiences of COVID-19 for people with dementia and their care partners. METHODS: We collected tweets on COVID-19 and dementia using the GetOldTweets application in Python from February 15 to September 7, 2020. Thematic analysis was used to analyze the tweets. RESULTS: From the 5063 tweets analyzed with line-by-line coding, we identified 4 main themes including (1) separation and loss; (2) COVID-19 confusion, despair, and abandonment; (3) stress and exhaustion exacerbation; and (4) unpaid sacrifices by formal care providers. CONCLUSIONS: There is an imminent need for governments to rethink using a one-size-fits-all response to COVID-19 policy and use a collaborative approach to support people with dementia. Collaboration and more evidence-informed research are essential to reducing COVID-19 mortality and improving the quality of life for people with dementia and their care partners.

Cuidadores , Demencia , Familia , Personal de Salud , Medios de Comunicación Sociales , Aflicción , Minería de Datos , Humanos , Casas de Salud , Pandemias , Calidad de Vida , Riesgo , Estrés Psicológico , Visitas a Pacientes
BMC Palliat Care ; 20(1): 7, 2021 Jan 08.
Artículo en Inglés | MEDLINE | ID: mdl-33419428


BACKGROUND: For cancer patients and their family, an important factor that determines the choice to die at home is the caregivers' feeling of security when caring for the patient at home. Support to caregivers from healthcare professionals is important for the feeling of security. In rural areas, long distances and variable infrastructure may influence on access to healthcare services. This study explored factors that determined the security of caregivers of patients with advanced cancer who cared for the patients at home at the end of life in the rural region of Sogn og Fjordane in Norway, and what factors that facilitated home death. METHODS: A qualitative study using semi-structured in-depth interviews with bereaved with experience from caring for cancer patients at home at the end of life was performed. Meaning units were extracted from the transcribed interviews and divided into categories and subcategories using Kvale and Brinkmann's qualitative method for analysis. RESULTS: Ten bereaved caregivers from nine families where recruited. Five had lived together with the deceased. Three main categories of factors contributing to security emerged from the analysis: "Personal factors", "Healthcare professionals" and "Organization" of healthcare. Healthcare professionals and the organization of healthcare services contributed most to the feeling of security. CONCLUSION: Good competence in palliative care among healthcare professionals caring for patients with advanced cancer at home and well- organized palliative care services with defined responsibilities provided security to caregivers caring for advanced cancer patients at home in Sogn og Fjordane.

Aflicción , Cuidadores , Neoplasias/enfermería , Cuidados Paliativos , Población Rural , Cuidado Terminal , Niños Adultos , Femenino , Servicios de Atención de Salud a Domicilio , Humanos , Masculino , Noruega , Padres , Investigación Cualitativa , Esposos
BMC Palliat Care ; 20(1): 15, 2021 Jan 12.
Artículo en Inglés | MEDLINE | ID: mdl-33435936


BACKGROUND: Effective communication in support of clinical decision-making is central to the pediatric cancer care experience for families. A new laboratory derived pharmacogenetic test (LDT) that can diagnose difficult-to-treat brain cancers has been developed to stratify children based on their ability to respond to available treatment; however, the potential implementation of the LDT may make effective communication challenging since it can potentially remove the option for curative treatment in those children identified as non-responders, i.e. those with a catastrophic diagnosis. OBJECTIVE: We solicited the perspectives of parents of children with difficult-to-treat brain cancer on communication preferences surrounding the potential implementation of the LDT in standard care using deliberative stakeholder consultations. METHODS: Eight bereaved parents of children who succumbed to difficult-to-treat brain cancer, and four parents of children currently undergoing treatment for similar cancers attended separate small-group deliberative consultations - a stakeholder engagement method that enables the co-creation of recommendations following the consideration of competing arguments and diverse opinions of parents with different experiences. In the small-group consultations (Phase I), parents discussed four questions about potential communication issues that may arise with the LDT in practice. In Phase II, a total of five parents from both stakeholder groups (4 bereaved and 1 in current treatment) attended a consultation, known as the 'mixed' consultation, with the purpose of co-developing concrete recommendations for implementation of the LDT. RESULTS: Explaining the risks, benefits, and accuracy of the LDT were considered essential to parents. Once an LDT-based diagnosis/prognosis can be made, parents valued honesty, empathy, and clarity in communication. Parents also requested that all results and treatment options be presented to them in measured doses, and in an unbiased manner over the course of several meetings. This communication strategy allowed sufficient time to understand and accept the diagnosis/prognosis, particularly if it was catastrophic. Continuous access to the appropriate psychological and social support or counselling at and post-diagnosis was also strongly recommended. CONCLUSIONS: Deliberants co-created family-centered recommendations surrounding communication issues of the LDT, providing guidance to pediatric oncologists that could implement the test in practice.

Neoplasias Encefálicas/terapia , Comunicación , Oncología Médica , Cuidados Paliativos , Padres , Pruebas de Farmacogenómica , Relaciones Profesional-Familia , Revelación de la Verdad , Aflicción , Neoplasias Encefálicas/genética , Empatía , Humanos , Pediatría , Participación de los Interesados
Soins ; 65(850): 39-42, 2020 Nov.
Artículo en Francés | MEDLINE | ID: mdl-33357738


Death has become a topic in our society and talking about it with young children is often the source of numerous questions on the part of adults, especially parents. How should we talk about death with young children? Does the migration process play a role in certain families? Do they draw on their culture of origin, their cultural or religious customs? Interviews carried out with ten parents provide some insights.

Aflicción , Comunicación , Muerte , Relaciones Padres-Hijo , Adulto , Niño , Preescolar , Cultura , Humanos , Padres
JAMA Netw Open ; 3(12): e2027259, 2020 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-33346843


Importance: Although family members of patients who die in the intensive care unit commonly experience long-term psychological distress, end-of-life bereavement support programs for such relatives are uncommon. Whether art influences the grief experience of families is largely unexplored. Objective: To explore the influence of personalized paintings created to honor deceased critically ill patients on family members' bereavement experience. Design, Setting, and Participants: A qualitative descriptive analysis was conducted of semistructured interviews of grieving relatives who received a painting after the death of their loved one. The deceased patients were from a 21-bed medical-surgical intensive care unit. Eleven families were invited to receive a painting, of whom 1 family declined. A total of 22 family members of 10 patients who died in the intensive care unit were interviewed in the study between July 11, 2017, and May 19, 2019. Interventions: Patients were enrolled in an end-of-life care program that elicits and implements wishes of patients and their families to bring peace during the dying process. Selected families of 10 decedents were invited to receive a painting to honor their loved one 1 to 10 months after the patient's death. Using details about the patient's life story, the artist created individualized paintings to commemorate each patient. Main Outcomes and Measures: The experiences of family members receiving a personalized painting and its reported influence on their grieving experience. Results: The family members of 10 decedents (mean [SD] age, 60 [14] years; 5 women [50%]; 8 White patients [80%]) were interviewed. The central theme of art to facilitate healing was illustrated through the following domains: the cocreation process, painting narratives, postmortem connections, and legacy. The process of cocreating the paintings with the artist and family members involved reminiscing, storytelling, and creativity. Family members emphasized the role of art to facilitate healing, exemplified through connections with images portrayed that deeply resonated with memories of their loved one. Participants indicated that the paintings validated that the patient was remembered, helped families feel less alone during a time of grief, honored the loved one's life, and enhanced connections between family members and clinicians. Conclusions and Relevance: This qualitative study's findings suggest that the creation of personalized paintings commemorating the lives of patients may help foster legacy and postmortem connections with clinicians and may help family members in their healing process.

Actitud Frente a la Muerte , Aflicción , Familia/psicología , Pinturas/psicología , Anciano , Femenino , Humanos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Ontario , Investigación Cualitativa , Cuidado Terminal
Med. U.P.B ; 39(2): 24-33, 21/10/2020. tab, Ilus
Artículo en Español | LILACS, COLNAL | ID: biblio-1123563


Objetivo: Realizar una revisión sistemática de la tendencia de investigación sobre síntomas de trastornos mentales durante la pandemia por COVID-19. Métodos: Se recuperaron artículos publicados entre el 31 de diciembre 2019 y el 3 de mayo 2020, en Pubmed, SCOPUS, EBSCO, PsycINFO, Science Direct, Redalyc y Web of Science, seleccionando, conforme a la metodología PRISMA, un total de 16 artículos, al descartarse duplicados o estudios no empíricos. Resultados: La mayoría se realizaron en China, el tamaño de la muestra osciló entre 20 y 7236 participantes, en su mayoría adolescentes y adultos, entre 12 a 80 años, con muestreo no probabilístico por conveniencia. La tendencia de los síntomas y trastornos más estudiados fueron ansiedad (28%), depresión (23%), estrés (15.3%), trastorno del sueño-vigilia (9.6%) y trastorno por estrés postraumático (5.7%), asociados con el consumo de sustancias psicoactivas, bajo rendimiento académico, pérdida de trabajo, calidad del sueño, bajo autocuidado y baja percepción del estado de salud durante la pandemia. Conclusiones: Los síntomas y trastornos de ansiedad, depresión y estrés son los más frecuentes. Algunas limitaciones son la ausencia de medición previa a la pandemia o cuarentena y el uso de muestreo no aleatorio, para hacer generalización de resultados. Es necesario formular investigaciones de intervención para mitigar el impacto psicológico. Los sistemas de salud deben ofrecer programas de prevención y de promoción de la salud, que consideren factores psicosociales dirigidos a la población general, pacientes y personal sanitario, para disminuir la prevalencia de estas dificultades, en particular, para Iberoamérica, en donde es escasa la producción científica al respecto.

Objective: To carry out a systematic review of the research trend on mental disorders symptoms during the COVID -19 pandemic. Methods: Articles published between December 31, 2019 and May 3, 2020 were retrieved in Pubmed, SCOPUS, EBSCO, PsycINFO, Science Direct, Redalyc, and Web of Science, selected according to the PRISMA methodology, a total of 16 articles by ruling out duplicates or non-empirical studies. Results: Most were carried out in China, the sample size ranged between 20 and 7236 participants, mostly adolescents and adults, between 12 and 80 years old, with non-probability sampling for convenience. The most studied symptoms and disorders were anxiety (28%), depression (23%), stress (15.3%), sleep-wake disorder (9.6%) and post-traumatic stress disorder (5.7%), associated with psychoactive substance use, low academic performance, job loss, sleep quality, low self-care, and low perception of health status during the pandemic. Conclusions: The symptoms and disorders of anxiety, depression, and stress are the most frequent. Some limitations are the absence of pre-pandemic or quarantine measurement and the use of non-random sampling to generalize the results. Intervention research needs to be formulated to mitigate the psychological impact. Health systems must offer prevention and health promotion programs that consider psychosocial factors aimed at the general population, patients, and health personnel, to decrease the prevalence of these difficulties, particularly for Latin America where about scientific production is scarce.

Objetivo: Realizar uma revisão sistemática da tendência de investigação sobre sintomas de transtornos mentais durante a pandemia por COVID-19. Métodos: Se recuperaram artigos publicados entre 31 de dezembro 2019 e 3 de maio 2020, em Pubmed, SCOPUS, EBSCO, PsycINFO, Science Direct, Redalyc e Web of Science, selecionando, conforme à metodologia PRISMA, um total de 16 artigos, ao descartar-se duplicados ou estudos não empíricos. Resultados: A maioria se realizaram na China, o tamanho da amostra oscilou entre 20 e 7236 participantes, na sua maioria adolescentes e adultos, entre 12 a 80 anos, com amostragem não probabilístico por conveniência. A tendência dos sintomas e transtornos mais estudados foram ansiedade (28%), depressão (23%), estresse (15.3%), transtorno do sono-vigília (9.6%) e transtorno por estresse pós-traumático (5.7%), associados com o consumo de substâncias psicoativas, sob rendimento acadêmico, perda de trabalho, qualidade do sono, baixo autocuidado e baixa percepção do estado de saúde durante a pandemia. Conclusões: Os sintomas e transtornos de ansiedade, depressão e estresse são os mais frequentes. Algumas limitações são a ausência de medição prévia à pandemia ou quarentena e o uso de amostragem não aleatório, para fazer generalização de resultados. É necessário formular investigações de intervenção para mitigar o impacto psicológico. Os sistemas de saúde devem oferecer programas de prevenção e de promoção da saúde, que considerem fatores psicossociais dirigidos à população geral, pacientes e pessoal sanitário, para diminuir a prevalência destas dificuldades, em particular, para Ibero América, onde é escassa a produção científica ao respeito.

Humanos , Infecciones por Coronavirus , Ansiedad , Psicología , Aflicción , Cuarentena , Personal de Salud , Depresión , Pandemias , Distrés Psicológico , Necesidades y Demandas de Servicios de Salud , Trastornos Mentales
Rev Lat Am Enfermagem ; 28: e3361, 2020 Sep 07.
Artículo en Inglés, Español, Portugués | MEDLINE | ID: mdl-32901773


OBJECTIVE: amidst the greatest health crisis in history triggered by COVID-19, this documental study was intended to understand the meanings individuals who have lost loved ones in this context assign to the phenomenon of suppressed funeral rituals. METHOD: based on the theory of grief, the corpus of this study was composed of documents published in digital media containing personal writings and reports of experiences freely and easily available to the public. Two researchers with expertise in the field used inductive thematic analysis to interpret data. RESULTS: the experiences shared in the reports reflect the suffering experienced by the sudden death of a significant person, which is amplified by the absence or impediment to performing familial farewell rituals. The suppression or abbreviation of funeral rituals is a traumatic experience because family members are prevented from fulfilling their last homage to the loved one who has suddenly passed away, causing feelings of disbelief and indignation. CONCLUSION: alternatives and new ways to celebrate passage rituals in emergencies of strong social commotion such as a pandemic are needed to provide support and comfort to family members, friends, and relatives. These rituals help survivors to overcome the critical moment, decreasing the risk of developing complicated grief.

Aflicción , Infecciones por Coronavirus/psicología , Ritos Fúnebres , Neumonía Viral/psicología , Betacoronavirus , Humanos , Internet , Pandemias
J Bras Nefrol ; 42(2 suppl 1): 44-46, 2020 Aug 26.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-32877499


INTRODUCTION: Palliative care is an approach aimed at relieving suffering, controlling symptoms and seeking to improve quality of life. It must be offered in conjunction with standard treatment for any disease that threatens the continuation of life, such as a Covid-19 infection. DISCUSSION: The bioethical principles and strategies used by palliative medicine can assist nephrologists in the care of patients with renal dysfunction, who face the difficulties of isolation at the beginning and follow-up of dialysis in outpatient treatment, and those who are at risk for a more serious disease progress. Some of them: - a Shared decision making, which enables the patient and family to participate as facilitators in the systematization of the team's reasoning, in addition to respecting the principle of autonomy; - Symptom Management: which should be a priority to ensure relief of suffering even in times of social isolation; - Communication skills: making it possible to alleviate suffering in announcing bad news or complex decisions through communication techniques;; - Bereavement assistance: which in acute situations such as the pandemic, causing unexpected losses, the importance of sympathy from healthcare professionals becomes even greater. CONCLUSION: The principles of palliative care are essential to face the challenges of a planet-wide crisis, which raises human suffering in all dimensions, and which requires the construction of strategies that can keep patients assisted, comfortable and with measures proportional to their clinical condition and preferences.

Betacoronavirus , Infecciones por Coronavirus/epidemiología , Cuidados Paliativos/métodos , Neumonía Viral/epidemiología , Terapia de Reemplazo Renal/normas , Aflicción , Comunicación , Toma de Decisiones Conjunta , Humanos , Nefrología/normas , Pandemias , Terapia de Reemplazo Renal/métodos , Evaluación de Síntomas/métodos
J Pain Symptom Manage ; 60(5): e15-e20, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32889042


CONTEXT: Coronavirus disease 2019 (COVID-19) has impacted most elements of daily life, including the provision of support after a child's death and the experience of parental bereavement. OBJECTIVES: This study aims to examine ways in which COVID-19 has affected the bereavement experiences of parents whose children died of cancer before the pandemic. METHODS: Parents who participated in a survey-based study examining the early grief experience were invited to complete a semistructured interview. During the interview, which focused on examining the current support for parents and other family members within the first several years after the child's death, participants were asked how COVID-19 has impacted their life and bereavement. RESULTS: Fifteen of 33 eligible parents completed the interview; 14 were white and non-Hispanic, five were males. Parents participated an average of 19 (range 12-34) months after their child's death. COVID-19 was addressed in 13 interviews. Eleven codes were used to describe interview segments; the most commonly used codes were change in support, no effect, familiarity with uncertainty/ability to cope, and change in contact with care/research team. CONCLUSION: Parents identified multiple and variable ways-both positive, negative, and neutral-how COVID-19 has affected their bereavement. Many parents commented on feeling more isolated because of the inability to connect with family or attend in-person support groups, whereas others acknowledged their experience has made them uniquely positioned to cope with the uncertainty of the current situation. Clinicians must find innovative ways to connect with and support bereaved parents during this unique time.

Actitud Frente a la Muerte , Aflicción , Infecciones por Coronavirus/psicología , Neoplasias , Padres/psicología , Neumonía Viral/psicología , Adaptación Psicológica/fisiología , Femenino , Humanos , Masculino , Pandemias
Siglo cero (Madr.) ; 51(3): 47-60, jul.-sept. 2020. graf, tab
Artículo en Español | IBECS | ID: ibc-ET6-1293


El duelo puede definirse como el conjunto de procesos psicológicos y psicosociales que siguen a la pérdida de un ser querido con el que la persona en duelo estaba psicológicamente vinculada, tratándose de una reacción comportamental y emocional causada por la ruptura del vínculo afectivo y manifestándose en forma de sufrimiento. El presente estudio pretende analizar cienciométricamente la producción científica de mayor impacto sobre el duelo y la pérdida en personas con discapacidad intelectual en las principales bases de datos de carácter multidisciplinar: Scopus y Web of Science (WoS). Para ello se delimitaron tres descriptores: "grief", "bereavement" e "intellectual disability". El procedimiento se realizó mediante una búsqueda combinada a tres, analizando la información en torno a ocho variables: publicaciones entre los años 2009-2019, número de registros en la producción científica desde los años 2009 a 2019, número de registros por tipología de documentos publicados, número de registros por títulos de las fuentes procedentes de la literatura científica de mayor impacto, número de registros por países, número de registros por instituciones, número de registros por autores y número de citas en artículos. Los resultados muestran que nos encontramos con un campo científico en vías de desarrollo. Es importante trabajar en investigaciones para conocer de manera detallada las características en el proceso de duelo, junto a una herramienta de uso profesional que ayude a determinar las necesidades de apoyo de las personas con discapacidad intelectual

Grief can be defined as the set of psychological and psychosocial processes that follow the loss of a loved one with whom the grieving person was psychologically linked, being a behavioral and emotional reaction caused by the breakdown of the emotional bond manifesting itself in a way of suffering. The present study intends to scientifically analyze the scientific production with the greatest impact on grief and bereavement of people with intellectual disabilities in the main multidisciplinary data-bases: Scopus and Web of Science (WoS), for this purpose three descriptors were delimited: "grief", "bereavement" and "intellectual disability". The procedure was carried out by means of a combined search by triplets, analyzing the information around eight variables: publications between the years 2009-2019, number of records in the scientific production from the years 2009 to 2019, number of records by type of documents published, number of records by titles of the sources from the scientific literature, number of records by countries, number of records by institutions, number of records by authors and number of citations in articles. The results show that we find a scientific field in development. It is important to work in research to know in detail the characteristics in the grieving process, together with a professional use tool that helps determine the support needs of people with intellectual disabilities

Humanos , Pesar , Aflicción , Discapacidad Intelectual , Bibliometría , Factores de Tiempo , Publicaciones Periódicas como Asunto/estadística & datos numéricos , Bases de Datos Bibliográficas/estadística & datos numéricos
Med. paliat ; 27(3): 226-233, jul.-sept. 2020. graf
Artículo en Español | IBECS | ID: ibc-197376


La población con enfermedad avanzada al final de la vida, la más vulnerable, ha sufrido sobremanera la escasa atención presencial durante la pandemia. Describimos tres experiencias diferentes en relación con la atención domiciliaria de esta población no COVID

The population with advanced disease at the end of life, the most vulnerable one, has suffered greatly from the limited in-person care during the pandemic. We describe three different experiences in relation to home care for this non-COVID population

Humanos , Servicios de Atención de Salud a Domicilio/organización & administración , Cuidados Paliativos/métodos , Pandemias/prevención & control , Planes de Contingencia , Atención Primaria de Salud/organización & administración , Infecciones por Coronavirus/prevención & control , Cuidados Paliativos al Final de la Vida/métodos , Pesar , Aflicción/psicología
Palliat Med ; 34(9): 1165-1181, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32736489


BACKGROUND: The global COVID-19 pandemic has left health and social care systems facing the challenge of supporting large numbers of bereaved people in difficult and unprecedented social conditions. Previous reviews have not comprehensively synthesised the evidence on the response of health and social care systems to mass bereavement events. AIM: To synthesise the evidence regarding system-level responses to mass bereavement events, including natural and human-made disasters as well as pandemics, to inform service provision and policy during the COVID-19 pandemic and beyond. DESIGN: A rapid systematic review was conducted, with narrative synthesis. The review protocol was registered prospectively (, CRD 42020180723). DATA SOURCES: MEDLINE, Global Health, PsycINFO and Scopus databases were searched for studies published between 2000 and 2020. Reference lists were screened for further relevant publications, and citation tracking was performed. RESULTS: Six studies were included reporting on system responses to mass bereavement following human-made and natural disasters, involving a range of individual and group-based support initiatives. Positive impacts were reported, but study quality was generally low and reliant on data from retrospective evaluation designs. Key features of service delivery were identified: a proactive outreach approach, centrally organised but locally delivered interventions, event-specific professional competencies and an emphasis on psycho-educational content. CONCLUSION: Despite the limitations in the quantity and quality of the evidence base, consistent messages are identified for bereavement support provision during the pandemic. High quality primary studies are needed to ensure service improvement in the current crisis and to guide future disaster response efforts.

Adaptación Psicológica , Aflicción , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/psicología , Pesar , Pandemias , Neumonía Viral/mortalidad , Neumonía Viral/psicología , Apoyo Social , Infecciones por Coronavirus/epidemiología , Humanos , Neumonía Viral/epidemiología , Investigación Cualitativa