Psychological Risk Factors of Functional Impairment After COVID-19 Deaths

Context. People bereaved from COVID-19 report higher levels of grief than people bereaved from natural causes. The full impact of this onslaught of grief will not be known for some time. Ensuring high-quality bereavement care in the context of COVID-19 presents unprecedented challenges to end-of-life care. Objectives. We aimed to determine how psychological symptoms explain functional impairment. Methods. A sample of people bereaved through COVID-19 (N = 307) in the United States completed demographic questions and self-report measures of neuroticism; symptoms of depression, generalized anxiety, posttraumatic stress, separation distress, and dysfunctional grief; and functional impairment due to a COVID-19 loss. Results. Most participants' scores were in the clinical ranges for generalized anxiety, depression, dysfunctional grief, and functional impairment. Functional impairment scores were not associated with age, gender, and time since loss but were associated with being diagnosed with COVID-19, having received professional help with the loss, and a close relationship to the deceased. A logistic regression model showed that, after controlling for covariates, the odds of functional impairment significantly increased by 27% for higher scores in separation distress, 25% for higher scores in dysfunctional grief, and 13% for higher scores in posttraumatic stress. Conclusion. People bereaved because of COVID-19 are at risk of functional impairment, especially if they have symptoms of separation distress, dysfunctional grief, and/or posttraumatic stress. Attention to identifying and treating functional impairment may be important in facilitating grieving persons' full participation in social and economic life during and after the pandemic. (C) 2021 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Automated summary

Bereaved individuals from COVID-19 experience higher levels of grief compared to those bereaved from natural causes. Functional impairment in this group is associated with symptoms of separation distress, dysfunctional grief, and posttraumatic stress. Identifying and addressing functional impairment may be crucial in helping bereaved individuals fully participate in social and economic activities during and after the pandemic.