| Study (Year/Country) |
Aim |
Methods |
n |
Clinical and demographic characterization |
Main results |
| Guité-Verret et al. 3535. Guité-Verret A, Vachon M, Ummel D, Lessarde E, Francoeur-Carron C. Expressing grief through metaphors: family caregivers' experience of care and grief during the Covid-19 pandemic. Int J Qual Stud Health Well-being 2021; 16:1996872. (2021/Canada) |
To gain in-depth understanding of family caregivers’ lived experiences of caregiving and bereavement in the context of the COVID-19 pandemic in Quebec |
Design: qualitative research Instrument: in-depth, individual open interviews Theoretical approach: IPA Data analysis: IPA |
20 |
Bereaved family caregivers (7 mothers, 6 fathers, 5 spouses, 2 grandparents) Gender: 17 women and 3 men Age: 21 to 78 years old Cause of death: ND Place of death: 14 hospital, 6 residence for elderly Deceased’s age: ND Death occurred during the pandemic |
Results indicate that bereaved family caregivers lived and understood their experience in terms of metaphoric cut-offs, obstructions, and shockwaves. These three metaphors represented the grief process and the bereaved’s quest for social connection, narrative coherence and recognition |
| Hamid & Jahangir 3636. Hamid W, Jahangir MS. Dying, death and mourning amid COVID-19 pandemic in Kashmir: a qualitative study. OMEGA (Westport) 2020; 85:690-715. (2020/India) |
To examine the changing nature of death, dying, and mourning among muslims of Kashmir due to the COVID-19 pandemic |
Design: qualitative research approach Instrument: Semi-structured telephonic interviews Theoretical approach: ND Data analysis: data was then analyzed using the techniques of Braun and Clarke (software NVivo 12) |
17 |
Sunni muslims whose loved ones died after the outbreak of the COVID-19 in Kashmir (1 granddaughter, 2 brothers, 1 sister, 5 sons, 1 distant relative, 1 niece, 1 cousin brother, 1 father, 1 friend, 1 husband, 1 aunt and 1 sister-in-law) Gender: 6 females and 11 males Age: 29 to 69 years old Cause of death: 7 COVID-19, 2 accident, 2 normal death, 4 illness, 1 cardiac arrest, 1 suicide Place of death: 9 hospital, 5 home, 1 outside country, 1 outside state, 1 location of accident Deceased’s age: 19 to 68 years old Death occurred during the pandemic |
The findings revealed that 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 well-being |
| Tay et al. 3737. Tay DL, Thompson C, Jones M, Gettens C, Cloyes KG, Reblin M, et al. "I feel all alone out here": analysis of audio diaries of bereaved hospice family caregivers during the COVID-19 pandemic. J Hosp Palliat Nurs 2021; 23:346-53. (2021/United States) |
To better understand the impact of the pandemic on bereaved hospice family caregivers’ experiences of social connection and isolation in a time of social distancing and general anxiety |
Design: secondary qualitative analysis Instrument: 59 audio diaries Theoretical approach: ND Data analysis: qualitative content analysis was conducted using NVivo 12 Plus |
6 |
Caregivers (3 children, 2 spouses, 1 sibling) Gender: 5 females and 1 males Age: 32 to 67 years old Cause of death: ND Place of death: ND Deceased’s age: ND Death occurred during the pandemic |
Findings provide insight into how caregivers experienced bereavement. They were able to connect with others despite physical distancing expectations, expressed loneliness and grief while in isolation, and described moving on in the face of uncertainty |
| Testoni et al. 3838. Testoni I, Azzola C, Tribbia N, Biancalani G, Iacona E, Orkibi H, et al. The COVID-19 disappeared: from traumatic to ambiguous loss and the role of the internet for the bereaved in Italy. Front Psychiatry 2021; 12:620583. (2021/Italy) |
To investigate whether and how bereaved individuals coped with their mourning during the lockdown and in its aftermath via Facebook |
Design: qualitative research Instrument: semi-structured interview by phone, Skype, or Zoom Theoretical approach: grounded theory Data analysis: thematic analysis (Atlas.ti software) |
40 |
Bereaved relatives Age: 23 to 63 years old Gender: 32 females and 8 males Cause of death: COVID-19 Place of death: ND Deceased’s age: ND Death occurred during the pandemic |
Grief had a complex profile: on the one hand, it was traumatic and characterized by all the risk factors causing mourners to experience prolonged grief, but on the other, some features were similar to ambiguous loss (that occurs without closure and clear understanding) because of the impossibility to be with their relatives in their final moments |
| Becqué et al. 3939. Becqué YN, Geugten W, Heide A, Korfage IJ, Pasman HRW, Onwuteaka-Philipsen BD, et al. Dignity reflections based on experiences of end-of-life care during the first wave of the COVID-19 pandemic: a qualitative inquiry among bereaved relatives in the Netherlands (the CO-LIVE study). Scand J Caring Sci 2021; 36:769-81. (2021/Netherlands) |
To give insight into aspects of end-of-life care practices that might have jeopardized or supported the dignity of the patients and their family members during the first wave of the COVID-19 pandemic in the Netherlands |
Design: qualitative study Instrument: in-depth interviews Theoretical approach: theory-inspired analytical framework developed and based on the dignity models for end-of-life experiences by Chochinov and Van Gennip Data analysis: in-depth content analysis |
25 |
Bereaved relatives of patients who died during the COVID-19 pandemic Gender: 20 females and 5 males Age: 20 to 79 years old Cause of death: 16 COVID-19, 4 probably COVID-19, 6 other causes Place of death: 11 hospital (6 COVID-19 ward, 4 ICU, 1 general ward), 1 mental hospital, 11 nursing home, 1 hospice, 1 sheltered house, 1 home, 1 unknown Deceased’s age: 60 to 90 years old (1 missing) Death occurred during the pandemic |
Experienced dignity of bereaved relatives was associated with the unfamiliarity of the virus and issues associated with preventive measures |
| Selman et al. 4040. Selman L, Chamberlain C, Sowden R, Chao D, Selman D, Taubert M, et al. Sadness, despair and anger when a patient dies alone from COVID-19: a thematic content analysis of Twitter data from bereaved family members and friends. Palliat Med 2021; 35:1267-76. (2021/United Kingdom) |
To explore the views and experiences of Twitter social media users who reported that a relative, friend or acquaintance died of COVID-19 without a family member/friend present |
Design: qualitative research Instrument: software system developed by the authors to harvest publicly available tweets from Twitter Theoretical approach: critical realist theoretical approach Data analysis: data were analyzed using thematic content analysis |
196 |
Next-of-kin (39 sons or daughters, 27 nephews or nieces, 8 brothers or sisters, 4 cousins, 33 grandchildren, 2 husbands, 13 more distant relatives, 47 friends, 23 relationships not stated) Gender: ND Age: ND Cause of death: COVID-19 Place of death: 43 hospitals, 15 care home/nursing home/assisted living, 6 home, 1 hospice, 1 government isolation facility, 130 not stated Deceased’s age: ND Death occurred during the pandemic |
Saying goodbye via video-conferencing technology was viewed ambivalently. Clinicians’ presence during a death was little consolation. Anger, frustration, and blame were directed at governments’ inaction/policies or the public. The sadness of not being able to say goodbye as wished was compounded by lack of social support and disrupted after-death rituals |
| Wong et al. 4242. Wong LP, Tan SL, Alias H, Sai TE, Saw A. Psychological consequences of the delay in the Silent Mentor Programme during the COVID-19 pandemic: perspectives from family members of silent mentors. OMEGA (Westport) 2021; [Online ahead of print]. (2021/Malaysia) |
To describe the psychological impact and experiences of family members of silent mentors during the COVID-19 |
Design: ND Instrument: in-depth interview (4 in-person and 3 via telephone) with open-ended follow-up questions Theoretical approach: empirical phenomenological approach Data analysis: iterative thematic approach (Braun & Clarke, 2013) (NVivo 10) |
7 |
First-degree relatives of silent mentors (5 siblings and 2 children) Gender: ND Age: ND Cause of death: ND Place of death: ND Deceased’s age: 41 to 63 years old Death occurred during the pandemic |
Several participants relayed the belief that the soul cannot rest until the body receives a proper burial while some worried about the deterioration of the physical condition of the mentors |
| Chen et al. 4343. Chen C, Wittenberg E, Sullivan SS, Lorenz RA, Chang YP. The experiences of family members of ventilated COVID-19 patients in the intensive care unit: a qualitative study. Am J Hosp Palliat Care 2021; 38:869-76. (2021/United States) |
To explore the experiences and support needs of family members of ventilated COVID-19 patients in the ICU |
Design: exploratory, qualitative design Instrument: in-depth individual telephone interviews Theoretical approach: ND Data analysis: thematic analysis |
10 |
Family members of adult COVID-19 patients in the ICU (3 spouses, 3 children, 2 parents, 1 nephew and 1 niece) Gender: 8 females and 2 males Age: 36 to 77 years old Cause of death: COVID-19 Place of death: ICU Deceased’s age: mean age 54.2 years old Death occurred during the pandemic |
Family members’ feelings about the patient’s diagnosis and how the virus was contracted exacerbated their stress and anxiety. They struggled to feel informed about care that they could not witness and had difficulty understanding information. Family members reported that video calls were unhelpful. While these experiences made them question the quality of care, they expressed their appreciation of the frontline healthcare providers taking care of their loved ones |
| Hanna et al. 4444. Hanna JR, Rapa E, Dalton LJ, Hughes R, McGlinchey T, Bennett KM, et al. A qualitative study of bereaved relatives' end of life experiences during the COVID-19 pandemic. Palliat Med 2021; 35:843-51. (2021/United Kingdom) |
To explore relatives’ experiences and needs when a family member was dying during the COVID-19 pandemic |
Design: interpretative qualitative study Instrument: semi-structured interviews Theoretical approach: ND Data analysis: Braun and Clarke’s thematic analysis framework |
19 |
Relatives whose family member died during the COVID-19 pandemic in the United Kingdom (4 spouse/partner, 11 adult children, 2 sons/daughters in law, 1 niece and 1 grandchild) Gender: 12 females and 7 males Age: 20 to 79 years old Cause of death: 13 COVID-19, 6 other causes Place of death: 10 hospitals (3 general ward, 4 ICU, 3 coronavirus ward), 9 nursing home Deceased’s age: 50 to 90 years old Death occurred during the pandemic |
In the absence of direct physical contact, it was important for families to have a clear understanding of their family member’s condition and declining health, stay connected with them in the final weeks/days of life and have the opportunity for a final contact before they died. Health and social care professionals were instrumental to providing these aspects of care but faced practical challenges in achieving these |
| Kentish-Barnes et al. 4545. Kentish-Barnes N, Cohen-Solal Z, Morin L, Souppart V, Pochard F, Azoulay E. Lived experiences of family members of patients with severe COVID-19 who died in intensive care units in France. JAMA Netw Open 2021; 4:e2113355. (2021/France) |
To better understand the experiences of bereaved family members of patients who died in an ICU during the COVID-19 pandemic, from the time of hospital admission until after the patient’s death |
Design: qualitative study Instrument: semi-structured, in-depth telephone interviews Theoretical approach: ND Data analysis: thematic analysis |
19 |
Bereaved family members of patients who died from severe COVID-19 (6 daughters, 5 wives, 1 niece, 2 sons, 1 sister, 3 husbands, 1 granddaughter) Gender: 14 women and 5 men Age: 23 to 75 years old Cause of death: COVID-19 Place of death: Hospital Deceased’s age: 50 to 80 years old Death occurred during the pandemic |
Results indicate the difficulty in building a relationship with the ICU clinicians and dealing with the experience of solitude: family members experienced difficulties in establishing rapport and bonding with the ICU team as well as understanding the medical information. Participants felt the feeling of solitude, powerlessness, abandonment, and unreality. The regarding disruptions in end-of-life rituals generating strong feelings of disbelief that may lead to complicated grief |
| Hernández-Fernández & Meneses-Falcón 4141. Hernández-Fernández C, Meneses-Falcón C. I can't believe they are dead. Death and mourning in the absence of goodbyes during the COVID-19 pandemic. Health Soc Care Community 2023; 30:e1220-32. (2021/Spain) |
To analyze the experience of losing a loved one without traditional, cultural-specific rituals for saying goodbye, explores the different factors affecting the onset of mourning by family members and studies the existence of complicating risk factors associated with grief from this distinct type of loss |
Design: qualitative research Instrument: in-depth, individual interviews Theoretical approach: phenomenology Data analysis: categorical analysis that considered both content and discourse analysis |
7 |
First or second-degree relatives of a deceased person (4 daughters, 1 granddaughter, 1 wife and 1 friend) Gender: ND Age: ND Cause of death: ND Place of death: ND Deceased’s age: ND Death occurred during the pandemic |
The main results concluded that deaths caused by the pandemic are, due to their characteristics, a complicating factor for bereavement. Furthermore, professionals who had a holistic approach toward the deaths facilitated the process for the family members, being a determining factor in enabling the beginning of the mourning process and reducing anguish for the family members |
| Cardoso et al. 4646. Cardoso EAO, Silva BCA, Santos JH, Lotério LS, Accoroni AG, Santos MA. The effect of suppressing funeral rituals during the COVID-19 pandemic on bereaved families. Rev Latinoam Enferm 2020; 28:e3361. (2021/Brazil) |
To understand the meanings individuals who have lost loved ones in this context assign to the phenomenon of suppressed funeral rituals |
Design: qualitative research Instrument: documents published in digital media containing personal writings and reports of experiences freely and easily available to the public Theoretical approach: theory of grief Data analysis: Inductive thematic analysis |
23 |
Bereaved family members (6 sons, 4 cousins, 3 mothers, 3 daughters in law, 2 nephews, 2 husbands, 1 wife, 1 brother-in-law and 1 grandson) Gender: ND Age: ND Cause of death: COVID-19 Place of death: ND Deceased’s age: ND Death occurred during the pandemic |
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 |
| Mohammadi et al. 4747. Mohammadi F, Oshvandi K, Shamsaei F, Cheraghi F, Khodaveisi M, Bijani M. The mental health crises of the families of COVID-19 victims: a qualitative study. BMC Fam Pract 2021; 22:94. (2021/Iran) |
To identify the psychological crises which the families of COVID-19 victims are faced with |
Design: qualitative research Instrument: semi-structured individual interviews which were conducted via video call on Whatsapp Theoretical approach: ND Data analysis: content analysis |
16 |
Bereaved families of COVID-19 victims (6 wives, 3 husbands, 5 children, 2 mothers) Gender: 9 females and 7 males Age: average age 38 years old Cause of death: COVID-19 Place of death: ND Deceased’s age: ND Death occurred during the pandemic |
Emotional shock (including feelings of guilt and rumination, bitter farewell, strange burial and concern about unreligious burial), and fear of the future (including instability in the family, lack of job security and difficult financial conditions, stigmatization and complications in social interactions) |
| Cordero Jr 4848. Cordero Jr DA. Sákit Pighati and Pag-asa: a pastoral reflection on suffering during the COVID-19 pandemic in the Philippines. J Relig Health 2021; 60:1521-42. (2021/Philippines) |
To explore the concept of suffering as experienced by Filipinos during the COVID-19 pandemic |
Design: descriptive research design Instrument: social media posts Theoretical approach: themes are then discussed in the light of John Paul II’s Salvifci Doloris Data analysis: modified form of thematic analysis (Braun and Clarke, 2006) |
2 |
Bereaved family members (1 son and 1 daughter) Gender: 1 male, 1 female Age: 24 and 47 years old Cause of death: 2 COVID-19 Place of death: hospital Deceased’s age: ND Death occurred during the pandemic |
Findings revealed three contextualized themes: sákit (pain), pighati (grief), and pag-asa (hope) |
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