Farewell, grief and depression of individuals who lost close relatives during social isolation: A mixed methods study.

OBJECTIVE

To compare grief outcomes between individuals who were able to say goodbye to a dying relative and those who were not, and to explore the lived experiences of grief and bereavement.

DESIGN

Observational, descriptive, cross-sectional survey study. SITE: Conducted in Mexico through an online survey administered to the general population after the COVID-19 pandemic.

PARTICIPANTS

Adults aged 18 years or older who had lost a close family member since November 2020. 261 participants were included, with a median age of 28 years (IQR 23-41).

INTERVENTIONS: Not applicable.

MAIN MEASUREMENTS: Sociodemographic characteristics were recorded, prolonged grief disorder was assessed using the PGD-13-R, and depressive symptoms were evaluated with the Beck Depression Inventory (BDI). Chi-square and Fisher's exact tests were used for quantitative analysis, and qualitative responses were analyzed using thematic analysis.

RESULTS

Eight participants met criteria for prolonged grief disorder. No statistically significant differences were found in the prevalence of prolonged grief between participants who were able to say goodbye and those who were not (p=0.493). Qualitative analysis identified seven major themes: COVID-19-related restrictions, emotional impact and coping strategies, memories and legacy, presence and participation in the grieving process, spirituality, social support and family dynamics, and sudden loss.

CONCLUSIONS

In this Mexican sample, the opportunity to say goodbye was not associated with differences in the risk of prolonged grief disorder or depressive symptoms. However, qualitative findings underscore the importance of farewell rituals in meaning-making, coping processes, and perceived social support during bereavement.