Restricted End-of-Life Care and Mourning During COVID-19: A Longitudinal Study on Grief, Mental Health, and Rumination

This longitudinal study examined the mental health impact of COVID-19 restrictions on individuals bereaved during the pandemic, focusing on the mediating role of grief-specific rumination. A total of 141 adults who lost a significant person during the COVID-19 pandemic completed questionnaires at two time points, assessing perceived restrictions, psychological impact, trauma, anxiety, depression, prolonged grief, and rumination. Results showed that high levels of restrictions' psychological impact were associated with elevated symptoms of trauma, anxiety, depression, and prolonged grief. Although only 8.5% met criteria for Prolonged Grief Disorder (PGD), trauma symptoms remained prevalent in 70.9% nearly a year after the loss. Mediation analyses showed that grief-specific rumination statistically accounted for the association between the psychological impact of restrictions and prolonged grief symptoms. The findings underscore the disruptive effects of pandemic-related restrictions on grieving processes and suggest that interventions targeting rumination may reduce long-term psychological distress in bereaved individuals.