Grief responses during the COVID-19 pandemic: A qualitative study in Spain.

Introduction: The recent COVID-19 pandemic led to a rise in the number of people bereaved by the death of a loved one. There are many pandemic-related stressors that may have further complicated grief in these people. The aim of this research was to conduct an in-depth the experience of illness and death during the pandemic, as well as obstacles to and factors facilitating grief in people who had lost a loved one during this period, whether due to COVID-19 or to natural or sudden causes. Method: The sample consisted of 42 participants who had lost loved ones to COVID-19 or other causes (both natural and sudden). An inductive approach using grounded theory with open, axial and selective coding was used to analyse the semi-structured open-ended interviews. Results: The resulting theory was structured around a central category: "Processes of Loss and Grief in Pandemics". The other relevant and related categories were: disease processes during the pandemic, emotional responses to the loss, factors facilitating the grieving process and obstacles to the grieving process. The various analytical categories were then further classified with reference to the Dual Process Model. Conclusion: This study highlights the main features of grief during the pandemic, including the impact of restrictive measures on disease processes; the funeral rituals performed and subsequent coping; responses such as intense shock, anger, fear or loneliness; and the way in which factors facilitating the grief process were adapted to the circumstances.