Predicting factors of complicated grief in Iranians after COVID-19 losses: A descriptive–correlational study

Azam Eshaghian  Dorcheh; Hadis  Ashrafizadeh; Fatemeh  Khademi; Salman  Barasteh; Arndt  Büssing; Klaus  Baumann; Mahmood  Salesi; Mohadese  Babaie; Maryam  Karami; Mitra  Jaras; Maryam  Rassouli

doi:10.18502/npt.v13i1.20599

Azam Eshaghian Dorcheh Department of Pediatric and Neonatal Nursing, Isfahan University of Medical Sciences, Isfahan, Iran
Hadis Ashrafizadeh Student Research Committee, Faculty of Nursing, Dezful University of Medical Sciences, Dezful, Iran
Fatemeh Khademi Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Salman Barasteh Nursing Care Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
Arndt Büssing Department of Health, Witten Herdecke University, Herdecke, North Rhine-Westphalia, Germany
Klaus Baumann Faculty of Theology, Freiburg University, Germany
Mahmood Salesi Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
Mohadese Babaie Department of Anesthesiology, School of Allied Medical Sciences, Alborz University of Medical Sciences, Karaj, Iran
Maryam Karami Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Mitra Jaras Department of Nursing, Faculty of Nursing, Arak University of Medical Sciences, Arak, Iran
Maryam Rassouli Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/npt.v13i1.20599

Keywords: grief; loss; bereavement; complicated grief; COVID-19

Abstract

Background & Aim: Understanding predictive factors for complicated grief after COVID-19 losses is critical for developing targeted support strategies. This study aimed to examine predictors of complicated grief among Iranians who lost a family member during the pandemic.

Materials & Methods: This descriptive-correlational study was conducted from December 2022 to August 2023. A total of 150 relatives of COVID-19 victims were recruited via convenience sampling. Data were collected using the Inventory of Complicated Grief, the Burdened by Grief and Loss questionnaire, the WHO-5 Well-being Index, and a measure of pandemic-related burden. Data were analyzed using SPSS v. 26, employing chi-square, Fisher's exact test, and multiple logistic regression to identify predictors.

Results: The likelihood of developing complicated grief among women compared to men was 3.77 times higher (p<0.001, OR=3.77), and the chance of complicated grief in close family members compared to distant relatives was 4.55 times higher (p<0.001, OR=4.55). An increase in psychological well-being score significantly lowered the likelihood of complicated grief in bereaved companions (p<0.001, OR=0.86); however, an increase in being burdened by grief and loss scale significantly augmented the likelihood of complicated grief in bereaved companions (p<0.001, OR=1.11). However, an increase in the Burdened by Grief and Loss score significantly increased the likelihood of complicated grief in bereaved companions (p<0.001, OR=1.11). The prevalence of complicated grief in Iranian people who have lost their family members because of COVID-19 was higher compared to similar studies.

Conclusion: Female gender, close kinship with the deceased, and a heavier psychological burden of loss were significant risk factors for complicated grief, while stronger mental health served as a protective factor. Given the crucial role of nurses in bereavement care, there is an urgent need for structured, supportive interventions and psychological services, ideally delivered through clinical guidelines tailored for these vulnerable groups.