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Study Protocol

Healing grief – an online self-help intervention programme for bereaved Chinese with prolonged grief: study protocol for a randomised controlled trial

Sanando el duelo: un programa de intervención de autoayuda en línea para chinos en luto con duelo prolongado: protocolo de estudio para un ensayo controlado aleatorizado

哀伤疗愈—针对中国延长哀伤丧亲者的在线自助干预程序:一项随机对照试验的研究方案

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Article: 2323422 | Received 29 Sep 2023, Accepted 11 Feb 2024, Published online: 20 Mar 2024

References

  • American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders, fifth edition, text revision (DSM-5-TR). American Psychiatric Association.
  • Andrews, G., & Williams, A. D. (2014). Internet psychotherapy and the future of personalized treatment. Depression and Anxiety, 31(11), 912–915. https://doi.org/10.1002/da.22302
  • Atwoli, L., Stein, D. J., King, A., Petukhova, M., Aguilar-Gaxiola, S., Alonso, J., Bromet, E. J., de Girolamo, G., Demyttenaere, K., Florescu, S., Haro, J. M., Karam, E. G., Kawakami, N., Lee, S., Lepine, J.-P., Navarro-Mateu, F., O'Neill, S., Pennell, B.-E., … & the members of WHO World Mental Health Survey Collaborators. (2017). Posttraumatic stress disorder associated with unexpected death of a loved one: Cross-national findings from the world mental health surveys. Depression and Anxiety, 34(4), 315–326. https://doi.org/10.1002/da.22579
  • Beck, A. T., Brown, G. K., Steer, R. A., Dahlsgaard, K. K., & Grisham, J. R. (1999). Suicide ideation at its worst point: A predictor of eventual suicide in psychiatric outpatients. Suicide and Life-Threatening Behavior, 29(1), 1–9. https://doi.org/10.1111/j.1943-278X.1999.tb00758.x
  • Beck, A. T., Kovacs, M., & Weissman, A. (1979). Assessment of suicidal intention: The scale for suicide ideation. Journal of Consulting and Clinical Psychology, 47(2), 343–352. https://doi.org/10.1037//0022-006x.47.2.343
  • Beck, A. T. (1991). BSI, Beck scale for suicide ideation: Manual. Psychological Corporation.
  • Blevins, C. A., Weathers, F. W., Davis, M. T., Witte, T. K., & Domino, J. L. (2015). The posttraumatic stress disorder checklist for DSM-5 (PCL-5): Development and initial psychometric evaluation. Journal of Traumatic Stress, 28(6), 489–498. https://doi.org/10.1002/jts.22059
  • Brodbeck, J., Berger, T., Biesold, N., Rockstroh, F., & Znoj, H. J. (2019). Evaluation of a guided Internet-based self-help intervention for older adults after spousal bereavement or separation/divorce: A randomised controlled trial. Journal of Affective Disorders, 252, 440–449. https://doi.org/10.1016/j.jad.2019.04.008
  • Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4), 822–848. https://doi.org/10.1037/0022-3514.84.4.822
  • Carper, M. M., McHugh, R. K., Murray, H. W., & Barlow, D. H. (2014). Psychometric analysis of the perceptions of computerized therapy questionnaire-patient version (PCTQ-P). Administration and Policy in Mental Health, 41(1), 104–113. https://doi.org/10.1007/s10488-012-0440-x
  • Chan, A.-W., Tetzlaff, J. M., Gøtzsche, P. C., Altman, D. G., Mann, H., Berlin, J. A., Dickersin, K., Hróbjartsson, A., Schulz, K. F., Parulekar, W. R., Krleža-Jerić, K., Laupacis, A., & Moher, D. (2013). SPIRIT 2013 explanation and elaboration: Guidance for protocols of clinical trials. BMJ: British Medical Journal, 346, e7586. https://doi.org/10.1136/bmj.e7586
  • Chen, C., & Tang, S. (2021). Profiles of grief, post-traumatic stress, and post-traumatic growth among people bereaved due to COVID-19. European Journal of Psychotraumatology, 12(1), 1947563. https://doi.org/10.1080/20008198.2021.1947563
  • Chen, L., Fu, F., Sha, W., Chan, C. L. W., & Chow, A. Y. M. (2019). Mothers coping with bereavement in the 2008 China earthquake: A dual process model analysis. Omega: Journal of Death and Dying, 80(1), 69–86. https://doi.org/10.1177/0030222817725181
  • Cheng, P., Xu, L.-Z., Zheng, W.-H., Ng, R. M. K., Zhang, L., Li, L.-J., & Li, W.-H. (2020). Psychometric property study of the posttraumatic stress disorder checklist for DSM-5 (PCL-5) in Chinese healthcare workers during the outbreak of corona virus disease 2019. Journal of Affective Disorders, 277, 368–374. https://doi.org/10.1016/j.jad.2020.08.038
  • China Internet Network Information Center. (2023). The 51th statistical report on Internet development in China. http://www.cac.gov.cn/2021-02/03/c_1613923423079314.htm.
  • Chinese Psychological Society. (2021). A brief introduction to clinical and counseling psychology registration system (CCPRS) in China. http://www.chinacpb.net/public/index.php/xwz/english/info/id/613.html.
  • Chow, A. Y. M., Caserta, M., Lund, D., Suen, M. H. P., Xiu, D., Chan, I. K. N., & Chu, K. S. M. (2019). Dual-process bereavement group intervention (DPBGI) for widowed older adults. The Gerontologist, 59(5), 983–994. https://doi.org/10.1093/geront/gny095
  • Deng, Y.-Q., Li, S., Tang, Y.-Y., Zhu, L.-H., Ryan, R., & Brown, K. (2012). Psychometric properties of the Chinese translation of the mindful attention awareness scale (MAAS). Mindfulness, 3(1), 10–14. https://doi.org/10.1007/s12671-011-0074-1
  • Dominguez-Rodriguez, A., Sanz-Gomez, S., Ramirez, L. P. G., Herdoiza-Arroyo, P. E., Garcia, L. E. T., de la Rosa-Gomez, A., González-Cantero, J. O., Macias-Aguinaga, V., & Miaja, M. (2023). The efficacy and usability of an unguided web-based grief intervention for adults who lost a loved one during the COVID-19 pandemic: Randomized controlled trial. Journal of Medical Internet Research, 25, e43839. https://doi.org/10.2196/43839
  • Eisma M. C., Stroebe, M. S., Schut, H. A. W., van den Bout, J., Boelen, P. A., & Stroebe, W. (2014). Development and psychometric evaluation of the Utrecht grief rumination scale.  Journal of Psychopathology and Behavioral Assessment, 36, 165–176. https://doi.org/10.1007/s10862-013-9377-y
  • Ewing, J. A. (1984). Detecting alcoholism. The CAGE questionnaire. JAMA: Journal of the American Medical Association, 252(14), 1905–1907. https://doi.org/10.1001/jama.252.14.1905
  • Field, N. P., & Filanosky, C. (2009). Continuing bonds, risk factors for complicated grief, and adjustment to bereavement. Death Studies, 34(1), 1–29. https://doi.org/10.1080/07481180903372269
  • Field, N. P., Gal-Oz, E., & Bananno, G. A. (2003). Continuing bonds and adjustment at 5 years after the death of a spouse. Journal of Consulting and Clinical Psychology, 71(1), 110–117. https://doi.org/10.1037//0022-006x.71.1.110
  • Fiore, J. (2021). A systematic review of the dual process model of coping with bereavement (1999-2016). Omega: Journal of Death and Dying, 84(2), 414–458. https://doi.org/10.1177/0030222819893139
  • Godzik, C., Crawford, S., & Ryan, E. (2021). Feasibility of an online cognitive behavioral therapy program to improve insomnia, mood, and quality of life in bereaved adults ages 55 and older. Geriatric Nursing, 42(1), 99–106. https://doi.org/10.1016/j.gerinurse.2020.12.006
  • He, L., Tang, S., Yu, W., Xu, W., Xie, Q., & Wang, J. (2014). The prevalence, comorbidity and risks of prolonged grief disorder among bereaved Chinese adults. Psychiatry Research, 219(2), 347–352. https://doi.org/10.1016/j.psychres.2014.05.022
  • Ho, S. M. Y., Chan, I. S. F., Ma, E. P. W., & Field, N. P. (2013). Continuing bonds, attachment style, and adjustment in the conjugal bereavement among Hong Kong Chinese. Death Studies, 37(3), 248-268. https://doi.org/10.1080/07481187.2011.634086
  • Huberty, J., Sullivan, M., Green, J., Kurka, J., Leiferman, J., Gold, K., & Cacciatore, J. (2020). Online yoga to reduce post traumatic stress in women who have experienced stillbirth: A randomized control feasibility trial. BMC Complementary Medicine and Therapies, 20(1), 173. https://doi.org/10.1186/s12906-020-02926-3
  • Kersting, A., Dolemeyer, R., Steinig, J., Walter, F., Kroker, K., Baust, K., & Wagner, B. (2013). Brief Internet-based intervention reduces posttraumatic stress and prolonged grief in parents after the loss of a child during pregnancy: A randomized controlled trial. Psychotherapy and Psychosomatics, 82(6), 372–381. https://doi.org/10.1159/000348713
  • Kersting, A., Kroker, K., Schlicht, S., Baust, K., & Wagner, B. (2011). Efficacy of cognitive behavioral Internet-based therapy in parents after the loss of a child during pregnancy: Pilot data from a randomized controlled trial. Archives of Women's Mental Health, 14(6), 465–477. https://doi.org/10.1007/s00737-011-0240-4
  • Killikelly, C., Zhou, N., Merzhvynska, M., Stelzer, E.-M., Dotschung, T., Rohner, S., Sun, L. H., & Maercker, A. (2020). Development of the international prolonged grief disorder scale for the ICD-11: Measurement of core symptoms and culture items adapted for chinese and german-speaking samples. Journal of Affective Disorders, 277, 568–576. https://doi.org/10.1016/j.jad.2020.08.057
  • Knowles, L. M., Stelzer, E.-M., Jovel, K. S., & O'Connor, M.-F. (2017). A pilot study of virtual support for grief: Feasibility, acceptability, and preliminary outcomes. Computers in Human Behavior, 73, 650–658. https://doi.org/10.1016/j.chb.2017.04.005
  • Komischke-Konnerup, K. B., Zachariae, R., Johannsen, M., Nielsen, L. D., & O'Connor, M. (2021). Co-occurrence of prolonged grief symptoms and symptoms of depression, anxiety, and posttraumatic stress in bereaved adults: A systematic review and meta-analysis. Journal of Affective Disorders Reports, 4, 100140. https://doi.org/10.1016/j.jadr.2021.100140
  • Ladwig, I., Rief, W., & Nestoriuc, Y. (2014). What are the risks and side effects of psychotherapy? – Development of an inventory for the assessment of negative effects of psychotherapy. Verhaltenstherapie, 24(4), 252–264. https://doi.org/10.1159/000367928
  • L’akoa, R. M., Noubiap, J. J. N., Fang, Y., Ntone, F. E., & Kuaban, C. (2013). Prevalence and correlates of depressive symptoms in HIV-positive patients: A cross-sectional study among newly diagnosed patients in Yaoundé, Cameroon. BMC Psychiatry, 13, 228. https://doi.org/10.1186/1471-244X-13-228
  • Lange, A., Schrieken, B., van de Ven, J.-P., Bredeweg, B., Emmelkamp, P. M. G., van der Kolk, J., Lydsdottir, L., Massaro, M., & Reuvers, A. (2000). “Interapy”: The effects of a short protocolled treatment of post-traumatic stress and pathological grief through the Internet. Behavioural and Cognitive Psychotherapy, 28(2), 175–192. https://doi.org/10.1017/S1352465800001089
  • Li, J., & Prigerson, H. G. (2016). Assessment and associated features of prolonged grief disorder among Chinese bereaved individuals. Comprehensive Psychiatry, 66, 9–16. https://doi.org/10.1016/j.comppsych.2015.12.001
  • Li, L., Su, F., Zhang, W., & Mao, J.-Y. (2017). Digital transformation by SME entrepreneurs: A capability perspective. Information Systems Journal, 28(6), 1129–1157. https://doi.org/10.1111/isj.12153
  • Li, X.-Y., Phillips, M. R., Tong, Y.-S., Li, K.-J., Zhang, Y.-L., Zhang, Y.-P., Xu, D., & Niu, Y.-J. (2010). Reliability and validity of the Chinese version of Beck suicide ideation scale (BSI-CV) in adult community residents. Chinese Mental Health Journal, 24(4), 250–255. https://doi.org/10.3969/j.issn.1000-6729.2010.04.003
  • Litz, B. T., Schorr, Y., Delaney, E., Au, T., Papa, A., Fox, A. B., Morris, S., Nickerson, A., Block, S., & Prigerson, H. G. (2014). A randomized controlled trial of an internet-based therapist-assisted indicated preventive intervention for prolonged grief disorder. Behaviour Research and Therapy, 61, 23–34. https://doi.org/10.1016/j.brat.2014.07.005
  • Liu, Z., Ren, X., Wang, G., Tang, S., Wu, Y., & Zhang, J. (2020). A randomized controlled trial of Internet-based cognitive behavior therapy for college students with anxiety. Chinese Mental Health Journal, 34(3), 159–165. https://doi.org/10.3969/j.issn.1000-6729.2020.3.001
  • Lu, J., Xu, X., Huang, Y., Li, T., Ma, C., Xu, G., Yin, H., Xu, X., Ma, Y., Wang, L., Huang, Z., Yan, Y., Wang, B., Xiao, S., Zhou, L., Li, L., Zhang, Y., Chen, H., Zhang, T., … & Zhang, N. (2021). Prevalence of depressive disorders and treatment in China: A cross-sectional epidemiological study. The Lancet. Psychiatry, 8(11), 981–990. https://doi.org/10.1016/s2215-0366(21)00251-0
  • Lundorff, M., Holmgren, H., Zachariae, R., Farver-Vestergaard, I., & O'Connor, M. (2017). Prevalence of prolonged grief disorder in adult bereavement: A systematic review and meta-analysis. Journal of Affective Disorders, 212, 138–149. https://doi.org/10.1016/j.jad.2017.01.030
  • Margraf, J., Cwik, J. C., Pflug, V., & Schneider, S. (2017). Structured clinical interviews for mental disorders across the life span: Psychometric quality and further developments of the DIPS open access interviews. Zeitschrift für Klinische Psychologie und Psychotherapie, 46(3), 176–186. https://doi.org/10.1026/1616-3443/a000430
  • Margraf, J., Cwik, J. C., Suppiger, A., & Schneider, S. (2017). DIPS open access: Diagnostic interview for mental disorders. Mental Health Research and Treament Center, Ruhr-Universität Bochum.
  • Meij, L. W. d., Stroebe, M., Schut, H., Stroebe, W., Bout, J., Heijden, P., & Dijkstra, I. (2011). Parents grieving the loss of their child: Interdependence in coping. British Journal of Clinical Psychology, 47(1), 31–42. https://doi.org/10.1348/014466507X216152
  • National Bureau of Statistics. (2024). Statistical communiqué of the people's republic of China on the 2023 national economic and social development. Retrieved from https://www.stats.gov.cn/sj/sjjd/202401/t20240118_1946701.html.
  • National Health Commission of the People’s Republic of China. (2022a). Transcript of the press conference of the National Health Commission of the People’s Republic of China on August 25, 2022. http://www.nhc.gov.cn/xcs/s3574/202208/7a207303d09b4112836c27623f62c988.shtml.
  • National Health Commission of the People’s Republic of China. (2022b). Reply to recommendation No. 6462 of the fourth session of the 13th National People's Congress. http://www.nhc.gov.cn/wjw/jiany/202201/44b7d040f0974e97ae63bc1933c1bb44.shtml.
  • O’Brien, C. P. (2008). The CAGE questionnaire for detection of alcoholism: A remarkably useful but simple tool. JAMA: Journal of the American Medical Association, 300(17), 2054–2056. https://doi.org/10.1001/jama.2008.570
  • Park, S.-R., & Cha, Y.-J. (2023). Effects of online group art therapy on psychological distress and quality of life after family bereavement: In COVID-19 pandemic. Arts in Psychotherapy, 82, 101972. https://doi.org/10.1016/j.aip.2022.101972
  • Reitsma, L., Boelen, P. A., de Keijser, J., & Lenferink, L. I. M. (2023). Self-guided online treatment of disturbed grief, posttraumatic stress, and depression in adults bereaved during the COVID-19 pandemic: A randomized controlled trial. Behaviour Research and Therapy, 163, 104286. https://doi.org/10.1016/j.brat.2023.104286
  • Ren, Z., Li, X., Zhao, L., Yu, X., Li, Z., Lai, L., Ruan, Y., & Jiang, G. (2016). Effectiveness and mechanism of internet-based self-help intervention for depression: The Chinese version of MoodGYM. Acta Psychologica Sinica, 48(07), 818–832. https://doi.org/10.3724/SP.J.1041.2016.00818
  • Salisbury, M. R., Harmsen, C. R. W., & Muller, R. T. (2022). Help-seeking buffers the impact of grief on quality of life: A study of loss during the COVID-19 pandemic. Omega: Journal of Death and Dying, 302228221146337. https://doi.org/10.1177/00302228221146337
  • Schrauwen, D. (2021). The effectiveness of an unguided online grief-specific cognitive behavioral therapy for people who have lost a loved one during the COVID-19 pandemic [Master's thesis, Utrecht University]. https://studenttheses.uu.nl/handle/20.500.12932/41330.
  • Schulz, K. F., Altman, D. G., Moher, D. & the members of For the CONSORT Group. (2010). CONSORT 2010 statement: Updated guidelines for reporting parallel group randomized trials. Annals of Internal Medicine, 152(11), 726–732. https://doi.org/10.7326/0003-4819-152-11-201006010-00232
  • Stroebe, M., & Schut, H. (1999). The dual process model of coping with bereavement: Rationale and description. Death Studies, 23(3), 197–224. https://doi.org/10.1080/074811899201046
  • Stroebe, M., Schut, H., & Stroebe, W. (2007). Health outcomes of bereavement. The Lancet, 370(9603), 1960–1973. https://doi.org/10.1016/S0140-6736(07)61816-9
  • Sullivan, M., Huberty, J., Green, J., & Cacciatore, J. (2022). Adding a Facebook support group to an online yoga randomized trial for women who have experienced stillbirth: A feasibility study. Journal of Integrative and Complementary Medicine, 28(2), 179–187. https://doi.org/10.1089/jicm.2021.0097
  • Sveen, J., Jernelöv, S., Pohlkamp, L., Kreicbergs, U., & Kaldo, V. (2021). Feasibility and preliminary efficacy of guided Internet-delivered cognitive behavioral therapy for insomnia after the loss of a child to cancer: Randomized controlled trial. Internet Interventions, 25, 100409. https://doi.org/10.1016/j.invent.2021.100409
  • Tang, S., & Chow, A. Y. M. (2017). How do risk factors affect bereavement outcomes in later life? An exploration of the mediating role of dual process coping. Psychiatry Research, 255, 297–303. https://doi.org/10.1016/j.psychres.2017.06.001
  • Tang, S., Chow, A. Y. M., Breen, L. J., & Prigerson, H. G. (2020). Can grief be a mental disorder? An online survey on public opinion in mainland China. Death Studies, 44(3), 152–159. https://doi.org/10.1080/07481187.2018.1527415
  • Tang, S., Eisma, M. C., Li, J., & Chow, A. Y. M. (2019). Psychometric evaluation of the Chinese version of the Utrecht Grief Rumination Scale. Clinical Psychology & Psychotherapy, 26(2), 262–272. https://doi.org/10.1002/cpp.2348
  • Tang, S., Fan, Y., & Zeng, Z. (2022). Help-seeking behavior and its correlates among individuals bereaved due to COVID-19. Community Psychology Research, 13(1), 167–182.
  • Tang, S., & Xiang, Z. (2021). Who suffered most after deaths due to COVID-19? Prevalence and correlates of prolonged grief disorder in COVID-19 related bereaved adults. Globalization and Health, 17(1), 19. https://doi.org/10.1186/s12992-021-00669-5
  • Tang, S., Yu, Y., Chen, Q., Fan, M., & Eisma, M. C. (2021). Correlates of mental health after COVID-19 bereavement in mainland China. Journal of Pain and Symptom Management, 61(6), e1–e4. https://doi.org/10.1016/j.jpainsymman.2021.02.016
  • Tedeschi, R. G., & Calhoun, L. G. (1996). The posttraumatic growth inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9(3), 455–471. https://doi.org/10.1007/BF02103658
  • Treml, J., Nagl, M., Linde, K., Kündiger, C., Peterhänsel, C., & Kersting, A. (2021). Efficacy of an Internet-based cognitive-behavioural grief therapy for people bereaved by suicide: A randomized controlled trial. European Journal of Psychotraumatology, 12(1), Article 1926650. https://doi.org/10.1080/20008198.2021.1926650
  • van der Houwen, K., Schut, H., van den Bout, J., Stroebe, M., & Stroebe, W. (2010). The efficacy of a brief Internet-based self-help intervention for the bereaved. Behaviour Research and Therapy, 48(5), 359–367. https://doi.org/10.1016/j.brat.2009.12.009
  • Verdery, A. M., Smith-Greenaway, E., Margolis, R., & Daw, J. (2020). Tracking the reach of COVID-19 kin loss with a bereavement multiplier applied to the United States. The National Academy of Sciences, 117(30), 17695–17701. https://doi.org/10.1073/pnas.2007476117
  • Wagner, B., Hofmann, L., & Maaß, U. (2022). A therapist-supported Internet-based intervention for bereaved siblings: A randomized controlled trial. Palliative Medicine, 36(10), 1532–1543. https://doi.org/10.1177/02692163221122344
  • Wagner, B., Knaevelsrud, C., & Maercker, A. (2006). Internet-based cognitive-behavioral therapy for complicated grief: A randomized controlled trial. Death Studies, 30(5), 429–453. https://doi.org/10.1080/07481180600614385
  • Wagner, B., Rosenberg, N., Hofmann, L., & Maass, U. (2020). Web-based bereavement care: A systematic review and meta-analysis. Frontiers in Psychiatry, 11, 525. https://doi.org/10.3389/fpsyt.2020.00525
  • Wang, J., Chen, Y., Wang, Y., & Liu, X. (2011). Revision of the posttraumatic growth inventory and testing its reliability and validity. Journal of Nursing Science, 26(14), 26–29. https://doi.org/10.3870/hlxzz.2011.14.026
  • Wang, Z., Tang, S., Wang, J., & Maercker, A. (2012). Foundations and future application of Internet-based interventions for PTSD in PR China. International Journal of Electronic Healthcare, 7(1), 19–35. https://doi.org/10.1504/IJEH.2012.048667
  • Wang, Z., Wang, J., & Maercker, A. (2013). Chinese my trauma recovery, a web-based intervention for traumatized persons in two parallel samples: Randomized controlled trial. Journal of Medical Internet Research, 15(9), e213. https://doi.org/10.2196/jmir.2690
  • World Health Organization. (2018). ICD-11 for mortality and morbidity statistics: 6B42 prolonged grief disorder. https://icd.who.int/browse11/lm/en#/http://id.who.int/icd/entity/1183832314
  • World Health Organization. (2022). World mental health report: Transforming mental health for all. https://www.who.int/publications/i/item/9789240049338
  • Xu, J., He, L., & Wang, J. (2020). The bereaved one's grief reaction characteristics and suggestions for grief counseling under the COVID-19 epidemic. Chinese Mental Health Journal, 34 (4), 382–386. https://doi.org/10.3969/j.issn.1000-6729.2020.4.016.
  • Ye, W., & Xu, J. (1993). Application and evaluation of the hospital anxiety and depression scale in patients in general hospitals. Chinese Journal of Behavioral Medicine, 2(3), 17–19.
  • Ying, Y., Ji, Y., Kong, F., Wang, M., Chen, Q., Wang, L., Hou, Y., Yu, L., Zhu, L., Miao, P., & Zhou, J., Zhang, L., Yang, Y., Wang, G., Chen, R., Liu, D., Huang, W., Lv, Y., Lou, Z., & Ruan, L. (2023). Efficacy of an Internet-based cognitive behavioral therapy for subthreshold depression among Chinese adults: A randomized controlled trial. Psychological Medicine, 53(9), 3932–3942. https://doi.org/10.1017/s0033291722000599
  • Yu, W., He, L., Xu, W., Wang, J., & Prigerson, H. G. (2016). How do attachment dimensions affect bereavement adjustment? A mediation model of continuing bonds. Psychiatry Research, 238, 93–99. https://doi.org/10.1016/j.psychres.2016.02.030
  • Yu, Z., Liang, J., Guo, L., Jiang, L., Wang, J. Y., Ke, M., Shen, L., Zhou, N., & Liu, X. (2022). Psychosocial intervention on the dual-process model for a group of COVID-19 bereaved individuals in Wuhan: A pilot study. Omega: Journal of Death and Dying, 302228221083067. https://doi.org/10.1177/00302228221083067
  • Zhang, R. (2013). Mental health nursing. Zhengzhou University Press.
  • Zhao, C., Zhao, Z., Levin, M. E., Lai, L., Shi, C., Hu, J., Chen, W., & Ren, Z. (2023). Efficacy and acceptability of mobile application-delivered acceptance and commitment therapy for posttraumatic stress disorder in China: A randomized controlled trial. Behaviour Research and Therapy, 171, 104440. https://doi.org/10.1016/j.brat.2023.104440
  • Zhou, N., Wen, J., Stelzer, E. M., Killikelly, C., Yu, W., Xu, X., Shi, G., Luo, H., Wang, J., & Maercker, A. (2020). Prevalence and associated factors of prolonged grief disorder in Chinese parents bereaved by losing their only child. Psychiatry Research, 284, 112766. https://doi.org/10.1016/j.psychres.2020.112766
  • Zhu, X. (1983). Variorum of the four books. Zhonghua Book Company.
  • Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x
  • Zuelke, A. E., Luppa, M., Löbner, M., Pabst, A., Schlapke, C., Stein, J., & Riedel-Heller, S. G. (2021). Effectiveness and feasibility of Internet-based interventions for grief after bereavement: Systematic review and meta-analysis. JMIR Mental Health, 8(12), e29661. https://doi.org/10.2196/29661