Prevalence and risk factors of prolonged grief disorder among bereaved survivors seven years after the Wenchuan earthquake in China: A cross-sectional study

Background: This study aimed to determine the prevalence and predictive factors of prolonged grief disorder (PGD) among those bereaved by the Wenchuan earthquake in Southwestern China seven years after the event. Methods: A cross-sectional survey based on census tracts was conducted on the bereaved earthquake survivors. Responses to the questionnaire regarding PGD and its potential associated factors were obtained either through face-to-face or telephone interview. PGD was screened by a validated Chinese version of the PGD questionnaire-13 (PG-13). Bivariate and multivariate regression analyses were used to determine the prevalence and associated risk factors of PGD. Results: A total of 1464 bereaved earthquake survivors, with a response rate of 97.6%, were included in the study. Of the 1464 respondents studied, 124 (8.47%) were diagnosed with PGD. Multivariate regression analysis demonstrated that PGD in the bereaved earthquake individuals was significantly associated with several factors, including age, economic burden, close kinship with the deceased, and living with the deceased before the loss. Wenchuan earthquake bereaved aged 41–60 years were more likely to develop PGD compared to those aged younger than 40 or older than 60 (OR = 2.075, 95%CI = 1.297–3.319). Those who had a close kinship with the deceased had a higher tendency to develop PGD (OR = 5.144, 95%CI = 2.716–9.740). The odds of PGD among the earthquake bereaved with economic burdens were higher relative to those who did not experience an economic burden (OR = 8.123, 95%CI = 2.657–24.831). Those who living with the deceased before loss also had a higher tendency to develop PGD (OR = 0.179, 95%CI = 0.053–0.602). Conclusions: This study revealed that a significantly high proportion (8.47%) of the Wenchuan earthquake-bereaved remain grieving seven years after the event. Those diagnosed with PGD should receive appropriate interventions from clinical psychologists. The risk factors identified in this study are crucial for the early screening and prevention of PGD in future nursing and psycho-clinical practices. Keywords: Earthquake, Prolonged grief disorder, Root cause analysis, Cross-sectional studie