{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T11:59:18Z","timestamp":1777895958443,"version":"3.51.4"},"reference-count":85,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o Para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["2023.05086.BDANA"],"award-info":[{"award-number":["2023.05086.BDANA"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o Para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["UIDB\/05380\/2020"],"award-info":[{"award-number":["UIDB\/05380\/2020"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o Para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["2020.00523.CEECIND"],"award-info":[{"award-number":["2020.00523.CEECIND"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Omega (Westport)"],"abstract":"<jats:p>\n                    Past research showed that bereaved individuals with higher levels of prolonged grief symptoms report poorer health. However, research addressing the downstream consequences of prolonged grief to physical health and its potential underlying mechanisms is still limited. This study explored whether meaning in life explained the associations of prolonged grief symptoms with mental and physical health outcomes. In a cross-sectional study (\n                    <jats:italic toggle=\"yes\">N<\/jats:italic>\n                    = 332), participants who experienced the death of a family member, a romantic partner, or a close friend 12\u00a0months or longer ago completed an online survey. Results showed that higher levels of prolonged grief symptoms were associated with more depression symptoms, higher perceived loneliness, and lower perceived physical health. These associations were explained by the perception of less meaning in life. Our findings offer insights for researchers and mental health professionals that can contribute to improving health among bereaved adults. Implications and suggestions for future research are discussed.\n                  <\/jats:p>","DOI":"10.1177\/00302228261427791","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T22:00:53Z","timestamp":1771365653000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prolonged Grief and Perceived Mental and Physical Health: The Mediating Role of Meaning in Life"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8225-9782","authenticated-orcid":false,"given":"Ecem","family":"Sarper","sequence":"first","affiliation":[{"name":"Iscte-Instituto Universit\u00e1rio de Lisboa"},{"name":"INTEC-Instituto de Tecnologia Comportamental"}]},{"given":"S\u00edlvia","family":"Lu\u00eds","sequence":"additional","affiliation":[{"name":"INTEC-Instituto de Tecnologia Comportamental"},{"name":"Universidade de Lisboa"}]},{"given":"David L.","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Iscte-Instituto Universit\u00e1rio de Lisboa"}]}],"member":"179","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"e_1_3_5_2_1","doi-asserted-by":"crossref","unstructured":"Al-Mamun F. Das P. Almerab M. M. Muhit M. Mamun M. A. (2025). Prevalence of mental health symptoms following child loss: A population-based study of bereaved mothers in Bangladesh. Journal of Affective Disorders 398 Article 121018. https:\/\/doi.org\/10.1016\/j.jad.2025.121018","DOI":"10.1016\/j.jad.2025.121018"},{"key":"e_1_3_5_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5642"},{"key":"e_1_3_5_4_1","doi-asserted-by":"publisher","DOI":"10.1089\/pmr.2023.0009"},{"key":"e_1_3_5_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/07481187.2024.2369865"},{"key":"e_1_3_5_6_1","doi-asserted-by":"crossref","unstructured":"Barreto M. Victor C. Hammond C. Eccles A. Richins M. T. Qualter P. (2021). Loneliness around the world: Age gender and cultural differences in loneliness. Personality and Individual Differences 169 Article 110066. https:\/\/doi.org\/10.1016\/j.paid.2020.110066","DOI":"10.1016\/j.paid.2020.110066"},{"key":"e_1_3_5_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/074811801461900"},{"key":"e_1_3_5_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/15299732.2015.1027841"},{"key":"e_1_3_5_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/00048674211025728"},{"key":"e_1_3_5_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/00223891.2013.765882"},{"key":"e_1_3_5_11_1","doi-asserted-by":"publisher","DOI":"10.2196\/27707"},{"key":"e_1_3_5_12_1","doi-asserted-by":"crossref","unstructured":"Buur C. Zachariae R. Komischke-Konnerup K. B. Marello M. M. Schierff L. H. O\u2019Connor M. (2024). Risk factors for prolonged grief symptoms: A systematic review and meta-analysis. Clinical Psychology Review 107 Article 102375. https:\/\/doi.org\/10.1016\/j.cpr.2023.102375","DOI":"10.1016\/j.cpr.2023.102375"},{"key":"e_1_3_5_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/00302228211018115"},{"key":"e_1_3_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2024.01.094"},{"key":"e_1_3_5_15_1","doi-asserted-by":"publisher","DOI":"10.32872\/cpe.14351"},{"key":"e_1_3_5_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0000000000001427"},{"key":"e_1_3_5_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/0020764020960202"},{"key":"e_1_3_5_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejtd.2024.100451"},{"key":"e_1_3_5_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2017.12.064"},{"key":"e_1_3_5_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/00048674231154206"},{"key":"e_1_3_5_21_1","doi-asserted-by":"crossref","unstructured":"Eisma M. C. Bernemann K. Aehlig L. Janshen A. Doering B. K. (2023). Adult attachment and prolonged grief: A systematic review and meta-analysis. Personality and Individual Differences 214 Article 112315. https:\/\/doi.org\/10.1016\/j.paid.2023.112315","DOI":"10.1016\/j.paid.2023.112315"},{"key":"e_1_3_5_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beth.2024.04.014"},{"key":"e_1_3_5_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2018.12.122"},{"key":"e_1_3_5_24_1","volume-title":"Karma\u015f\u0131k yas envanteri (revize edilmi\u015f formu)\u2019nin T\u00fcrk\u00e7e\u2019ye \u00e7evirisi: Ge\u00e7erlik ve g\u00fcvenirlik \u00e7al\u0131\u015fmas\u0131","author":"Erdem Atak \u0130.","year":"2012","unstructured":"Erdem Atak \u0130., Beyaz\u0131t U., Subay N., Sar\u0131 B., Reyhan B. (2012) Karma\u015f\u0131k yas envanteri (revize edilmi\u015f formu)\u2019nin T\u00fcrk\u00e7e\u2019ye \u00e7evirisi: Ge\u00e7erlik ve g\u00fcvenirlik \u00e7al\u0131\u015fmas\u0131. Ulusal Psikoloji Kongresi 17. [Poster Presentation]."},{"issue":"1","key":"e_1_3_5_25_1","first-page":"55","article-title":"Development of the Portuguese version of MOS SF-36. Part I. Cultural and linguistic adaptation","volume":"13","author":"Ferreira P. L.","year":"2000","unstructured":"Ferreira P. L. (2000). Development of the Portuguese version of MOS SF-36. Part I. Cultural and linguistic adaptation. Acta Medica Portuguesa, 13(1\u20132), 55\u201366. https:\/\/europepmc.org\/article\/med\/11059056.","journal-title":"Acta Medica Portuguesa"},{"key":"e_1_3_5_26_1","unstructured":"Frade B. Rocha J. Sousa H. Pacheco D. (2009). Validation of Portuguese version for inventory of complicated grief Oslo Norway June 15-18. https:\/\/doi.org\/10.13140\/RG.2.1.2981.7208"},{"key":"e_1_3_5_27_1","article-title":"Protective factors in the context of childhood bereavement: Youth gratitude, future orientation, and purpose in life","volume":"003022282412469","author":"Giang C.","year":"2024","unstructured":"Giang C., Alvis L., Oosterhoff B., Kaplow J. B. (2024). Protective factors in the context of childhood bereavement: Youth gratitude, future orientation, and purpose in life. Omega: The Journal of Death and Dying, Article, 00302228241246919. https:\/\/doi.org\/10.1177\/00302228241246919","journal-title":"Omega: The Journal of Death and Dying, Article"},{"key":"e_1_3_5_28_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0237021"},{"key":"e_1_3_5_29_1","doi-asserted-by":"crossref","unstructured":"Grauerholz K. R. Berry S. N. Capuano R. M. Early J. M. (2021). Uncovering prolonged grief reactions subsequent to a reproductive loss: Implications for the primary care provider. Frontiers in Psychology 12 Article 673050. https:\/\/doi.org\/10.3389\/fpsyg.2021.673050","DOI":"10.3389\/fpsyg.2021.673050"},{"key":"e_1_3_5_30_1","doi-asserted-by":"publisher","DOI":"10.1207\/s15402010bsm0302_4"},{"key":"e_1_3_5_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2006.052043"},{"key":"e_1_3_5_32_1","doi-asserted-by":"publisher","DOI":"10.1080\/20008198.2019.1583524"},{"key":"e_1_3_5_33_1","doi-asserted-by":"publisher","DOI":"10.1080\/15325024.2010.507660"},{"key":"e_1_3_5_34_1","doi-asserted-by":"publisher","DOI":"10.1017\/gmh.2023.28"},{"key":"e_1_3_5_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10862-010-9214-5"},{"key":"e_1_3_5_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/0164027504268574"},{"key":"e_1_3_5_37_1","doi-asserted-by":"crossref","unstructured":"Igartua J. J. Hayes A. F. (2021). Mediation moderation and conditional process analysis: Concepts computations and some common confusions. Spanish Journal of Psychology 24 Article e49. https:\/\/doi.org\/10.1017\/SJP.2021.46","DOI":"10.1017\/SJP.2021.46"},{"key":"e_1_3_5_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcad.12518"},{"key":"e_1_3_5_39_1","doi-asserted-by":"publisher","DOI":"10.1080\/20008066.2024.2371762"},{"key":"e_1_3_5_40_1","doi-asserted-by":"publisher","DOI":"10.1093\/epirev\/mxaf011"},{"key":"e_1_3_5_41_1","doi-asserted-by":"publisher","DOI":"10.1348\/135910706X128278"},{"key":"e_1_3_5_42_1","doi-asserted-by":"publisher","DOI":"10.2190\/OM.65.2.a"},{"key":"e_1_3_5_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00737-009-0112-3"},{"key":"e_1_3_5_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(19)30248-8"},{"key":"e_1_3_5_45_1","doi-asserted-by":"publisher","DOI":"10.4236\/psych.2012.34048"},{"issue":"2","key":"e_1_3_5_46_1","first-page":"102","article-title":"SF-36\u2019n\u0131n T\u00fcrk\u00e7e i\u00e7in g\u00fcvenilirli\u011fi ve ge\u00e7erlili\u011fi","volume":"12","author":"Ko\u00e7yi\u011fit H.","year":"1999","unstructured":"Ko\u00e7yi\u011fit H., Aydemir \u00d6., \u00d6lmez N., Memi\u015f A. (1999). SF-36\u2019n\u0131n T\u00fcrk\u00e7e i\u00e7in g\u00fcvenilirli\u011fi ve ge\u00e7erlili\u011fi. Ege Fizik Tedavi ve Rehabilitasyon Dergisi, 12(2), 102\u2013106.","journal-title":"Ege Fizik Tedavi ve Rehabilitasyon Dergisi"},{"key":"e_1_3_5_47_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269216320948007"},{"key":"e_1_3_5_48_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10902-020-00230-y"},{"key":"e_1_3_5_49_1","doi-asserted-by":"publisher","DOI":"10.1080\/15325024.2010.519287"},{"key":"e_1_3_5_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anr.2023.11.003"},{"key":"e_1_3_5_51_1","doi-asserted-by":"publisher","DOI":"10.1080\/07481187.2010.496686"},{"key":"e_1_3_5_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2009.06.019"},{"key":"e_1_3_5_53_1","doi-asserted-by":"publisher","DOI":"10.1002\/jts.22383"},{"key":"e_1_3_5_54_1","doi-asserted-by":"crossref","unstructured":"Maci\u00e0 D. Cattaneo G. Solana J. Tormos J. M. Pascual-Leone A. Bartr\u00e9s-Faz D. (2021). Meaning in life: A major predictive factor for loneliness comparable to health status and social connectedness. Frontiers in Psychology 12 Article 627547. https:\/\/doi.org\/10.3389\/fpsyg.2021.627547","DOI":"10.3389\/fpsyg.2021.627547"},{"key":"e_1_3_5_55_1","doi-asserted-by":"publisher","DOI":"10.1080\/15524256.2020.1745726"},{"key":"e_1_3_5_56_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2020.537674"},{"key":"e_1_3_5_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.paid.2011.06.012"},{"key":"e_1_3_5_58_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10488-012-0430-z"},{"key":"e_1_3_5_59_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201200561"},{"key":"e_1_3_5_60_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijop.12951"},{"key":"e_1_3_5_61_1","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S87118"},{"key":"e_1_3_5_62_1","article-title":"Vers\u00e3o portuguesa do question\u00e1rio do sentido da vida: Primeiros estudos psicom\u00e9tricos","author":"Portugal M. V.","year":"2017","unstructured":"Portugal M. V. (2017). Vers\u00e3o portuguesa do question\u00e1rio do sentido da vida: Primeiros estudos psicom\u00e9tricos. Reposit\u00f3rio da Universidade de Lisboa. Universidade de Lisboa. https:\/\/repositorio.ul.pt\/handle\/10451\/33211","journal-title":"Reposit\u00f3rio da Universidade de Lisboa. Universidade de Lisboa"},{"key":"e_1_3_5_63_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000121"},{"key":"e_1_3_5_64_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-clinpsy-081219-093600"},{"key":"e_1_3_5_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1781(95)02757-2"},{"key":"e_1_3_5_66_1","doi-asserted-by":"crossref","unstructured":"Quadlander-Goff E. Meyer J. (2024). Risk factors of prolonged grief disorder. OMEGA - Journal of Death and Dying 8 Article 302228241272601. https:\/\/doi.org\/10.1177\/00302228241272601","DOI":"10.1177\/00302228241272601"},{"key":"e_1_3_5_67_1","first-page":"S460","article-title":"Turkish reliability of the patient health questionnaire-9","volume":"27","author":"Sari Y. E.","year":"2016","unstructured":"Sari Y. E., Kokoglu B., Balcioglu H., Bilge U., Colak E., Unluoglu I. (2016). Turkish reliability of the patient health questionnaire-9. Biomedical Research-India, 27, S460\u2013S462.","journal-title":"Biomedical Research-India"},{"key":"e_1_3_5_68_1","doi-asserted-by":"publisher","DOI":"10.1177\/00302228241229484"},{"key":"e_1_3_5_69_1","doi-asserted-by":"publisher","DOI":"10.1080\/07481187.2024.2340726"},{"key":"e_1_3_5_70_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2016.12.016"},{"key":"e_1_3_5_71_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-023-02469-1"},{"key":"e_1_3_5_72_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12144-021-02394-z"},{"key":"e_1_3_5_73_1","doi-asserted-by":"publisher","DOI":"10.1080\/10720537.2018.1461717"},{"key":"e_1_3_5_74_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-0167.53.1.80"},{"key":"e_1_3_5_75_1","doi-asserted-by":"publisher","DOI":"10.1080\/17439760802303127"},{"key":"e_1_3_5_76_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpm.12739"},{"key":"e_1_3_5_77_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19106065"},{"key":"e_1_3_5_78_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.focus.20200052"},{"key":"e_1_3_5_79_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2013.05.022"},{"key":"e_1_3_5_80_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-017-2373-7"},{"issue":"1","key":"e_1_3_5_81_1","first-page":"E1497","article-title":"Preliminary psychometric characteristics of the Portuguese version of patient health questionnaire 9 (PHQ-9) in a sample of Portuguese breast cancer women","volume":"28","author":"Torres A.","year":"2013","unstructured":"Torres A., Pereira A., Monteiro S., Albuquerque E. (2013). Preliminary psychometric characteristics of the Portuguese version of patient health questionnaire 9 (PHQ-9) in a sample of Portuguese breast cancer women. European Psychiatry, 28(1), E1497. https:\/\/doi.org\/10.1016\/S0924-9338(13)77209-2","journal-title":"European Psychiatry"},{"key":"e_1_3_5_82_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16020281"},{"key":"e_1_3_5_83_1","volume-title":"SF-36 physical and mental health summary scales: A user\u2019s manual","author":"Ware J. E.","year":"1995","unstructured":"Ware J. E., Kosinski M. A., Keller S. D. (1995). SF-36 physical and mental health summary scales: A user\u2019s manual. Health Institute, New England Medical Center."},{"issue":"26","key":"e_1_3_5_84_1","first-page":"1","article-title":"Can physical activity support grief outcomes in individuals who have been bereaved? A systematic review","volume":"7","author":"Williams J.","year":"2021","unstructured":"Williams J., Shorter G. W., Howlett N., Zakrzewski-Fruer J., Chater A. M. (2021). Can physical activity support grief outcomes in individuals who have been bereaved? A systematic review. Sports Medicine-Open, 7(26), 1\u201317. https:\/\/doi.org\/10.1186\/s40798-021-00311-z","journal-title":"Sports Medicine-Open"},{"key":"e_1_3_5_85_1","doi-asserted-by":"publisher","DOI":"10.1177\/0030222820977305"},{"key":"e_1_3_5_86_1","doi-asserted-by":"publisher","DOI":"10.1080\/07481187.2023.2192010"}],"container-title":["OMEGA - Journal of Death and Dying"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00302228261427791","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00302228261427791","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00302228261427791","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T08:11:23Z","timestamp":1777623083000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00302228261427791"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,17]]},"references-count":85,"alternative-id":["10.1177\/00302228261427791"],"URL":"https:\/\/doi.org\/10.1177\/00302228261427791","relation":{},"ISSN":["0030-2228","1541-3764"],"issn-type":[{"value":"0030-2228","type":"print"},{"value":"1541-3764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,17]]},"article-number":"00302228261427791"}}