{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T16:43:31Z","timestamp":1769013811672,"version":"3.49.0"},"reference-count":76,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T00:00:00Z","timestamp":1705017600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FCT\u2014Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","award":["UIDB\/05704\/2020"],"award-info":[{"award-number":["UIDB\/05704\/2020"]}]},{"name":"FCT\u2014Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","award":["UIDP\/05704\/2020"],"award-info":[{"award-number":["UIDP\/05704\/2020"]}]},{"name":"Scientific Employment Stimulus","award":["UIDB\/05704\/2020"],"award-info":[{"award-number":["UIDB\/05704\/2020"]}]},{"name":"Scientific Employment Stimulus","award":["UIDP\/05704\/2020"],"award-info":[{"award-number":["UIDP\/05704\/2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Healthcare"],"abstract":"<jats:p>The COVID-19 pandemic imposed changes upon the capacity of healthcare systems, with significant repercussions on healthcare provision, particularly at end-of-life. This study aims to analyze the concept map of death unpreparedness due to the COVID-19 pandemic, capturing the relationships among the attributes, antecedents, consequences, and empirical indicators. Walker and Avant\u2019s method was used to guide an analysis of this concept. A literature search was performed systematically, between May 2022 and August 2023, using the following electronic databases on the Elton Bryson Stephens Company (EBSCO) host platform: Medical Literature Analysis and Retrieval System Online (Medline), Psychological Information Database (PsycINFO), Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete, Cochrane Library, and Nursing and Allied Health Collection. Thirty-four articles were retrieved. The unexpected and unpredictable impositions associated with inexperience and unskillfulness in dealing with COVID-19 configured challenges for healthcare professionals, family\/caregivers, and even the dying person. Nine key attributes emerged in three main domains: (1) Individual: (a) disease-related conditions, (b) separation distress, and (c) scarcity of death and grief literacy; (2) Relational: (a) Dying alone, (b) poor communication, and (c) existential issues; and (3) Contextual: (a) disrupted collective mourning and grieving, (b) disrupted compassionate care and, (c) pandemic social stigma. This study contributed a full definition of death unpreparedness in a global pandemic scenario such as COVID-19. In this sense, feeling unprepared or unready for death brought new challenges to the bioecological resources of those affected. It is essential to embrace strategies capable of providing emotional and spiritual support in the dying process and to respect patient wishes. The lessons learned from COVID-19 should be applied to events with a comparable impact to minimize their consequences.<\/jats:p>","DOI":"10.3390\/healthcare12020188","type":"journal-article","created":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T07:47:16Z","timestamp":1705045636000},"page":"188","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Death Unpreparedness Due to the COVID-19 Pandemic: A Concept Analysis"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4648-355X","authenticated-orcid":false,"given":"Cristina","family":"Costeira","sequence":"first","affiliation":[{"name":"Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo Andr\u00e9-66-68, Campus 5, 13 Polytechnic University of Leiria, 2410-541 Leiria, Portugal"},{"name":"School of Health Sciences, Polytechnic University of Leiria, Campus 2\u2014Morro do Lena, Alto do Vieiro\u2014Apart. 4137, 2411-901 Leiria, Portugal"},{"name":"The Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9035-8548","authenticated-orcid":false,"given":"Maria Anjos","family":"Dixe","sequence":"additional","affiliation":[{"name":"Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo Andr\u00e9-66-68, Campus 5, 13 Polytechnic University of Leiria, 2410-541 Leiria, Portugal"},{"name":"School of Health Sciences, Polytechnic University of Leiria, Campus 2\u2014Morro do Lena, Alto do Vieiro\u2014Apart. 4137, 2411-901 Leiria, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5021-773X","authenticated-orcid":false,"given":"Ana","family":"Querido","sequence":"additional","affiliation":[{"name":"Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo Andr\u00e9-66-68, Campus 5, 13 Polytechnic University of Leiria, 2410-541 Leiria, Portugal"},{"name":"School of Health Sciences, Polytechnic University of Leiria, Campus 2\u2014Morro do Lena, Alto do Vieiro\u2014Apart. 4137, 2411-901 Leiria, Portugal"},{"name":"Center for Health Technology and Services Research (CINTESIS), NursID, University of Porto, 4200-450 Porto, Portugal"}]},{"given":"Ana","family":"Rocha","sequence":"additional","affiliation":[{"name":"Nursing School of Coimbra, Avenida Bissaya Barreto s\/n, 3004-011 Coimbra, Portugal"}]},{"given":"Joel","family":"Vitorino","sequence":"additional","affiliation":[{"name":"School of Health Sciences, Polytechnic University of Leiria, Campus 2\u2014Morro do Lena, Alto do Vieiro\u2014Apart. 4137, 2411-901 Leiria, Portugal"},{"name":"Palliative Care Unit, Portuguese Institute of Oncology of Coimbra, 3000-075 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6101-9560","authenticated-orcid":false,"given":"C\u00e1tia","family":"Santos","sequence":"additional","affiliation":[{"name":"Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo Andr\u00e9-66-68, Campus 5, 13 Polytechnic University of Leiria, 2410-541 Leiria, Portugal"},{"name":"School of Health Sciences, Polytechnic University of Leiria, Campus 2\u2014Morro do Lena, Alto do Vieiro\u2014Apart. 4137, 2411-901 Leiria, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1080-9535","authenticated-orcid":false,"given":"Carlos","family":"Laranjeira","sequence":"additional","affiliation":[{"name":"Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo Andr\u00e9-66-68, Campus 5, 13 Polytechnic University of Leiria, 2410-541 Leiria, Portugal"},{"name":"School of Health Sciences, Polytechnic University of Leiria, Campus 2\u2014Morro do Lena, Alto do Vieiro\u2014Apart. 4137, 2411-901 Leiria, Portugal"},{"name":"Comprehensive Health Research Centre (CHRC), University of \u00c9vora, 7000-801 \u00c9vora, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,12]]},"reference":[{"key":"ref_1","unstructured":"WHO\u2014World Health Organization (2023, September 08). 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