Kristina Thomas1, Peter Hudson2, Thomas Trauer3, Cheryl Remedios4, David Clarke5. 1. Centre for Palliative Care, St. Vincent's Hospital, Melbourne, Victoria, Australia; Collaborative Centre of The University of Melbourne, Melbourne, Victoria, Australia. Electronic address: kristina.thomas@svhm.org.au. 2. Centre for Palliative Care, St. Vincent's Hospital, Melbourne, Victoria, Australia; Collaborative Centre of The University of Melbourne, Melbourne, Victoria, Australia; Queen's University, Belfast, United Kingdom. 3. Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia; School of Psychology and Psychiatry, Monash University, Melbourne, Victoria, Australia; St. Vincent's Hospital Mental Health Service, Melbourne, Victoria, Australia. 4. Centre for Palliative Care, St. Vincent's Hospital, Melbourne, Victoria, Australia; Collaborative Centre of The University of Melbourne, Melbourne, Victoria, Australia. 5. School of Psychology and Psychiatry, Monash University, Melbourne, Victoria, Australia.
Abstract
CONTEXT: Family carers of palliative care patients report high levels of psychological distress throughout the caregiving phase and during bereavement. Palliative care providers are required to provide psychosocial support to family carers; however, determining which carers are more likely to develop prolonged grief (PG) is currently unclear. OBJECTIVES: To ascertain whether family carers reporting high levels of PG symptoms and those who develop PG disorder (PGD) by six and 13 months postdeath can be predicted from predeath information. METHODS: A longitudinal study of 301 carers of patients receiving palliative care was conducted across three palliative care services. Data were collected on entry to palliative care (T1) on a variety of sociodemographic variables, carer-related factors, and psychological distress measures. The measures of psychological distress were then readministered at six (T2; n=167) and 13 months postdeath (T3; n=143). RESULTS: The PG symptoms at T1 were a strong predictor of both PG symptoms and PGD at T2 and T3. Greater bereavement dependency, a spousal relationship to the patient, greater impact of caring on schedule, poor family functioning, and low levels of optimism also were risk factors for PG symptoms. CONCLUSION: Screening family carers on entry to palliative care seems to be the most effective way of identifying who has a higher risk of developing PG. We recommend screening carers six months after the death of their relative to identify most carers with PG.
CONTEXT: Family carers of palliative care patients report high levels of psychological distress throughout the caregiving phase and during bereavement. Palliative care providers are required to provide psychosocial support to family carers; however, determining which carers are more likely to develop prolonged grief (PG) is currently unclear. OBJECTIVES: To ascertain whether family carers reporting high levels of PG symptoms and those who develop PG disorder (PGD) by six and 13 months postdeath can be predicted from predeath information. METHODS: A longitudinal study of 301 carers of patients receiving palliative care was conducted across three palliative care services. Data were collected on entry to palliative care (T1) on a variety of sociodemographic variables, carer-related factors, and psychological distress measures. The measures of psychological distress were then readministered at six (T2; n=167) and 13 months postdeath (T3; n=143). RESULTS: The PG symptoms at T1 were a strong predictor of both PG symptoms and PGD at T2 and T3. Greater bereavement dependency, a spousal relationship to the patient, greater impact of caring on schedule, poor family functioning, and low levels of optimism also were risk factors for PG symptoms. CONCLUSION: Screening family carers on entry to palliative care seems to be the most effective way of identifying who has a higher risk of developing PG. We recommend screening carers six months after the death of their relative to identify most carers with PG.
Authors: Angela R Ghesquiere; Melissa D Aldridge; Rosemary Johnson-Hürzeler; Daniel Kaplan; Martha L Bruce; Elizabeth Bradley Journal: J Am Geriatr Soc Date: 2015-10-12 Impact factor: 5.562
Authors: Kailey Roberts; Jimmie Holland; Holly G Prigerson; Corinne Sweeney; Geoffrey Corner; William Breitbart; Wendy G Lichtenthal Journal: Palliat Support Care Date: 2016-08-12