Maxwell T Vergo1, Jeremy Whyman2, Zhigang Li3, Jeanne Kestel4, Spencer L James1, Christopher Rector5, John M Salsman6. 1. 1 Section of Palliative Medicine, Department of Medicine, Dartmouth-Hitchcock Medical Center , Geisel School of Medicine at Dartmouth, Hanover, New Hampshire. 2. 2 Department of Geriatrics and Palliative Medicine, Mount Sinai Hospital and Medical School , New York, New York. 3. 3 Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth , Hanover, New Hampshire. 4. 4 Illinois Crisis Prevention Network , Chicago, Illinois. 5. 5 Department of Clinical Psychology, Illinois School of Professional Psychology at Argosy University , Chicago, Illinois. 6. 6 Wake Forest Baptist Comprehensive Cancer Center , Wake Forest School of Medicine, Winston-Salem, North Carolina.
Abstract
BACKGROUND: Grief is a universal experience for patients living with a terminal illness, but it is not routinely measured. The Preparatory Grief in Advanced Cancer (PGAC) instrument has been used in Greece, but this is its first use in an American population with advanced cancer. OBJECTIVE: Our aim was to use the PGAC instrument in an American population of advanced cancer patients to explore demographic, clinical, and psychological factors that may predict higher preparatory grief. DESIGN: Subjects completed a single cross-sectional time point evaluation. SETTING/ SUBJECTS: Fifty-three adult outpatients and inpatients with incurable solid malignancies from Chicago, IL. MEASUREMENTS: Demographic and clinical information, the PGAC instrument, the Hospital Anxiety and Depression Scale (HADS), the distress thermometer (DT), the Edmonton Symptom Assessment Scale (ESAS), and a quality-of-life (QOL) 2-question scale. RESULTS: The mean PGAC score was 26.9 (range 0-70) and was only correlated with DT in multivariate analysis. CONCLUSIONS: Preparatory grief was a common experience, and one-fourth of our sample participants had significant grief. Distress was the only independent factor (including psychological, physical, clinical, or demographic factors) correlated with higher preparatory grief scores.
BACKGROUND: Grief is a universal experience for patients living with a terminal illness, but it is not routinely measured. The Preparatory Grief in Advanced Cancer (PGAC) instrument has been used in Greece, but this is its first use in an American population with advanced cancer. OBJECTIVE: Our aim was to use the PGAC instrument in an American population of advanced cancerpatients to explore demographic, clinical, and psychological factors that may predict higher preparatory grief. DESIGN: Subjects completed a single cross-sectional time point evaluation. SETTING/ SUBJECTS: Fifty-three adult outpatients and inpatients with incurable solid malignancies from Chicago, IL. MEASUREMENTS: Demographic and clinical information, the PGAC instrument, the Hospital Anxiety and Depression Scale (HADS), the distress thermometer (DT), the Edmonton Symptom Assessment Scale (ESAS), and a quality-of-life (QOL) 2-question scale. RESULTS: The mean PGAC score was 26.9 (range 0-70) and was only correlated with DT in multivariate analysis. CONCLUSIONS: Preparatory grief was a common experience, and one-fourth of our sample participants had significant grief. Distress was the only independent factor (including psychological, physical, clinical, or demographic factors) correlated with higher preparatory grief scores.
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