Kelly M Trevino1,2, Brett Litz3,4, Anthony Papa5, Paul K Maciejewski1,6, Wendy Lichtenthal7, Charlotte Healy8, Holly G Prigerson1,2. 1. 1 Cornell Center for Research on End-of-Life Care , Weill Cornell Medicine, New York, New York. 2. 2 Department of Medicine, Weill Cornell Medicine , New York, New York. 3. 3 VA Boston Healthcare System , Jamaica Plain, Massachusetts. 4. 4 Department of Psychiatry, Boston University Medical Center , Bosten, Massachusetts. 5. 5 Department of Psychology, University of Nevada , Reno, Reno, Nevada. 6. 6 Department of Radiology, Weill Cornell Medicine , New York, New York. 7. 7 Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center , New York, New York. 8. 8 Department of Professional Studies, Columbia University , New York, New York.
Abstract
OBJECTIVE: The psychosocial challenges confronted by bereaved survivors may contribute to poor bereavement adjustment. Measures of the challenges of bereavement are limited. This study is a preliminary examination of the factor structure of a new measure of bereavement challenges and their relationships to quality of life and mental illness in bereaved cancer caregivers. This measure was designed to identify intervention targets to reduce the likelihood of prolonged grief. METHODS: Caregivers of advanced cancer patients were administered measures of bereavement challenges (Bereavement Challenges Scale, BCS), quality of life (Medical Outcomes Study Short Form-36), prolonged grief (PG-13), and mental disorders (Structured Clinical Interview for the DSM-IV). Principal component factor analyses identified the underlying factor structure of the BCS. We examined associations between the factors and caregiver quality of life, prolonged grief, and rates of mental disorders. RESULTS: A factor analysis identified five factors: "Challenges with Connecting with Others," "Challenges with Change," "Challenges Imagining a Hopeful Future," "Challenges with Accepting the Loss," and "Challenges with Guilt." Greater endorsement of bereavement challenges was associated with worse quality of life, more severe symptoms of prolonged grief, and greater likelihood of meeting criteria for a mental disorder. CONCLUSIONS: Assessing the challenges associated with bereavement is important to understanding barriers to bereaved individuals' adjustment. The five factors of the BCS point to potential targets for clinical intervention. Additional research on the BCS is needed, including validation in larger more diverse samples, and confirmation that reduction of these challenges is associated with less psychiatric morbidity and, specifically, symptoms of prolonged grief.
OBJECTIVE: The psychosocial challenges confronted by bereaved survivors may contribute to poor bereavement adjustment. Measures of the challenges of bereavement are limited. This study is a preliminary examination of the factor structure of a new measure of bereavement challenges and their relationships to quality of life and mental illness in bereaved cancer caregivers. This measure was designed to identify intervention targets to reduce the likelihood of prolonged grief. METHODS: Caregivers of advanced cancerpatients were administered measures of bereavement challenges (Bereavement Challenges Scale, BCS), quality of life (Medical Outcomes Study Short Form-36), prolonged grief (PG-13), and mental disorders (Structured Clinical Interview for the DSM-IV). Principal component factor analyses identified the underlying factor structure of the BCS. We examined associations between the factors and caregiver quality of life, prolonged grief, and rates of mental disorders. RESULTS: A factor analysis identified five factors: "Challenges with Connecting with Others," "Challenges with Change," "Challenges Imagining a Hopeful Future," "Challenges with Accepting the Loss," and "Challenges with Guilt." Greater endorsement of bereavement challenges was associated with worse quality of life, more severe symptoms of prolonged grief, and greater likelihood of meeting criteria for a mental disorder. CONCLUSIONS: Assessing the challenges associated with bereavement is important to understanding barriers to bereaved individuals' adjustment. The five factors of the BCS point to potential targets for clinical intervention. Additional research on the BCS is needed, including validation in larger more diverse samples, and confirmation that reduction of these challenges is associated with less psychiatric morbidity and, specifically, symptoms of prolonged grief.
Entities:
Keywords:
bereavement; cancer; mental health; oncology; prolonged grief; quality of life
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