Danielle R Glick1, Melissa Motta2, Debra L Wiegand3, Patrick Range4, Robert M Reed1, Avelino C Verceles1, Nirav G Shah1, Giora Netzer5. 1. Division of Pulmonary and Critical Care, University of Maryland School of Medicine, Baltimore, MD, United States. 2. Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States. 3. University of Maryland School of Nursing, Baltimore, MD, United States. 4. Department of Social Work, University of Maryland Medical Center, Baltimore, MD, United States. 5. Division of Pulmonary and Critical Care, University of Maryland School of Medicine, Baltimore, MD, United States; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, United States. Electronic address: gnetzer@som.umaryland.edu.
Abstract
OBJECTIVES: Anticipatory grief, the experience of grief before the death of a mourned individual, is common among people with seriously ill loved ones and associated with impaired social problem solving. We sought to evaluate anticipatory grief in the Intensive Care Unit setting. RESEARCH METHODOLOGY/ DESIGN: Cross-sectional study of surrogate decision-makers of patients admitted to an intensive care unit, incorporating survey methodology. SETTING: Intensive care units at a tertiary care centre. MAIN OUTCOME MEASURES: Surrogates completed a 78-question, self-administered questionnaire consisting of demographic and clinical data, as well as three validated instruments: Anticipatory Grief Scale (AGS), Hospital Anxiety and Depression Scale (HADS), and Social Problem Solving Inventory Revised Short Form (SPSI-R:S). MAIN RESULTS: Surveys were completed by 50 surrogate decision-makers, among whom anticipatory grief was elevated and associated with anxiety and depression. Anticipatory grief was also significantly associated with worsened overall problem solving (Spearman's Rho -0.32, p value 0.02). Surrogates with loved ones who were older or admitted to a trauma unit experienced anticipatory grief at lower levels. Prior admission and Charlson Comorbidity Index scores were not associated with anticipatory grief. CONCLUSION: Levels of anticipatory grief in the intensive care unit are high and associated with concurrent anxiety and depression. Association of anticipatory grief with worsened social problem solving may worsen decision making ability in surrogates.
OBJECTIVES: Anticipatory grief, the experience of grief before the death of a mourned individual, is common among people with seriously ill loved ones and associated with impaired social problem solving. We sought to evaluate anticipatory grief in the Intensive Care Unit setting. RESEARCH METHODOLOGY/ DESIGN: Cross-sectional study of surrogate decision-makers of patients admitted to an intensive care unit, incorporating survey methodology. SETTING: Intensive care units at a tertiary care centre. MAIN OUTCOME MEASURES: Surrogates completed a 78-question, self-administered questionnaire consisting of demographic and clinical data, as well as three validated instruments: Anticipatory Grief Scale (AGS), Hospital Anxiety and Depression Scale (HADS), and Social Problem Solving Inventory Revised Short Form (SPSI-R:S). MAIN RESULTS: Surveys were completed by 50 surrogate decision-makers, among whom anticipatory grief was elevated and associated with anxiety and depression. Anticipatory grief was also significantly associated with worsened overall problem solving (Spearman's Rho -0.32, p value 0.02). Surrogates with loved ones who were older or admitted to a trauma unit experienced anticipatory grief at lower levels. Prior admission and Charlson Comorbidity Index scores were not associated with anticipatory grief. CONCLUSION: Levels of anticipatory grief in the intensive care unit are high and associated with concurrent anxiety and depression. Association of anticipatory grief with worsened social problem solving may worsen decision making ability in surrogates.
Authors: Wendy G Lichtenthal; Martin Viola; Madeline Rogers; Kailey E Roberts; Lindsay Lief; Christopher E Cox; Chris R Brewin; Jiehui Cici Xu; Paul K Maciejewski; Cynthia X Pan; Taylor Coats; Daniel J Ouyang; Shayna Rabin; Susan C Vaughan; William Breitbart; Marjorie E Marenberg; Holly G Prigerson Journal: Palliat Support Care Date: 2022-04