Fur-Hsing Wen1, Wen-Chi Chou2,3, Wen-Chi Shen2,3, Siew Tzuh Tang2,4,5. 1. Department of International Business, Soochow University, Taipei, Taiwan. 2. Division of Hematology-Oncology, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan. 3. College of Medicine, Chang Gung University, Tao-Yuan, Taiwan. 4. School of Nursing, Chang Gung University, Tao-Yuan, Taiwan. 5. Department of Nursing, Chang Gung Memorial Hospital at Kaohsiung, Taiwan.
Abstract
OBJECTIVE: Grief reactions in bereaved caregivers of cancer patients have been identified individually as distinct prolonged grief disorder (PGD)-and major depressive disorder (MDD)-symptom trajectories, but no research has examined whether the patterns of change (trajectories) for PGD and MDD symptoms synchronize during bereavement. We conducted a secondary analysis study to investigate the construct distinctiveness of PGD and MDD by simultaneously identifying and examining similarities and differences between bereaved caregivers' PGD- and depressive-symptom trajectories from immediately post-loss through 2 years later. METHODS: PGD and depressive symptoms were measured for 849 cancer patients' caregivers over their first 2 years of bereavement using 11 grief-symptom items of the prolonged grief-13 scale (PG-11) and the center for epidemiologic studies-depression (CES-D) scale, respectively. PGD- and depressive-symptom trajectories were identified using latent class growth analysis with continuous latent-class indicators (total PG-11 and CES-D scores). Concordance of caregiver participants' membership in PGD- and depressive-symptom trajectories was examined by a percentage and a kappa value. RESULTS: Five distinct symptom trajectories were identified for both PGD and MDD, with four shared trajectories (endurance, transient-reaction, resilience, and prolonged-symptomatic) having different prevalence rankings. Nonetheless, unique trajectories were identified for PGD (potential recurrence) and depressive symptoms (chronically distressed), respectively. Concordance between membership in PGD- and depressive-symptom trajectories was moderate (61.3%, kappa [95% CI]: 0.49 [0.44, 0.53]). CONCLUSION: PGD and MDD are related but distinct constructs indicated by the unique trajectories identified for each, different prevalence rankings for PGD- and depressive-symptom trajectories, and moderate concordance between membership in PGD- and depressive-symptom trajectories, respectively.
OBJECTIVE: Grief reactions in bereaved caregivers of cancerpatients have been identified individually as distinct prolonged grief disorder (PGD)-and major depressive disorder (MDD)-symptom trajectories, but no research has examined whether the patterns of change (trajectories) for PGD and MDD symptoms synchronize during bereavement. We conducted a secondary analysis study to investigate the construct distinctiveness of PGD and MDD by simultaneously identifying and examining similarities and differences between bereaved caregivers' PGD- and depressive-symptom trajectories from immediately post-loss through 2 years later. METHODS: PGD and depressive symptoms were measured for 849 cancerpatients' caregivers over their first 2 years of bereavement using 11 grief-symptom items of the prolonged grief-13 scale (PG-11) and the center for epidemiologic studies-depression (CES-D) scale, respectively. PGD- and depressive-symptom trajectories were identified using latent class growth analysis with continuous latent-class indicators (total PG-11 and CES-D scores). Concordance of caregiver participants' membership in PGD- and depressive-symptom trajectories was examined by a percentage and a kappa value. RESULTS: Five distinct symptom trajectories were identified for both PGD and MDD, with four shared trajectories (endurance, transient-reaction, resilience, and prolonged-symptomatic) having different prevalence rankings. Nonetheless, unique trajectories were identified for PGD (potential recurrence) and depressive symptoms (chronically distressed), respectively. Concordance between membership in PGD- and depressive-symptom trajectories was moderate (61.3%, kappa [95% CI]: 0.49 [0.44, 0.53]). CONCLUSION: PGD and MDD are related but distinct constructs indicated by the unique trajectories identified for each, different prevalence rankings for PGD- and depressive-symptom trajectories, and moderate concordance between membership in PGD- and depressive-symptom trajectories, respectively.