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Long-term prevalence and predictors of prolonged grief disorder amongst bereaved cancer caregivers: A cohort study

Published online by Cambridge University Press:  15 February 2019

Rachel D. Zordan ,
Melanie L. Bell ,
Melanie Price ,
Cheryl Remedios ,
Elizabeth Lobb ,
Christopher Hall  and
Peter Hudson
Rachel D. Zordan*
Affiliation:
St Vincent’s Hospital, Melbourne, Australia University of Melbourne, Parkville, Australia
Melanie L. Bell
Affiliation:
Mel and Enid Zuckerman College of Public Health, Department of Epidemiology and Biostatistics, The University of Arizona, USA
Melanie Price
Affiliation:
Centre for Medical Psychology and Evidence-based Decision-making, University of Sydney, Camperdown, Australia
Cheryl Remedios
Affiliation:
Mercy Palliative Care, VIC, Australia
Elizabeth Lobb
Affiliation:
Calvary Palliative and End of Life Care Research Institute, Calvary Health Care, Kogarah, Australia School of Medicine, University of Notre Dame, Darlinghurst, Australia
Christopher Hall
Affiliation:
Australian Centre for Grief and Bereavement, Melbourne, Australia
Peter Hudson
Affiliation:
Centre for Palliative Care, St Vincent’s Hospital Melbourne, Australia The University of Melbourne, Parkville, Australia Vrije University, Brussels, Belgium
*
Author for correspondence: Dr Rachel D. Zordan, Senior Research Fellow, St Vincent's Hospital, Melbourne, Fitzroy, Australia. E-mail: rachel.zordan@shva.org.au
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Abstract

Context

The short-term impact of prolonged grief disorder (PGD) following bereavement is well documented. The longer term sequelae of PGD however are poorly understood, possibly unrecognized, and may be incorrectly attributed to other mental health disorders and hence undertreated.

Objectives

The aims of this study were to prospectively evaluate the prevalence of PGD three years post bereavement and to examine the predictors of long-term PGD in a population-based cohort of bereaved cancer caregivers.

Methods

A cohort of primary family caregivers of patients admitted to one of three palliative care services in Melbourne, Australia, participated in the study (n = 301). Sociodemographic, mental health, and bereavement-related data were collected from the caregiver upon the patient's admission to palliative care (T1). Further data addressing circumstances around the death and psychological health were collected at six (T2, n = 167), 13 (T3, n = 143), and 37 months (T4, n = 85) after bereavement.

Results

At T4, 5% and 14% of bereaved caregivers met criteria for PGD and subthreshold PGD, respectively. Applying the total PGD score at T4, linear regression analysis found preloss anticipatory grief measured at T1 and self-reported coping measured at T2 were highly statistically significant predictors (both p < 0.0001) of PGD in the longer term.

Conclusion

For almost 20% of caregivers, the symptoms of PGD appear to persist at least three years post bereavement. These findings support the importance of screening caregivers upon the patient's admission to palliative care and at six months after bereavement to ascertain their current mental health. Ideally, caregivers at risk of developing PGD can be identified and treated before PGD becomes entrenched.

Keywords

Prolonged grief disorderComplicated griefBereavementCaregiverMental healthPalliative care
Type
Original Article
Information
Palliative & Supportive Care , Volume 17 , Issue 5 , October 2019 , pp. 507 - 514
Copyright
Copyright © Cambridge University Press 2019 

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Footnotes

†

Deceased.

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