Assessing Preparatory Grief in Advanced Cancer Patients as an Independent Predictor of Distress in an American Population.

Abstract

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. 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. Subjects completed a single cross-sectional time point evaluation. Fifty-three adult outpatients and inpatients with incurable solid malignancies from Chicago, IL. 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. The mean PGAC score was 26.9 (range 0-70) and was only correlated with DT in multivariate analysis. 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.