Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-25T05:13:49.744Z Has data issue: false hasContentIssue false
  • English
  • Français

Portuguese validation of the Prolonged Grief Disorder Questionnaire–Predeath (PG–12): Psychometric properties and correlates

Published online by Cambridge University Press:  04 January 2017

Alexandra Coelho ,
Cláudia Silva  and
António Barbosa
Alexandra Coelho*
Affiliation:
Palliative Medicine Unit, Santa Maria Hospital, Lisbon, Portugal
Cláudia Silva
Affiliation:
Alcoitão School of Health, Alcoitão, Portugal
António Barbosa
Affiliation:
Palliative Medicine Unit, Faculty of Medicine, University of Lisbon, Santa Maria Hospital, Lisbon, Portugal
*
Address correspondence and reprint requests to: Alexandra Coelho, Unidade de Cuidados Paliativos, Hospital de Santa Maria, Avenida Prof. Egas Moniz, 1649-035 Lisboa, Portugal. E-mail: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

This study aimed to contribute to the validation of the Portuguese version of the Prolonged Grief Disorder Questionnaire–Predeath (PG–12), examining its psychometric properties, including factorial, discriminant, and predictive validity. The prevalence of predeath prolonged grief disorder (PGD) and its psychosocial correlates were also analyzed.

Method:

The PG–12 was assessed in a sample of family caregivers (FCs) of oncological patients in palliative care. The factorial and discriminant validity of the PG–12 were evaluated by confirmatory factor analysis. The prevalence of predeath PGD was calculated and correlated with sociodemographic characteristics, perception of illness, intensity of care, coping, and caregiver burden. Prospective data were used to assess predictive validity.

Results:

The sample was composed of 94 FCs, mostly female (78.8%) and daughters (61.3%), with a mean age of 52.02 (SD = 12.87). The PG–12 has been shown to be reliable, to have high internal consistency, to be monofactorial in structure, and to be independent from depression, anxiety, and burden, although predeath grief influences these symptoms. In our sample, 33% met the criteria for predeath PGD. The circumstances and coping mechanisms are also correlated with predeath grief. The PG–12 has also been shown to be predictive of postdeath outcome.

Significance of results:

The PG–12 can be a useful screening tool for early identification of risk for maladjustment to loss among family caregivers.

Keywords

Predeath griefProlonged grief disorderConfirmatory factor analysisDiscriminatory validityPredictive validity
Type
Original Articles
Information
Palliative & Supportive Care , Volume 15 , Issue 5 , October 2017 , pp. 544 - 553
Copyright
Copyright © Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Adelman, R.D., Tmanova, L.L., Delgado, D., et al. (2014). Caregiver burden: A clinical review. The Journal of the American Medical Association, 311(10), 1052–1060.CrossRefGoogle ScholarPubMed
Aldrich, C.K. (1974). Some dynamics of anticipatory grief. In Anticipatory grief. Schoenberg, B. et al. (eds.), pp. 3–9. New York: Columbia University Press.Google Scholar
Bastianelli, A., Gius, E. & Cipolletta, S. (2014). Changes over time in the quality of life, prolonged grief and family strain of family caregivers of patients in vegetative state: A pilot study. Journal of Health Psychology, 21(5), 844–852. Epub ahead of print Jul 1.CrossRefGoogle ScholarPubMed
Beaton, D.E., Bombardier, C., Guillemin, F., et al. (2000). Guidelines for the process of cross-cultural adaptation of self-report measures. Spine, 25(24), 3186–3191.CrossRefGoogle ScholarPubMed
Beery, L.C., Prigerson, H.G., Bierhals, A.J., et al. (1997). Traumatic grief, depression and caregiving in elderly spouses of the terminally ill. Omega, 35(3), 261–279.CrossRefGoogle Scholar
Bevans, M. & Sternberg, E.M. (2012). Caregiving burden, stress, and health effects among family caregivers of adult cancer patients. The Journal of the American Medical Association, 307(4), 398–403. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3304539/pdf/nihms-355747.pdf.CrossRefGoogle ScholarPubMed
Boelen, P.A. & van den Bout, J. (2008). Complicated grief and uncomplicated grief are distinguishable constructs. Psychiatry Research, 157(1–3), 311–314.CrossRefGoogle ScholarPubMed
Canavarro, M.C. (1999). Inventário de sintomas psicopatológicos [in Portuguese]. In Testes e provas psicológicas em Portugal. Simões, M.R. et al. (eds.), pp. 87–109. Braga, Portugal: SHO/APPORT.Google Scholar
Carver, C.S. (1997). You want to measure coping but your protocol's too long: Consider the Brief COPE. International Journal of Behavioral Medicine, 4(1), 92–100.CrossRefGoogle ScholarPubMed
Carver, C.S., Scheier, M.F. & Weintraub, J.K. (1989). Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology, 56(2), 267–283. Available from http://www.psy.miami.edu/faculty/ccarver/documents/p89COPE.pdf.CrossRefGoogle ScholarPubMed
Chiambretto, P., Moroni, L., Guarnerio, C., et al. (2008). Validazione Italiana del Questionario Prolonged Grief Disorder (PG–12) [in Italian]. Giornale Italiano di Medicina del Lavoro ed Ergonomia, 30(Suppl. A), A105–A110.Google ScholarPubMed
Chiambretto, P., Moroni, L., Guarnerio, C., et al. (2010). Prolonged grief and depression in caregivers of patients in vegetative state. Brain Injury, 24(4), 581–588.CrossRefGoogle ScholarPubMed
Cipolletta, S., Gius, E. & Bastianelli, A. (2014). How the burden of caring for a patient in a vegetative state changes in relation to different coping strategies. Brain Injury, 28(1), 92–96.CrossRefGoogle Scholar
Coelho, A. & Barbosa, A. (2016). Family anticipatory grief: An integrative literature review. The American Journal of Hospice & Palliative Care, pii: 1049909116647960. Epub ahead of print May 5.Google Scholar
Delalibera, M., Coelho, A. & Barbosa, A. (2011). Validation of prolonged grief disorder instrument for Portuguese population [in Portuguese]. Acta Médica Portuguesa, 24(6), 935–942. Epub ahead of print Feb 20.CrossRefGoogle ScholarPubMed
de la Morena, M.J. & Cruzado, J.A. (2013). Caregivers of patients with disorders of consciousness: Coping and prolonged grief. Acta Neurologica Scandinavica, 127(6), 413–418. Epub ahead of print Jan 11.CrossRefGoogle Scholar
Derogatis, L.R. & Melisaratos, N. (1983). The Brief Symptom Inventory: An introductory report. Psychological Medicine, 13(3), 595–605.CrossRefGoogle ScholarPubMed
Dillen, L., Fontaine, J.R. & Verhofstadt-Denève, L. (2008). Are normal and complicated grief different constructs? A confirmatory factor analytic test. Clinical Psychology & Psychotherapy, 15(6), 386–395.CrossRefGoogle ScholarPubMed
Ferreira, F., Pinto., A., Laranjeira, A., et al. (2010). Validação da escala de Zarit: Sobrecarga do cuidador em cuidados paliativos domiciliários, para população portuguesa [in Portuguese]. Cadernos de Saúde, 3, 13–19.Google Scholar
Gesi, C., Carmassi, C., Shear, K.M., et al. (2016). Adult separation anxiety disorder in complicated grief: An exploratory study on frequency and correlates. Comprehensive Psychiatry, 72, 6–12.CrossRefGoogle Scholar
Guarnerio, C., Prunas, A., Della Fontana, I., et al. (2012). Prevalence and comorbidity of prolonged grief disorder in a sample of caregivers of patients in a vegetative state. The Psychiatric Quarterly, 83(1), 65–73.CrossRefGoogle Scholar
Holley, C.K. & Mast, B.T. (2009). The impact of anticipatory grief on caregiver burden in dementia caregivers. The Gerontologist, 49(3), 388–396. Epub ahead of print Apr 22. Available from http://gerontologist.oxfordjournals.org/content/49/3/388.full.pdf+html.CrossRefGoogle ScholarPubMed
Hudson, P.L., Thomas, K., Trauer, T., et al. (2011). Psychological and social profile of family caregivers on commencement of palliative care. Journal of Pain and Symptom Management, 41(3), 522–534. Epub ahead of print Dec 3, 2010.CrossRefGoogle ScholarPubMed
Jacobsen, J.C., Zhang, B., Block, S.D., et al. (2010). Distinguishing symptoms of grief and depression in a cohort of advanced cancer patients. Death Studies, 34(3), 257–273. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953955/pdf/nihms-179496.pdf.CrossRefGoogle Scholar
Kiely, D.K., Prigerson, H. & Mitchell, S.L. (2008). Health care proxy grief symptoms before the death of nursing home residents with advanced dementia. The American Journal of Geriatric Psychiatry, 16(8), 664–673. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2670475/pdf/nihms101668.pdf.CrossRefGoogle ScholarPubMed
Latham, A.E. & Prigerson, H.G. (2004). Suicidality and bereavement: Complicated grief as psychiatric disorder presenting greatest risk for suicidality. Suicide & Life-Threatening Behavior, 34(4), 350–362. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1459278/pdf/nihms-8311.pdf.CrossRefGoogle ScholarPubMed
Li, Q.P., Mak, Y.W. & Loke, A.Y. (2013). Spouses' experience of caregiving for cancer patients: A literature review. International Nursing Review, 60(2), 178–187. Epub ahead of print Nov 21, 2012.CrossRefGoogle ScholarPubMed
Lindemann, E. (1944). Symptomatology and management of acute grief. The American Journal of Psychiatry, 151(Suppl. 6), 155–160.Google Scholar
Maciejewski, P.K., Zhang, B., Block, S.D., et al. (2007). An empirical examination of the stage theory of grief. The Journal of the American Medical Association, 297(7), 716–723. Available from https://www.medpagetoday.com/upload/2007/2/23/716.pdf.CrossRefGoogle ScholarPubMed
Maroco, J. (2010). Análise de equações estruturais: Fundamentos teóricos, software & aplicações [in Portuguese]. Pêro Pinheiro: Report Number.Google Scholar
Marques, L., Bui, E., LeBlanc., N., et al. (2013). Complicated grief symptoms in anxiety disorders: Prevalence and associated impairment. Depression and Anxiety, 30(12), 1211–1216. Epub ahead of print Mar 11. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4038035/pdf/nihms585399.pdf.CrossRefGoogle ScholarPubMed
Marwit, S.J. & Meuser, T.M. (2005). Development of a short-form inventory to assess grief in caregivers of dementia patients. Death Studies, 29(3), 191–205.CrossRefGoogle ScholarPubMed
Mulligan, E. (2011). Grief among dementia caregivers: A comparison of two assessment systems. Ph.D. dissertation. St. Louis: Graduate School of Arts & Sciences, Washington University.Google Scholar
Nielsen, M.K., Neergaard, M.A., Jensen, A.B., et al. (2016). Do we need to change our understanding of anticipatory grief in caregivers? A systematic review of caregiver studies during end-of-life caregiving and bereavement. Clinical Psychology Review, 44, 75–93. Epub ahead of print Jan 8.CrossRefGoogle ScholarPubMed
Ogrodniczuk, J.S., Piper, W.E., Joyce, A.S., et al. (2003). Differentiating symptoms of complicated grief and depression among psychiatric outpatients. The Canadian Journal of Psychiatry, 48(2), 87–93.CrossRefGoogle ScholarPubMed
Prigerson, H.G. & Maciejewski, P.K. (2008). Prolonged Grief Disorder Inventory (PG–12). Unpublished instrument.Google Scholar
Prigerson, H.G., Cherlin, E., Chen, J.H., et al. (2003). The Stressful Caregiving Adult Reactions to Experiences of Dying (SCARED) Scale: A measure for assessing caregiver exposure to distress in terminal care. The American Journal of Geriatric Psychiatry, 11(3), 309–319.CrossRefGoogle Scholar
Prigerson, H.G., Vanderwerker, L.C. & Maciejewski, P.K. (2008). A case for inclusion of prolonged grief disorder in the DSM–V. In Handbook of bereavement research and practice: Advances in theory and intervention. Stroebe, M. et al. (eds), pp. 165–186. Washington, DC: American Psychological Association.Google Scholar
Prigerson, H.G., Horowitz, M.J., Jacobs, S.C., et al. (2009). Prolonged grief disorder: Psychometric validation of criteria proposed for DSM–V and ICD–11. PLoS Medicine, 6(8), e1000121. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2711304/pdf/pmed.1000121.pdf.CrossRefGoogle ScholarPubMed
Rando, T.A. (1986). A comprehensive analysis of anticipatory grief: Perspectives, processes, promises and problems. In Loss and anticipatory grief. Rando, T.A. (ed.), pp. 3–37. Lanham, MA: Lexington Books.Google Scholar
Rando, T.A. (1988). Anticipatory grief: The term is a misnomer but the phenomenon exists. Journal of Palliative Care, 4(1–2), 70–73.CrossRefGoogle ScholarPubMed
Revenson, T.A., Griva, K., Luszczynska, A., et al. (2016). Caregiving outcomes. In Caregiving in the illness context. Revenson, T. et al. (eds), pp. 15–24. London: Palgrave Macmillan.Google Scholar
Ribeiro, J.L. & Rodrigues, A.P. (2004). Questões acerca do coping: A propósito do estudo de adaptação do Brief COPE [in Portuguese]. Psicologia, Saúde & Doenças, 5(1), 3–15.Google Scholar
Saldinger, A. & Cain, A.C. (2005). Deromanticizing anticipated death: Denial, disbelief and disconnection in bereaved spouses. Journal of Psychosocial Oncology, 22(3), 69–92.CrossRefGoogle Scholar
Sanderson, C., Lobb, E.A., Mowll, J., et al. (2013). Signs of post-traumatic stress disorder in caregivers following an expected death: A qualitative study. Palliative Medicine, 27(7), 625–631.CrossRefGoogle ScholarPubMed
Simon, N.M., Shear, K.M., Thompson, E.H., et al. (2007). The prevalence and correlates of psychiatric comorbidity in individuals with complicated grief. Comprehensive Psychiatry, 48(5), 395–399.CrossRefGoogle ScholarPubMed
Streiner, D.L. (2003). Starting at the beginning: An introduction to coefficient alpha and internal consistency. Journal of Personality Assessment, 80(1), 99–103.CrossRefGoogle ScholarPubMed
Thomas, K., Hudson, P., Trauer, T., et al. (2014). Risk factors for developing prolonged grief during bereavement in family carers of cancer patients in palliative care: A longitudinal study. Journal of Pain and Symptom Management, 47(3), 531–541. Epub ahead of print Aug 19, 2013.CrossRefGoogle ScholarPubMed
Tomarken, A., Holland, J., Schachter, S., et al. (2008). Factors of complicated grief pre-death in caregivers of cancer patients. Psycho-Oncology, 17(2), 105–111. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515552/pdf/nihms58579.pdf.CrossRefGoogle ScholarPubMed
van Doorn, C., Kasl, S.V., Beery, L.C., et al. (1998). The influence of marital quality and attachment styles on traumatic grief and depressive symptoms. The Journal of Nervous and Mental Disease, 186(9), 566–573.CrossRefGoogle ScholarPubMed