Bereavement Challenges and Their Relationship to Physical and Psychological Adjustment to Loss.

Bereavement Challenges and Their Relationship to Physical and Psychological Adjustment to Loss.

Publication TypeJournal Article
Year of Publication2018
AuthorsTrevino KM, Litz B, Papa A, Maciejewski PK, Lichtenthal W, Healy C, Prigerson HG
JournalJ Palliat Med
Date Published2018 Apr

OBJECTIVE: The psychosocial challenges confronted by bereaved survivors may contribute to poor bereavement adjustment. Measures of the challenges of bereavement are limited. This study is a preliminary examination of the factor structure of a new measure of bereavement challenges and their relationships to quality of life and mental illness in bereaved cancer caregivers. This measure was designed to identify intervention targets to reduce the likelihood of prolonged grief.

METHODS: Caregivers of advanced cancer patients were administered measures of bereavement challenges (Bereavement Challenges Scale, BCS), quality of life (Medical Outcomes Study Short Form-36), prolonged grief (PG-13), and mental disorders (Structured Clinical Interview for the DSM-IV). Principal component factor analyses identified the underlying factor structure of the BCS. We examined associations between the factors and caregiver quality of life, prolonged grief, and rates of mental disorders.

RESULTS: A factor analysis identified five factors: "Challenges with Connecting with Others," "Challenges with Change," "Challenges Imagining a Hopeful Future," "Challenges with Accepting the Loss," and "Challenges with Guilt." Greater endorsement of bereavement challenges was associated with worse quality of life, more severe symptoms of prolonged grief, and greater likelihood of meeting criteria for a mental disorder.

CONCLUSIONS: Assessing the challenges associated with bereavement is important to understanding barriers to bereaved individuals' adjustment. The five factors of the BCS point to potential targets for clinical intervention. Additional research on the BCS is needed, including validation in larger more diverse samples, and confirmation that reduction of these challenges is associated with less psychiatric morbidity and, specifically, symptoms of prolonged grief.

Alternate JournalJ Palliat Med
PubMed ID29182478
PubMed Central IDPMC5867503
Grant ListR35 CA197730 / CA / NCI NIH HHS / United States
K23 AG048632 / AG / NIA NIH HHS / United States
R01 CA106370 / CA / NCI NIH HHS / United States
R01 MH063892 / MH / NIMH NIH HHS / United States
R21 CA218313 / CA / NCI NIH HHS / United States

Weill Cornell Medicine Center for Research on End-of-Life Care 525 E 68th St, Box 39,
1414 Baker Pavilion
New York, NY 10065