临终癌症患者照顾者的与复杂悲伤风险相关的预损失症状。

Pre-loss symptoms related to risk of complicated grief in caregivers of terminally ill cancer patients.

机构信息

Section of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Corso Giovecca 203, 44121 Ferrara, Italy.

Section of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Corso Giovecca 203, 44121 Ferrara, Italy; Integrated Department of Mental Health and Drug Abuse, NHS Local Health Agency, Ferrara, Italy.

出版信息

J Affect Disord. 2014 May;160:87-91. doi: 10.1016/j.jad.2013.12.023. Epub 2013 Dec 30.

DOI:10.1016/j.jad.2013.12.023

PMID:24445130

Abstract

PURPOSE

A number of studies have underlined a 10-20% prevalence of complicated grief (CG) among caregivers of cancer patients. The study aimed at examining the relationship between pre-loss criteria for CG and post-loss diagnosis of CG and at evaluating the validity and factor structure of a predictive tool, the Inventory of Complicated Grief (ICG), in order to identify the risk of developing CG in a sample of Italian caregivers.

METHODS

Sixty family members of terminally ill patients admitted to hospice and receiving a Palliative Prognostic Score (PaP) predictive 30 day survival time <30% completed the Pre-Death ICG (ICG-PL) (T0). Family members were met again 6 months after the death of their loved one (T1) and submitted to the interview for Complicated Grief (Post-loss interview-PLI).

RESULTS

Caseness for CG was shown in 18.3% of caregivers at T1. ICG-PL score (T0) were higher among those who developed CG at T1 than non-cases. A cut off score ≥49 on the ICG-PL (AUC=0.98) maximized sensitivity (92%) and specificity (98%) on caseness at T1. Pre-loss criteria related to traumatic distress, separation distress and emotional symptoms in general were significantly related to a post-loss diagnosis of CG, while no effect was shown on duration of pre-loss distress.

CONCLUSIONS

The use of short screening tools, like the ICG-PL, may help health care professionals to identify subjects at risk for CG.

摘要

目的

许多研究强调了癌症患者照顾者中复杂悲伤（CG）的患病率为 10-20%。本研究旨在研究 CG 的预损失标准与损失后 CG 诊断之间的关系，并评估预测工具《复杂悲伤清单》（ICG）的有效性和因子结构，以便在意大利照顾者样本中确定发展 CG 的风险。

方法

60 名临终患者的家属接受姑息预后评分（PaP）预测 30 天生存率<30%，完成了《死亡前 ICG》（ICG-PL）（T0）。家属在亲人去世后 6 个月再次接受《复杂悲伤访谈》（PLI）。

结果

在 T1 时，18.3%的照顾者出现 CG 病例。在 T1 时发展为 CG 的患者的 ICG-PL 评分（T0）高于非病例。ICG-PL 得分≥49 分（AUC=0.98）可最大程度地提高 T1 时病例的敏感性（92%）和特异性（98%）。与创伤性痛苦、分离痛苦和一般情绪症状相关的预损失标准与损失后 CG 的诊断显著相关，而预损失痛苦的持续时间没有影响。