Department of Psychology, University of Zurich, Zurich, Switzerland.
Department of Psychology, University of Arizona, Tucson, Arizona, USA.
Psychopathology. 2020;53(1):8-22. doi: 10.1159/000505074. Epub 2020 Mar 6.
Prolonged grief disorder (PGD) is included in the ICD-11 (11th edition of the International Classification of Diseases). The new PGD criteria reflect the requirements and recommendations of the World Health Organization for improved clinical utility and international applicability. Even though the ICD classification system is globally used, no research has investigated how healthcare professionals (HP) in non-Western countries may adopt this change for their own practice.
The present study explored the extent to which the new PGD criteria were accepted and perceived to meet the standards for clinical utility and international applicability among Chinese and German-speaking HP.
Individual semistructured interviews were conducted in person, by phone, or online (e.g., via Skype), with 24 Chinese (n = 10) and German-speaking (n = 14) HP working with bereaved populations in China and Switzerland, and analyzed using a qualitative framework analysis. Questions included "what items are currently missing from the PGD criteria?".
Across all HP, the majority supported the inclusion of PGD and were generally aligned with the current criteria. HP found that the criteria distinguished between normal and abnormal grief and considered the criteria easy to use if their modifications were considered. Merits included, among others, improved clinical decision making, research promotion, and social acknowledgment. Main concerns included misdiagnosis, pathologization, and a lack of specificity of criteria. The importance of international applicability was emphasized across Chinese and German-speaking HP. Different grief-specific symptoms were identified by German-speaking and Chinese HP.
These findings provide evidence for the clinical utility and international applicability of ICD-11 PGD criteria among German-speaking and Chinese HP, as well as cultural similarities and differences in the barriers to implementation of these criteria.
延长哀伤障碍（PGD）被纳入国际疾病分类第 11 版（ICD-11）。新的 PGD 标准反映了世界卫生组织对提高临床实用性和国际适用性的要求和建议。尽管 ICD 分类系统在全球范围内使用，但尚无研究调查非西方国家的医疗保健专业人员（HP）如何将这一变化应用于自己的实践。
本研究旨在探讨中国和德语国家的 HP 对新的 PGD 标准的接受程度，以及他们认为这些标准在临床实用性和国际适用性方面是否达标。
对在中国和瑞士从事丧亲人群工作的 24 名中（n = 10）德（n = 14）语 HP 进行了个人半结构式访谈，访谈方式包括当面访谈、电话访谈和在线访谈（如 Skype 访谈），并采用定性框架分析进行分析。问题包括“PGD 标准目前缺失哪些项目？”。
所有 HP 都支持纳入 PGD，并普遍认同当前的标准。HP 认为这些标准区分了正常和异常的悲伤，并且如果对标准进行修改，这些标准也易于使用。其优点包括改善临床决策、促进研究和社会认可等。主要关注点包括误诊、病理化和标准缺乏特异性。中德 HP 都强调了国际适用性的重要性。德语和汉语 HP 确定了不同的与悲伤相关的症状。
这些发现为 ICD-11 PGD 标准在德语和汉语 HP 中的临床实用性和国际适用性提供了证据，同时也揭示了这些标准在中德实施中存在的文化相似性和差异。
