To identify relatives at risk for Prolonged Grief Disorder symptomatology: A cross-sectional study.

Abstract

Context: While most bereaved can navigate a death-related loss, some face persistent and disabling challenges, a condition known as Prolonged Grief Disorder (PGD). Early identification of PGD can prevent adverse health outcomes. The effectiveness of healthcare providers' clinical intuition versus relatives' self-report surveys in estimating the risk of developing PGD remains uncertain.

Objectives: The study evaluates the accuracy of healthcare providers' subjective risk estimates and self-reported surveys from relatives, conducted close to the cancer patient's death, in predicting ICD-11 PGD symptomatology seven months post-loss.

Methods: The study involved specialist palliative care healthcare providers and bereaved relatives of oncology patients in ten hospital and five home settings. Subjective risk estimates from healthcare providers (N=75) and relatives' self-report surveys (N=75) using the Pre-Loss Grief-12 (PG-12) were compared with Traumatic Grief Inventory-Self Report Plus (TGI-SR+) total scores seven months post-loss. Diagnostic efficacy was evaluated using the Receiver Operating Characteristic and Area Under Curve.

Results: In the sample of 75 relatives, 8% had ICD-11 PGD symptomatology. The Receiver Operating Characteristic analysis of the PG-12 (N=75) yielded an Area Under Curve of 0.891, 95% CI [0.782 - 1], while the healthcare providers' subjective estimates (N=75) resulted in an Area Under Curve of 0.549, 95% CI [0.299 - 0.799]. The optimal Pre-Loss Grief-12 cut-off score for identifying relatives at risk for PGD was 30 with a sensitivity of 100% and a specificity of 64.7%.

Conclusion: The Pre-Loss Grief-12 accurately predicted PGD symptomatology seven months post-loss, while clinical intuition did not perform better than chance. Future research should compare the predictive value of self-report data with clinical interviews.