Predictores de duelo complicado

Abstract

AIM To examine the evolution of first moment’s grief and determine which risk and protective factors pre loss may predict future complications in oncology patient’s caregiver’s grief. METHODS There have been assessed 236 oncology’s patient’s grievers from Valencia and Madrid palliative care settings. Structured interview following DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders IV-TR, 2002) complicated grief criteria and Inventory of Complicated Grief (ICG Prigerson & Jacobs 2001) administered 2 and 6 mo. post-loss RESULTS Similar answer patterns were found at 2 and 6 mo. post-loss in grievers (with and without complicated grief). Best complicated grief predictors were caregiver’s dependency, anger and guilt, previous grief problems (previous psychiatric problems and previous unresolved grief problems), symptoms without control during end of life last days and financial problems. Best protective factors that predicts between complicated/uncomplicated grievers were: capacity to fi nd sense to the death, ability to manage diffi cult situations and emotions. It was also considered self care, express positive emotions and confi dence in their own recovery. Binary logistic regression show how the variables: dependency, guilt, previous unresolved grief problems, symptoms without control during all illness trajectory and fi nancial problems predicts complicated grief. CONCLUSIONS Similar patterns of answers at 2 and 6 months post-loss in grievers with and without complicated grief suggest the possibility of earlier grief support. It is important to prevent grief complications by working in grief changeable risk factors before the death of the patient. Special attention has to be made toward dependency, anger, guilt and also resources enhancement as they facilitate grievers to adapt their new situation.