Psychometric evaluation of the anticipatory grief scale in a sample of family caregivers in the context of palliative care

Maja Holm,Joakim Öhlen,Anette Alvariza,Kristofer Årestedt,Carl-Johan Fürst

doi:10.1186/s12955-019-1110-4

Abstract

IntroductionIn palliative care, family caregivers are often faced with experiences of grief in anticipation of the loss of a close person. An instrument designed to measure this form of grief is the Anticipatory Grief Scale, which includes 27 items and has been used in several studies in various contexts. However, the instrument has not been validated.AimThe aim was to evaluate the psychometric properties, focusing on the factor structure, of the Anticipatory Grief Scale in a sample of family caregivers in palliative care.MethodsThe study had a cross-sectional design. Data were collected from an intervention study in palliative home care that took place between 2013 and 2014. In total, 270 family caregivers in palliative care completed a baseline questionnaire, including the Anticipatory Grief Scale. The factor structure of the scale was evaluated using exploratory factor analysis.ResultsThe initial factor analysis suggested a four-factor solution, but, due to weak communalities, extensive crossloadings, and item inconsistencies, the model was problematic. Further analysis supported that the scale should be reduced to 13 items and two factors. The two subscales captured the behavioral and emotional reactions of grief in family caregivers in palliative care and were named Behavioral reactions and Emotional reactions. This modified version will hereafter be named AGS-13.ConclusionsThis validation study of the Anticipatory Grief Scale resulted in a revised two-factor model, AGS-13, that appears to be promising for use in palliative care but needs to be tested further.

Highlights

In palliative care, family caregivers are often faced with experiences of grief in anticipation of the loss of a close person
The two subscales captured the behavioral and emotional reactions of grief in family caregivers in palliative care and were named Behavioral reactions and Emotional reactions. This modified version will hereafter be named AGS-13. This validation study of the Anticipatory Grief Scale resulted in a revised two-factor model, AGS-13, that appears to be promising for use in palliative care but needs to be tested further
Anticipatory grief was seen as a form of ‘grief work’ before an actual loss, where the grieving person would gradually detach their bonds to the dying person [3]

Summary

Introduction

Family caregivers are often faced with experiences of grief in anticipation of the loss of a close person. Grief before a close person’s death has been conceptualized as anticipatory grief, a term that was first defined by Lindemann in light of the Freudian psychoanalytic theory. Anticipatory grief was seen as a form of ‘grief work’ before an actual loss, where the grieving person would gradually detach their bonds to the dying person [3]. This understanding of the concept of anticipatory grief has since been expanded, in relation to palliative care, where family.

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