Preparatory grief, psychological distress and hopelessness in advanced cancer patients

Eur J Cancer Care (Engl). 2008 Mar;17(2):145-51. doi: 10.1111/j.1365-2354.2007.00825.x.


A study was undertaken to evaluate the preparatory grief process in advanced cancer patients and its relationship with hopelessness, depression and anxiety. In total, 94 advanced cancer patients treated in a Pain Relief and Palliative Care Unit completed the Preparatory Grief in Advanced Cancer Patients (PGAC) Scale, the Greek Hospital Anxiety and Depression (G-HAD) scales, and a measure of hopelessness the Beck Hopelessness Scale. The strongest correlation was found between grief and hopelessness (r = 0.63, P < 0.0005) and PGAC-1 'self-consciousness' (r = 0.54, P < 0.0005). Similarly, strong associations revealed between PGAC total with anxiety (HAD-D) and depression (HAD-D) (P < 0.0005). Significant associations were depicted between hopelessness, depression and anxiety with PGAC-total as well as with its components. Statistically significant associations were also obtained between grief, metastases (P = 0.073) and education (P = 0.043). In the multiple regression analysis (enter method), anxiety (P < 0.0005) was the strongest predictor of preparatory grief followed by hopelessness (P = 0.002), presence of metastases (P = 0.004) and depression (P = 0.033). Depression, hopelessness, anxiety and terminally ill patients' metastases contribute to the prediction of preparatory grief in this population.

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Aged
  • Aged, 80 and over
  • Anxiety / psychology*
  • Attitude to Death*
  • Depression / psychology*
  • Female
  • Grief*
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / psychology*
  • Palliative Care / psychology
  • Psychiatric Status Rating Scales
  • Self Concept
  • Stress, Psychological
  • Surveys and Questionnaires
  • Terminally Ill / psychology