Adaptation and psychometric validation of the Prolonged Grief Disorder scale among widows in central Nepal

Surkan, Pamela J.; Garrison-Desany, Henri; Rimal, Damodar; Luitel, Nagendra P.; Kim, Yoona; Prigerson, Holly G.; Shrestha, Sumeera; Tol, Wietse A.; Murray, Sarah

doi:10.1016/j.jad.2020.12.018

Cited by 4 publications

(3 citation statements)

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“…Accurate and reliable data on PGD among widows in Nepal can allow for the more efficient allocation of mental health resources and enable providers to have better understanding of the needs and vulnerabilities facing widows (Patel et al ., 2008). In response to these detection, diagnosis, and treatment needs of widows, we conducted mixed-methods research to locally adapt and validate the PG-13 (Kim et al ., 2020; Surkan et al ., 2021). The newly adapted scale (PG-12/17-N) contains 12 original scale items and five new items reflecting symptomology in the local context (Table 1).…”

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confidence: 99%

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Feasibility of implementing a culturally adapted Prolonged Grief Disorder scale in the mental healthcare system in Nepal

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Background Nepali widows have a high prevalence of mental disorders, including prolonged grief disorder (PGD). Despite the considerable needs that Nepali widows have for mental health services, resources for mental health in Nepal are limited, amplifying the importance of accurate screening and diagnosis. The objective of this study was to explore the feasibility of implementing a culturally adapted Prolonged Grief Scale (PG-12/17-N) and provide actionable recommendations for its implementation. Methods Twenty-five mental health service providers in Kathmandu and Chitwan, Nepal were interviewed using a semi-structured guide based on selected constructs from the Consolidated Framework for Implementation Research. Qualitative data were inductively and deductively coded and analyzed to identify prominent themes. Results Providers reported that the main advantages of the scale were the need to identify widows at risk, cultural relevance, easy language, and inclusion of detailed and specific symptoms. Perceived weaknesses included the complexity in response options and scoring, length, item redundancy, overlap with depression symptoms, and lack of somatic symptoms. Providers discussed the need for training, supervision, and a referral and detection system required to implement the scale in Nepal. Further development of a brief version of the scale as a routine screener may facilitate detection and referral to care. Conclusion Based on the results showing need to address PGD in Nepali widows, further efforts are needed to increase awareness about PGD and develop evidence-supported treatments for PGD, after which screening could be made routine for widows.

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Section: Introductionmentioning

confidence: 99%

“…The newly adapted scale (PG-12/17-N) contains 12 original scale items and five new items reflecting symptomology in the local context (Table 1). PG-17-N demonstrated strong psychometric properties among widows in central Nepal (Cronbach's α = 0.93; sensitivity = 82%; and specificity = 74%) (Surkan et al ., 2021).…”

Section: Introductionmentioning

confidence: 99%

Feasibility of implementing a culturally adapted Prolonged Grief Disorder scale in the mental healthcare system in Nepal

et al. 2021

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“…Although there is growing evidence of the cross-cultural validity of the PGD construct and its measures ( 16 , 17 ), the expression of grief may differ within the respective cultural and religious frameworks ( 18 , 19 ). A systematic review on the assessment of PGD in refugee and post-conflict samples ( 18 ) has shown that PGD can be identified with measures developed with Western samples.…”

Section: Introductionmentioning

confidence: 99%

Beliefs About Causes and Cures of Prolonged Grief Disorder Among Arab and Sub-Saharan African Refugees

Lechner-Meichsner

Comteße

2022

Front. Psychiatry

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BackgroundMany refugees have experienced the death of a loved one under traumatic circumstances. Accordingly, the prevalence of Prolonged Grief Disorder (PGD) among refugees is high. Culture-specific symptoms of PGD have been described previously, but beliefs about causes and cures of PGD among refugees remain unknown. We therefore aimed at identifying illness beliefs and treatment expectations regarding PGD among refugees.MethodWe focused on refugees from Arab countries (n = 14) and from Sub-Sahara Africa (n = 9) and applied qualitative and quantitative methods. In a semi-structured interview, participants first answered questions about assumed causes and potential cures for prototypical PGD symptoms according to ICD-11 that were presented in a vignette as representatives of their own culture. In the quantitative part, they completed the Cause Subscale of the Illness Perception Questionnaire (IPQ-R) that included additional culture-specific items. Interviews were analyzed with Qualitative Content Analysis.ResultsIn both groups of refugees, PGD symptoms were predominantly attributed to a close relationship to the deceased, lack of social support, personal vulnerabilities, and circumstances of the death. Participants also named a number of flight-related causes (e.g., inability to perform or participate in rituals, feeling isolated in the host country). None of the participants attributed PGD symptoms to supernatural causes. Descriptive analyses of responses on the IPQ-R indicated that participants predominantly attributed PGD symptoms to psychological causes. Participants believed that PGD can be cured and predominantly mentioned social and religious support. Psychological help was only mentioned by a minority of participants. In both groups, participants emphasized that a therapist must be familiar with the patient's culture and rituals. Participants also mentioned stigma associated with seeking psychological help.ConclusionResults suggest specific beliefs of refugees regarding causes and cures of PGD as well as similarities with Western conceptualizations. A culture-sensitive approach to the treatment of PGD in refugees that can include knowledge of culture-specific rituals and incorporating religious beliefs as well as decreasing stigma and increasing mental health literacy seem important. The study is limited by its focus on only two groups of refugees and its small sample size.

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Prevalence and Correlates of Complicated Grief in Military Primary Care: Implications for Healthcare Providers

Gibson

2024

Omega (Westport)

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Grief is a universal experience, but for approximately 1 in 10 individuals, grief can become impairing. Despite servicemembers’ frequent exposure to death, research on grief in the military remains limited. The purpose of the study was to explore the prevalence and correlates of complicated grief (CG) in military primary care. A quantitative survey was conducted with 161 non-treatment-seeking service members, veterans, and their dependents, of whom 138 reported a significant loss. Results revealed that 35% of the respondents who were bereaved met the cut-off score of 25 on the Inventory of Complicated Grief (ICG). Furthermore, 10% met the cut-off score of 30 on the Prolonged Grief Disorder-13-Revised Scale (PG-13-R). Importantly, death by suicide and pre-existing mental health conditions were associated with greater symptom severity. These findings have important implications for primary care providers and other clinicians working with military populations.

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Adaptation and psychometric validation of the Prolonged Grief Disorder scale among widows in central Nepal

Cited by 4 publications

References 40 publications

Feasibility of implementing a culturally adapted Prolonged Grief Disorder scale in the mental healthcare system in Nepal

Feasibility of implementing a culturally adapted Prolonged Grief Disorder scale in the mental healthcare system in Nepal

Beliefs About Causes and Cures of Prolonged Grief Disorder Among Arab and Sub-Saharan African Refugees

Prevalence and Correlates of Complicated Grief in Military Primary Care: Implications for Healthcare Providers

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