Bereaved females are more likely to suffer from mood problems even if they do not meet the criteria for prolonged grief.

PURPOSE: The goal of this study was to describe the gender difference of grief experience and mood distress among caregivers who cared for terminal cancer patients residing in a hospice ward. METHODS: This study recruited 432 caregivers who cared for terminal cancer patients in the hospice ward. Caregivers received telephone interviews 6 months after the patients had died. The Chinese versions of the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Inventory of Complicated Grief (ICG) developed in 1995 by Prigerson et al. were employed to assess the mood distress and grief status. RESULTS: Total scores of BDI, BAI, and ICG were significantly higher in females. Six out of twenty-one items of BDI, lack of satisfaction, crying spells, sleep disturbance, fatigability, somatic preoccupation, and loss of libido, showed significantly higher scores in females. According to BAI, inability to relax, dizziness, fear of dying, fright, flushed face, and hot/cold sweats were significantly higher in females. After adjustment for potential confounders, the results show that female gender is associated with higher BDI (regression coefficient 3.24, 95% CI: 1.48-4.99), BAI (3.8; 1.11-6.50), and ICG (4.25, 1.09-7.40). Dichotomizing the BDI, BAI, and ICG into severe and nonsevere cases, the results showed that gender only contributes to severe anxiety status (BAI ≥ 36), but not to severe depression (BDI ≥ 29) or to prolonged grief (ICG ≥ 25). CONCLUSIONS: Bereaved females had higher scores for depression and anxiety than males. Female gender is associated with severe anxiety; however, it is not associated with severe depression or prolonged grief.

Determinants of complicated grief in caregivers who cared for terminal cancer patients.

PURPOSE: There is little research on determinants and the grief that caregivers experience after their relatives die of cancer. This study evaluated factors which influence complicated grief among caregivers who cared for patients who died of cancer in Taiwan. METHODS: This prospective study recruited 668 caregivers who cared for terminally ill cancer patients in the hospice ward or who received shared-care consultation. Caregivers were interviewed on the telephone an average 8.9 months after the cancer patients passed away. The Inventory of Complicated Grief (ICG), modified for use in a Chinese population, was used to assess the grief status of caregivers. ICG >25 was defined as complicated grief. RESULTS: Our study found that female gender (odds ratio (OR), 2.27; 95% confidence interval (CI), 1.75-2.82), spouse relationship (OR, 1.20; 1.01-1.40), parents-children relationship (OR, 1.70; 1.11-2.31), lack of religious belief (OR, 1.47; 1.19-1.75), unavailable family support (OR, 1.42; 1.03-1.83), and history of mood co-morbidity (OR, 1.41; 1.02-1.83) were risk factors that would predispose towards complicated grief; whereas, longer duration of caring (months, OR, 0.79; 0.69-0.91), medical disease history in the carer (OR, 0.77; 0.57-0.99), and patients being cared for on the hospice ward (OR, 0.60; 0.44-0.77) were factors that would mitigate against complicated grief. CONCLUSIONS: These results suggest that clinical professionals who care for terminal cancer patients and their caregivers should pay particular attention to caregivers with these predisposing factors.