• Maxwell T Vergo, Jeremy Whyman, Zhigang Li, Jeanne Kestel, Spencer L James, Christopher Rector, and John M Salsman.
• 1 Section of Palliative Medicine, Department of Medicine, Dartmouth-Hitchcock Medical Center , Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
• J Palliat Med. 2017 Jan 1; 20 (1): 485248-52.

BackgroundGrief is a universal experience for patients living with a terminal illness, but it is not routinely measured. The Preparatory Grief in Advanced Cancer (PGAC) instrument has been used in Greece, but this is its first use in an American population with advanced cancer.ObjectiveOur aim was to use the PGAC instrument in an American population of advanced cancer patients to explore demographic, clinical, and psychological factors that may predict higher preparatory grief.DesignSubjects completed a single cross-sectional time point evaluation.Setting/SubjectsFifty-three adult outpatients and inpatients with incurable solid malignancies from Chicago, IL.MeasurementsDemographic and clinical information, the PGAC instrument, the Hospital Anxiety and Depression Scale (HADS), the distress thermometer (DT), the Edmonton Symptom Assessment Scale (ESAS), and a quality-of-life (QOL) 2-question scale.ResultsThe mean PGAC score was 26.9 (range 0-70) and was only correlated with DT in multivariate analysis.ConclusionsPreparatory grief was a common experience, and one-fourth of our sample participants had significant grief. Distress was the only independent factor (including psychological, physical, clinical, or demographic factors) correlated with higher preparatory grief scores.

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