Grief, recurrent sorrow, and depression among caregivers and bereaved.

Abstract

Grief that accompanies significant loss is a universal human experience. It has long been presumed that grief should resolve over a finite period of time. Because of the difficulties with defining the appropriate time limitations for uncomplicated grieving, an alternate conceptualization of grief resolution, in which sorrow is expected to recur periodically rather than dissipate over time was introduced as a conceptual perspective. The research followed a retrospective design in which three groups of persons who had experienced significant, yet different, types of loss were examined to determine the pattern of grief resolution over time. The groups included those whose loved one had a congenital cognitive deficit (Congenital), persons whose loved one had an acquired cognitive deficit (Acquired), and bereaved persons (Bereaved). The outcome variables of initial and present grief, recurrent sorrow, and depressive symptoms were examined for relationship to the covariates of attachment, spirituality, and perceived social support. Participants completed questionnaires that referenced past and present feelings about the loss. Instrumentation included a new scale, the Recurrent Sorrow Inventory, developed to assess pattern of grief over time. Data were analyzed with descriptive and chi-square statistics, analysis of variance, and factor analysis. In addition, graphic format data were used to supplement analysis of the other Likert-format scales. One hundred twenty subjects completed questionnaires. For the combined sample, a significantly greater number of participants selected graphs and descriptive phrases representative of recurrent sorrow over time, than the other choices that suggested either time-bound grief resolution or persistent sadness following loss. The findings did not differ across groups when the sample was separated by type of loss. As hypothesized, the data supported separate, orthogonal factors of initial and present grief, recurrent sorrow, and depression. This supports distinction of depression from grief and recurrent sorrow and suggests avenues for theory development regarding human response to loss. The findings of the study support the need to continue examination of the pervasive nature of grief over time, particularly for relevance to emotional and psychosocial well-being. Nursing science is an appropriate context in which to consider these relationships.