Reliability and validity of the preparatory grief scale for use with hemodialysis patients

During the gradual decline of physical and social functioning associated with end-stage renal disease, patients might experience a premonition of impending death, resulting in a series of pre-mourning grief responses called preparatory grief. The preparatory grief in advanced cancer patients (PGAC) scale is the most widely used preparatory grief scale for patients on hemodialysis in China.

To verify the reliability and validity of the PGAC scale in patients on hemodialysis.

In total, 327 patients undergoing regular hemodialysis in the blood purification center of three grade-A tertiary hospitals in Guangdong and Guizhou provinces were selected by convenience sampling. The assessment was administered using the general information questionnaire and the Chinese version of PGAC. SPSS 25.0 and Amos 24.0 were used for item analysis, confirmatory factor analysis (CFA), convergent validity, and internal consistency reliability estimation.

In the modified Chinese version of PGAC, 7 dimensions covering 27 total items were retained. CFA revealed a good fit of the factor model (chi-square degree of freedom = 2.056, standardized root mean square residual = 0.0479, root mean square error of approximation = 0.0570, GFI = 0.872, AGFI = 0.841, IFI = 0.931, CFI = 0.930, TLI = 0.919). The factor loadings of the items ranged 0.503-0.884. The composite reliability ranged 0.664-0.914, and the average variance extracted ranged 0.366-0.747. Cronbach's α of the scale was 0.945, and Cronbach's α for various dimensions ranged 0.662-0.914.

The modified PGAC has good reliability and validity, and it can effectively measure preparatory grief in patients on hemodialysis.