Change of pre-loss grief in relatives of cancer patients: a longitudinal study

Before the loss of a loved one to cancer, many relatives experience feelings of pre-loss grief. While pre-loss grief seems to have adverse health impacts, its longitudinal associations are still unclear. Therefore, this study aims to investigate the change of pre-loss grief over time, predictors of change and its relationship with psychological health over a time period of 1.5 years.

Fifty-two relatives of people with cancer who were at least 18 years old and spoke German were included. Multiple linear regression analysis and paired t-tests were performed.

The total pre-loss grief score significantly decreased over time (p = 0.009), while at the subscale level only emotional pain showed a significant decrease. Attendance of a psychotherapist (β = -0.452, p = 0.041) more than once per month compared to never, less than or once per month was associated with a greater reduction in pre-loss grief. While psychological health did not predict later pre-loss grief (p > 0.05), pre-loss grief was found to predict higher levels of anxiety (β = 0.335, p = 0.046) 1.5 years later.

Findings suggest that emotional pain may lessen over time, whereas other dimensions of pre-loss grief may remain stable. At the same time, because pre-loss grief is associated with some adverse health outcomes 1.5 years later, relatives with high levels of pre-loss grief may need additional support. Furthermore, this study provides preliminary insights into helpful intervention approaches for pre-loss grief. To understand underlying mechanisms, further dismantling studies are needed.