Purpose of the Questionnaire

The purpose of the questionnaire is to assess preparatory grief in patients with advanced-stage cancer.

Questionnaire Analysis

The questionnaire was developed by Mystakidou et al. in 2005. It contains 31 questions, which are divided into seven categories based on the thematic content. The study was conducted on patients with advanced-stage cancer.

Scoring and Statistical Analysis

Patients respond to the questions by circling the appropriate number. Each item is scored from 0 to 3, with 0 indicating disagreement and 3 indicating agreement. The total score ranges from 0 to 100, with higher scores indicating a higher level of preparatory grief.

Validity of the Questionnaire

Seven categories were formed using exploratory factor analysis, which explained 65.8% of the total variance.
The self-awareness factor accounted for 27.9% of the variance.
The adaptation to illness factor explained 11.7%.
The grief factor accounted for 7.7%.
The anger factor explained 5.6%.
The spiritual well-being factor accounted for 4.4%.
The physical symptoms factor and the perceived social support factor accounted for 4.3% and 4.1%, respectively.

Regarding the validity of the 31 selected questions

Cronbach’s alpha ranged between 0.82 and 0.86, with an overall score of 0.84.
Convergent and discriminant validity showed that items within each category were strongly correlated (correlation coefficients between 0.52 and 0.73), and there was clear distinction between categories, with each item correlating more strongly with its own category.
Inter-category correlations ranged from 0.22 (self-awareness and adaptation to illness) to 0.35 (self-awareness and physical symptoms).
Concurrent validity—assessed via the correlation of the seven factors with depression and anxiety scores—showed strong associations across all factors, except for the spiritual well-being factor.

Reliability of the Questionnaire

The reliability of the questionnaire was confirmed, with Cronbach’s alpha > 0.7 across all categories. Test-retest reliability was confirmed through repeated measurement after 3 days in a sample of 100 patients, showing consistent responses over time and statistically significant results.

Reference

Mystakidou, K., Tsilika, E., Parpa, E., Katsouda, E., Sakkas, P., & Soldatos, C. (2005). Life before death: identifying preparatory grief through the development of a new measurement in advanced cancer patients (PGAC). Supportive Care in Cancer, 13(10), 834–841.