Description

The Preparatory Lamentation in Terminal Patients (PLTP-31), also referred to as Προπαρασκευαστικός Θρήνος σε Ασθενείς Τελικού Σταδίου (ΠΘΑΤΣ-31), is a psychometric questionnaire designed to assess preparatory grief in patients with advanced-stage cancer.

Preparatory grief refers to the emotional, psychological, and existential responses experienced by individuals who are approaching the end of life and are confronted with significant losses related to health, autonomy, future expectations, and relationships.

The questionnaire was developed specifically for patients with advanced cancer and provides a structured assessment of the different dimensions associated with the grieving process before death.

Objective

The primary objective of the PLTP-31 is to evaluate the level and characteristics of preparatory grief experienced by patients with advanced-stage cancer.

The instrument aims to identify emotional and psychological reactions associated with terminal illness, including adaptation to disease, sadness, anger, self-awareness, physical symptoms, religious well-being, and perceived social support.

The assessment can contribute to improving psychosocial care, supporting communication between patients, families, and healthcare professionals, and guiding interventions focused on quality of life during advanced illness.

Structure and Content

The PLTP-31 was developed by Mystakidou and colleagues in 2005 and consists of 31 items.

The items are organized into seven thematic categories based on the content they assess.

The identified dimensions include:

Self-awareness, reflecting the individual’s understanding and acceptance of the illness and its consequences.

Adjustment to illness, assessing adaptation processes and psychological responses to the disease condition.

Sadness, evaluating emotional distress and feelings associated with impending loss.

Anger, assessing feelings of frustration, injustice, or emotional reaction toward the illness.

Religious well-being, examining spiritual beliefs and religious coping mechanisms.

Physical symptoms, evaluating the influence of physical burden and symptoms on emotional experience.

Perceived social support, assessing the individual’s perception of available interpersonal support.

Scoring

Patients respond to the questionnaire by selecting the number that best represents their experience.

Each item is scored on a scale ranging from 0 to 3, where:

0 = Disagreement
3 = Agreement

The total score ranges from 0 to 100, with higher scores indicating higher levels of preparatory grief.

Data Analysis and Use

The PLTP-31 provides quantitative information regarding the intensity and dimensions of preparatory grief among terminal cancer patients.

The results can be analyzed through subscale scores to identify specific psychological or existential areas requiring support.

The questionnaire may be used in clinical research, palliative care settings, psycho-oncology, and studies examining emotional adaptation to advanced illness.

Statistical Analysis

The psychometric evaluation of the PLTP-31 included exploratory factor analysis, which resulted in seven factors explaining 65.8% of the total variance.

The factor of self-awareness explained 27.9% of the total variance, adjustment to illness explained 11.7%, and sadness explained 7.7%.

The anger factor explained 5.6%, religious well-being explained 4.4%, while physical symptoms and perceived social support explained 4.3% and 4.1%, respectively.

Validity

The validity of the PLTP-31 was evaluated through several procedures.

The internal structure of the questionnaire was supported through exploratory factor analysis, confirming the presence of seven distinct dimensions.

For the 31 selected items, Cronbach’s alpha values ranged between 0.82 and 0.86, with an overall coefficient of 0.84, indicating strong internal consistency.

Convergent and discriminant validity analyses showed that items within each category were significantly associated with their corresponding factor, with correlation coefficients ranging from 0.52 to 0.73.

Concurrent validity was examined through correlations between the seven factors and depression and anxiety indicators, demonstrating high associations for all factors except religious well-being.

Reliability

The reliability of the PLTP-31 was confirmed across all assessed dimensions, with Cronbach’s alpha values greater than 0.70 for all categories.

The stability of responses was also evaluated through repeated measurements after three days in a sample of 100 patients. The results demonstrated consistency between the two measurement periods and statistically significant stability.

References

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.