STRUCTURED GRIEF SUPPORT GROUP EFFECT ON OLDER ADULTS

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DESCRIPTION: (Adapted from applicants abstract) The death of a spouse is one of the most devastating life events. Conjugal bereavement in older adults is characterized by emotional distress, physical symptoms, increased use of health services, and a higher morbidity and mortality rate in surviving spouses. Effective bereavement interventions can have significant long term implications for reducing grief intensity and improving health. However, existing research consists of few studies which evaluate the effectiveness of various interventions. This study will use quantitative and qualitative methods to compare the efficacy of two different types of bereavement intervention programs: standard hospice bereavement care which consists of mailed bereavement literature, phone contact, 1 home visit made by a hospice team member, and an invitation to a quarterly open support group; and enhanced bereavement care which consists of a closed structured support group that meets once a week for 6 weeks and is led by a trained professional. Specific aims are to: l) Compare the efficacy of an enhanced bereavement intervention program to the standard hospice bereavement care in reducing grief intensity and improving health of older bereaved spouses of hospice patients over time, and 2) Describe the demographic variables (gender, race, education, length of illness, and length of marriage) which correlate with grief intensity and health in both groups of older bereaved adults. A quasi experimental repeated measures factorial design with one preintervention and three postintervention measurements will be used. Conjugally bereaved older adults (N=162), bereaved 1-2 months, over age 60 and able to communicate in English, will be randomly assigned to the two intervention groups (Standard and Enhanced) for 6 weeks. Grief intensity will be measured using the Revised Grief Experience Inventory (RGEI) and health will be measured using the Rosencranz Health Index and a 10 point Likert Scale Cantril Ladder pre and post intervention, and at 6 months and 12 months post intervention. Primary statistical analysis will be the ANCOVA of 2x2x2x4 (group x gender x race x time) repeated measures with covariates (education, length of illness, and length of marriage) retained from multiple linear stepwise regression. Based on significant main and interaction effects, appropriate post hoc tests will be run. Results will identify the effects of a closed structured support group on reducing grief intensity and promoting the positive health of older black and white men and women over time. Gender and racial similarities and differences in grief intensity and health over time will be identified.