| Description |
Complicated grief (CG) is grief experienced over a prolonged period of time that negatively affects physical, mental, and social health. Rates of alcoholism, insomnia, psychiatric disorders, physical illness, and death are all higher in people who are experiencing CG. Estimated prevalence of CG in bereaved individuals is 7-20%. Veterans are at higher risk for CG due to the potential need to delay the grief response on the battlefield. Observing battlefield death is traumatic, which increases the risk for CG. Survivor guilt, a sense of powerlessness over the death, anger, stoicism, and self-blame can also contribute to CG among veterans. The first step in treating veterans with CG is identification. This can be done effectively in the primary health care setting with the use of the Brief Grief Questionnaire (BGQ), a validated tool designed to identify individuals with CG. Once an individual screens positive for CG, the next steps toward treatment, such as referrals to psychiatric interventions and support groups can occur. This project was a pilot study to determine the likely prevalence of CG in veterans, and the potential for rapid, effective screening. Four objectives guided the project: (a) assess current screening methods used in the Veterans Administration (VA) outpatient facilities, and select an appropriate screening tool for CG; (b) collect screening data on veterans; (c) evaluate the results of CG screening; and (d) to share findings with the healthcare providers at the study site clinic, disseminate the findings to peers through a professional poster presentation, and provide information regarding grief-related support and therapy resources within the community. To implement CG screenings, VA and University of Utah Institutional Review Board (IRB) approval was obtained. Whether or not CG screening currently occurred and how routine health screenings took place in the outpatient setting was researched. The current healthcare providers' understanding regarding CG's impact on health and any barriers to routine CG screening was assessed. Next, the validated CG screening tool, The Brief Grief Questionnaire (BGQ), was selected following discussions with content experts and a literature review. Information for a referral list with mental health providers at the VA and the content experts was researched. To implement the screening, a site was selected, and the project was discussed with the stakeholders at the site. Screenings were collected from February 7, 2017 through March 1, 2017. The sample was selected as the first 20 veterans that presented to the Community Based Outpatient Clinic for routine or acute care. Finally, the data was compiled, including the patient age, screening date, gender, relationship to the deceased, cause of death, and BGQ score. Nine out of twenty screened were positive for CG, and no one refused to participate. At the completion of the project, there was a clinic stakeholders meeting to disseminate the findings, and the poster was presented at the University of Utah Center on Aging Research Retreat Poster Session on April 27, 2017. The goal of this project was to determine the prevalence of CG in outpatient veterans. The expectation was to make recommendations for use of the BGQ to increase screening and awareness for CG in veterans, and to recommend increasing therapeutic support. CG is a health- and life-damaging condition often overlooked. Ultimately, if CG is recognized and treated, quality of life can improve for these veterans. |
