TY - JOUR

T1 - Understanding Nepali widows' experiences for the adaptation of an instrument to assess Prolonged Grief Disorder

AU - Kim, Yoona

AU - Rimal, Damodar

AU - Angela, K. C.

AU - Shrestha, Sumeera

AU - Luitel, Nagendra P.

AU - Prigerson, Holly G.

AU - Tol, Wietse A.

AU - Surkan, Pamela J.

PY - 2023

Y1 - 2023

N2 - The experience of grief varies across different cultures and contexts. Women in Nepal who lose their husbands confront discrimination, social isolation, and abuse that influence their experience of grief. Through eight focus group discussions with Nepali widows, we elicited socially sanctioned grief reactions and local idioms used to describe common cognitive, behavioral, and emotional symptoms of grief. Accordingly, modifications to an existing instrument for Prolonged Grief Disorder, the PG-13, are suggested to capture grief symptoms as experienced by Nepali widows. Items in the PG-13 were translated to colloquial Nepali and adapted to maintain comprehensibility, acceptability, relevance, and completeness. Based on the grief-related issues reported in the focus group discussions, the addition of five new items and a new criterion to capture symptoms related to social discrimination are proposed. Widows perceived elevated symptoms one year after the loss to be problematic. It is thus recommended that the duration criterion in the original PG-13 be adjusted from at least six months to at least one year after the loss. These proposed modifications to the instrument should be validated through future psychometric testing.

AB - The experience of grief varies across different cultures and contexts. Women in Nepal who lose their husbands confront discrimination, social isolation, and abuse that influence their experience of grief. Through eight focus group discussions with Nepali widows, we elicited socially sanctioned grief reactions and local idioms used to describe common cognitive, behavioral, and emotional symptoms of grief. Accordingly, modifications to an existing instrument for Prolonged Grief Disorder, the PG-13, are suggested to capture grief symptoms as experienced by Nepali widows. Items in the PG-13 were translated to colloquial Nepali and adapted to maintain comprehensibility, acceptability, relevance, and completeness. Based on the grief-related issues reported in the focus group discussions, the addition of five new items and a new criterion to capture symptoms related to social discrimination are proposed. Widows perceived elevated symptoms one year after the loss to be problematic. It is thus recommended that the duration criterion in the original PG-13 be adjusted from at least six months to at least one year after the loss. These proposed modifications to the instrument should be validated through future psychometric testing.

KW - grief

KW - Nepal

KW - PG-13

KW - Prolonged Grief Disorder

KW - widows

U2 - 10.1177/1363461520949005

DO - 10.1177/1363461520949005

M3 - Journal article

C2 - 33351725

VL - 60

JO - Transcultural Psychiatry

JF - Transcultural Psychiatry

SN - 1363-4615

IS - 6

ER -