Background: "Anticipatory" grief is a multidimensional concept consisting of anger, guilt, anxiety, irritability, sadness, feelings of loss, and decreased ability to perform usual tasks.
Purpose: To develop a new instrument highlighting the existence of many variables that determine the anticipatory grief experience, as it is provided directly from advanced cancer patients.
Results: Data were derived from 200 advanced cancer patients attending a palliative care unit, who completed the new scale, along with the Hospital Anxiety and Depression (HAD) scale. The items were derived from the literature, in particular studies dealing with the measurement of grief/bereavement, as well as from clinical experience. The resulting self-completed questionnaire, named "Anticipatory Grief in Advanced Cancer Patients" (AGACP), consisted of 31 items. An exploratory factor analysis resulted a model of 7 factors, accounting for 65.83% of the total variance. High internal consistency (alpha coefficients ranged from 0.6429 to 0.7575) and testretest reliability (r=0.986, p<0.0005) were evidences of the scale's reliability. The interscale correlations showed that each scale measures distinct variables. The AGACP total score's association with HAD scales (r=0.594 to r=0.891), suggested a valid, yet distinct, assessment tool. Thus, the AGACP, a scale with demonstrated internal consistency, and validity, provides an easily administered assessment for symptoms of anticipatory grief, in advanced cancer patients. Moreover, it may be a clinically useful tool for identifying patients at risk for pathological/complicated anticipatory grief, as well as potential aspects to target for intervention.