Attachment insecurities, continuing bonds, and grief among family caregivers of terminally ill cancer patients: A longitudinal study

The present study investigated the associations among pre-loss grief, attachment insecurities, continuing bonds (CBs) with the deceased person, and the post-loss adjustment of the caregivers of patients with terminal cancer. Data were collected in the hospice department of a cancer center in northern Taiwan; 66 bereaved caregivers completed both pre-loss and post-loss scales. The measures used for the pre-loss phase included the Hogan Grief Reaction Checklist (HGRC; pre-loss version), the Experiences in Close Relationship — Relationship Structures Questionnaire (ECR-RS), and the Inclusion of Other in the Self Scale (IOS). The measures used 6-12 months after the death of the patients were the HGRC (post-loss version) and the Continuing Bond Scale (CBS). Results showed that pre-loss grief, attachment avoidance, and externalized CBs explained 46% of the variance in post-loss grief, indicating that pre-loss grief and ongoing transformation of relationships after patients’ death may be strong predictors of caregivers’ post-loss grieving.