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Background: Symptoms of complicated grief are associated with a traumatic death. However, the subjective experience of whether or not the death was considered traumatic has not been substantially explored. This study first examined the difference between objective and subjective traumatic death, and then investigated their respective impacts on complicated grief and depressive symptoms following bereavement among older adults in Hong Kong.Methods: Participants were 187 Hong Kong adults aged 65 years or above who had lost a family member within the past five years. Demographic information, the Inventory of Complicated Grief (ICG), the Geriatric Depression Scale (GDS), and the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS) were utilized.Results: The subjective traumatic level of the death did not differ between the objective traumatic and non-traumatic death as defined by nature of death (t = -1.554, p = 0.122). Higher subjective traumatic levels and younger age of the deceased, were positively related to complicated grief symptoms, F (10, 161) = 14.222, p < 0.001, R 2 = 0.469. Higher subjective traumatic levels and older age of the bereaved were positively associated with symptoms of depression, F (10, 160) = 2.855, p = 0.003, R 2 = 0.151. However, objective traumatic death was found to have no relation to either complicated grief or depressive symptoms.Conclusions: Subjective and objective traumatic death may be two distinct concepts, and the subjective experience of the death as a trauma may be a more important factor that contributes to complicated grief and depressive symptoms. [ABSTRACT FROM AUTHOR]

Background: This paper reports the development and validation of the Chinese Significant Wish Fulfillment Scale (CSWFS), a new multidimensional scale for assessing the perceived importance and level of fulfillment of wishes of older adults.Methods: Three studies were involved. Study 1 developed a 26-item pool on wish fulfillment through in-depth interviews with 22 older adults. Study 2 reduced the pool to 23 items through validation with a new sample of 315 older adults and examined the internal reliability. Study 3 involved a confirmatory factor analysis (CFA) and examined the test-retest reliability and the convergent validity of the scale with the construct of regret.Results: A five-factor structure model of 23 items was identified through exploratory factor analysis, which accounted for 51.67% of variance. As informed by the CFA in Study 3, a five-factor 22-item model was the best fit. Internal reliability and test-retest reliability was found to be good. Convergent validity was examined through correlation with the construct of future regret. The correlation, though statistically significant, was small.Conclusion: CSWFS demonstrates good psychometric properties, but the construct might be slightly different from that of future regrets. Probably, CSWFS addresses a construct that is under-explored but is of importance to older adults and especially to the Chinese community. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to develop an assessment tool measuring comprehensive interdisciplinary competence in end-of-life care (EoLC) and investigate its content, construct validity, reliability, and their correlates., Method: Items of the Comprehensive End-of-Life Care Competence Scale (CECCS) were developed according to a comprehensive core competence framework in EoLC and refined by a multi-disciplinary panel of experts. The psychometric properties were further tested through region-wide surveys of self-administered questionnaires completed by health and social care professionals in Hong Kong., Results: Participants comprised social workers, nurses, physicians, and allied health care professionals (445 participants in 2016, 410 in 2017, and 523 in 2018). Factor analysis validated the construct of the questionnaire which encompassed 26 items describing EoLC core competences in seven domains with satisfactory internal reliability (confirmatory factor analysis: χ2/df = 3.12, GFI = 0.85, TLI = 0.93, CFI = 0.94, RMSEA = 0.07; Cronbach's alphas ranged from 0.89 to 0.97): overarching value & knowledge, communication skills, symptom management, psychosocial and community care, end-of-life decision-making, bereavement care, and self-care. Higher perceived levels in these competences were correlated with a higher level of job meaningfulness and satisfaction (r ranged from 0.17 to 0.39, p < 0.01) and correlated with lower perceived stress (r ranged from -0.11 to -0.28, p < 0.05). Regression analysis found that age and work involvement in EoLC were positively associated with the perceived competences in all domains; professionals working in hospices reported higher levels of competence than workers in other settings; social workers showed lower perceived competences in symptom management, but higher levels in bereavement care than other health care professionals., Significance of Results: The validity and internal reliability of CECCS were demonstrated. The levels of perceived competences working in EoLC were significantly associated with professionals' job-related well-being. Practically, there is still room for improvement in comprehensive competences among health and social care workers in Hong Kong.