title: Caregivers of patients with disorders of consciousness: coping and prolonged grief.
abstract: OBJECTIVE
  To study the relationship between coping strategies and prolonged grief disorder (PGD) in caregivers of patients with disorders of consciousness: vegetative state (VS) or minimally conscious state (MCS).
  
  
  METHODS
  Fifty-three caregivers of 43 patients with VS or MCS were assessed using PG-12 and Brief COPE-28. Mean differences for each coping strategy between caregivers of patients with/without PGD were compared using Bonferroni-adjusted t-tests, and the size effect was calculated (Cohen's d).
  
  
  RESULTS
  The frequency of PGD was very high (n = 32; 60.40%). The most common coping strategies were problem-focused: active coping (mean = 6.41; SD = 1.02), Instrumental support (mean = 6.41; SD = 1.06), Planning (mean = 6.32; SD = 1.01) and Acceptance (mean = 6.20; SD = 1.29). Acceptance predicted a lower presence of PGD (P = 0.001; Cohen's d = 1.02), while Denial (P = 0.003; Cohen's d = 0.98) and Self-blame (P = 0.004, Cohen's d = 0.91) increased the presence of PGD.
  
  
  CONCLUSIONS
  The caregivers of patients with VS or MCS show a high risk of PGD. Problem-focused coping strategies are the most used. Acceptance is highly protective of PGD, and Denial and Self-blame are associated with an increased presence of PGD. PGD in caregivers of patients in VS or MCS should be evaluated, Acceptance and problem-focused strategies should be promoted, and Denial and Self-blame should be diminished.
authors: Fundación Instituto San José, Orden Hospitalaria de San Juan de Dios, Madrid, Spain.
authors: M J
authors: MJ
authors: Elvira de la Morena
authors: J A
authors: JA
authors: Cruzado
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D003866:Depressive Disorder / Q000209:etiology; D005260:Female; D006117:Grief; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D018458:Persistent Vegetative State / Q000523:psychology* / Q000628:therapy*; D012307:Risk Factors; D012647:Self-Assessment; D013315:Stress, Psychological / Q000209:etiology; D011795:Surveys and Questionnaires; D055815:Young Adult