A1352
Title: Dynamic mediation and latent change modeling of the dual process model of grief in Parkinson's caregiving
Authors: James Haws - University of Colorado Anschutz (United States) [presenting]
Kathryn Colborn - University of Colorado Anschutz (United States)
Lane Drew - University of Colorado Anschutz (United States)
Elizabeth Juarez-Colunga - University of Colorado Anschutz Medical Campus (United States)
Yizhou Fei - University of Colorado Anschutz (United States)
Abstract: Caregivers of individuals with Parkinson's disease experience chronic stress, anticipatory grief, and ambiguous loss. The dual process model of grief posits coping through oscillation between loss-oriented (grief processing, yearning, emotional engagement) and restoration-oriented (role adjustment, future planning, identity reconstruction) processes, yet empirical tests of oscillation dynamics remain limited. An evaluation of the mechanistic pathways of caregiver and patient outcomes using mediation and latent change score is conducted, using data from a stepped-wedge cluster randomized trial of an outpatient palliative care intervention (N = 359 patients; N = 300 caregivers). Assessments occurred at baseline, 3-, 6-, and 12-month follow-ups. Outcomes include patient quality of life and caregiver burden and grief, with mediators including burden, mood, and spiritual wellbeing. Oscillation consistent with the DPM will be evaluated through coupled change processes between loss- and restoration-oriented indicators. The novel approach integrates longitudinal modeling with psychological theory to test dynamic mediation and regulatory processes underlying grief adaptation. Results may inform mechanism-focused palliative care interventions targeting both patient symptom management and caregiver grief adaptation.
