Anticipatory Grief among Chinese Family Caregivers of Patients with Advanced Cancer: A Cross-Sectional Study

Abstract

Objective: The objective of this study was to explore the interrelationship between anticipatory grief (AG), caregiver burden, communication, preparation for death, and coping style. Methods: A convenience sample of 256 Chinese family caregivers of patients with advanced cancer were recruited from an academic cancer hospital between April 2018 and May 2019. This cross-sectional survey included the AG Scale, caregiver burden (Caregiver Reaction Assessment), communication (Caregivers' Communication with Patients about Illness and Death Scale), preparation for death, and coping style (Simplified Coping Style Questionnaire). Structural equation modeling tested the interrelation between them. Results: The final model fitted the data acceptably (χ 2 = 25.79, degrees of freedom = 17, P = 0.08, root mean square error of approximation = 0.05, goodness-of-fit index [GFI] = 0.98, adjusted GFI [AGFI] = 0.95, parsimony GFI [PGFI] = 0.46, normed fit index = 0.94, comparative fit index = 0.98). Poor communication contributed to less preparation for death and caregiver burden, which further aggravate AG. Communication was positively associated with AG. In addition, communication and positive coping style interacted to further influence caregiver burden. Conclusions: Preliminary results supported the model and showed that poor communication, less preparation for death, and caregiver burden contributed to AG while positive coping alleviated AG. Findings suggest the need for further studies to explore effective intervention for communication, preparation for death, burden, and coping style of caregivers to ultimately alleviate AG.

Relationship Between Post-traumatic Stress Symptoms and Anticipatory Grief in Family Caregivers of Patients With Advanced Lung Cancer: The Mediation Role of Illness Uncertainty

“…AG not only affects the FCs 's ability to assess the patient's care needs, but also leads to a decrease in the quality of palliative care. In addition, experiencing AG may also have a negative impact on the FCs 's mental state, predisposing them to negative emotions such as anger, fear, and guilt and self-blame ( 6 ). Nevertheless, there is still limited evidence of study on FCs with advanced cancer experiencing AG.…”

“…A study by Nielsen showed that approximately one-third of FCs experienced AG, with up to 15% of those with severe symptoms ( 5 ). While AG is considered a natural progression when caring for a terminally ill relatives, its impacts are nonetheless debilitating for FCs who must learn to cope in the process ( 6 ).…”

Factors associated with parental burden among parents of children with food allergies in China: a cross-sectional study

“…The Chinese national norm for the active coping score is 1.78±0.52 and for the passive coping score, it is 1.59±0.66 39. The SCSQ has been widely used to assess caregivers’ coping styles in China, and the Cronbach’s alpha coefficiency of the two subscales ranged from 0.75 to 0.90 41–45. The cumulative contribution rate of the two common factors was 48.5% 46.…”

“…39 The SCSQ has been widely used to assess caregivers' coping styles in China, and the Cronbach's alpha coefficiency of the two subscales ranged from 0.75 to 0.90. [41][42][43][44][45] The cumulative contribution rate of the two common factors was 48.5%. 46 In the present study, the Cronbach's alphas of the active and passive coping styles were 0.909 and 0.752, respectively.…”

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“…A convenience sample was recruited from a public cancer hospital in Shenyang, China, between January and October 2021. Inclusion criteria were as follows: (1) FCs of patients with a clinicopathological histological or cytological diagnosis of lung cancer and TNM stage III or IV; (2) Age ≥ 18 years; (3) awareness of the patient's disease condition; (4) undertaking the primary care of the patient's daily life and being identified by the patient as their primary caregiver; (5) good reading and communication skills in Chinese; (6) and volunteer for this study. We excluded those who were unable to complete the questionnaire due to psychological or cognitive impairment and those who had <1 month of care.…”