The relationship between anticipatory grief and illness uncertainty among Chinese family caregivers of patients with advanced lung cancer: a cross-sectional study

Abstract

Background Anticipatory grief has been shown to be highly prevalent among family caregivers of patients with advanced illness. Qualitative study suggests that illness uncertainty may be one of the core characteristics of anticipatory grief, but it has not been confirmed in quantitative studies. Therefore, the purpose of this study was to explore the relationship between anticipatory grief and illness uncertainty among Chinese family caregivers of patients with advanced lung cancer and to determine the factors influencing anticipatory grief. Methods This descriptive cross-sectional study used a convenience sampling method and recruited 254 inpatient family caregivers from the thoracic medicine ward of Liaoning Cancer Hospital & Institute in Shenyang, mainland China. Anticipatory grief (Anticipatory Grief Scale (AGS), illness uncertainty (Uncertainty in Illness Scale Family Caregiver Version) and sociodemographic information (Self-compiled general information questionnaire) were measured using validated self-report measures. Results Chinese family caregivers of patients with advanced lung cancer had high levels of anticipatory grief (73.5 ± 16.1). The results of the correlation analysis showed a positive association between anticipatory grief and illness uncertainty (r = 0.580, P < 0.001). The final linear regression model with anticipatory grief as the dependent variable included four variables: illness uncertainty (β = 0.674, P < 0.001), lack of informativeness (β = − 0.168, P = 0.08), monthly income (β = 0.139, P = 0.006), and caregiving burden (β = − 0.196, P < 0.001). Conclusions Illness uncertainty is probably an important factor affecting anticipatory grief. Excessive caregiving burden is associated with high levels of anticipatory grief. Improving illness uncertainty and caregiving burden may effectively reduce anticipatory grief among Chinese family caregivers.

Effect of caregiver burden on anticipatory grief among caregivers of elderly cancer patients: Chain mediation role of family functioning and resilience

“…Caregivers of elderly cancer patients in this study showed a high level of anticipatory grief, which was higher than that reported by Li et al (2022a) . Their study was conducted on caregivers for adult Chinese patients with advanced lung cancer.…”

“…Well-family functioning provided by the family was significant to assist caregivers in reducing economic burden, maintaining social and mental health, and encouraging them to address issues actively, eventually improving their resilience (Hawkley et al, 2021), and leading to an adjustment in anticipatory grief (Coelho et al, 2018). Caregivers of elderly cancer patients in this study showed a high level of anticipatory grief, which was higher than that reported by Li et al (2022a). Their study was conducted on caregivers for adult Chinese patients with advanced lung cancer.…”

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

“…IU is defined as “the inability to determine the meaning of illness-related events and accurately anticipate or predict health outcomes” ( 14 ). The study we conducted previously confirmed that IU may be an important factor affecting AG ( 15 ). IU, also identified as one of the core characteristics in the conceptual framework of AG for FCs, may cause FCs to develop into a permanent state of hypervigilance and traumatic distress toward illness signs, mainly after crisis episodes ( 4 ).…”

“…FCs assume the primary responsibility for the care of patients with advanced cancer in China. However, due to the irreversible nature of advanced cancer patients' disease, FCs may experience varying degrees of AG when faced with the imminent death of the patient ( 15 ). 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.…”

Image_1.TIF

“…IU is defined as "the inability to determine the meaning of illness-related events and accurately anticipate or predict health outcomes" (14). The study we conducted previously confirmed that IU may be an important factor affecting AG (15). IU, also identified as one of the core characteristics in the conceptual framework of AG for FCs, may cause FCs to develop into a permanent state of hypervigilance and traumatic distress toward illness signs, mainly after crisis episodes (4).…”