Kim So Myeong, Kown So Hi
College of Nursing, Taegu Science University, Daegu, Korea.
College of Nursing · The Research Institute of Nursing Science, Kyungpook National University, Daegu, Korea.
J Korean Acad Nurs. 2018 Feb;48(1):59-69. doi: 10.4040/jkan.2018.48.1.59.
The purpose of this study was to investigate variables and construct paths that affect complicated grief.
Participants in this cross-sectional, descriptive study were 164 bereaved spouses of cancer patients at least 12 months before the death. Data were collected from October 2016 to February 2017 using self-report structured questionnaires and were analyzed using IBM SPSS 21.0 and AMOS 20.0.
The variables affecting complicated grief of bereaved spouses of cancer patients were the quality of end-of-life care (γ=.15, p<.001), preparedness for death (β=-.06, p=.005), and coping with bereavement (β=-.24, p<.001), whereas the quality of death and dying did not show any effects. Preparedness for death had multiple mediating effects in the relationship between the quality of end-of-life care and complicated grief (z=-2.20, p=.028), and in the relationship between the quality of end-of-life care and coping with bereavement (z=2.11, p=.035). Coping with bereavement had a mediating effect on the relationship between preparedness for death and complicated grief (z=-2.39, p=.017).
This study revealed that preparedness for death and coping with bereavement play a prominent role in complicated grief. Therefore, it is important to help in preparing for death and enhancing coping with bereavement of spouses providing end-of-life care to cancer patients. In addition, investigating cultural differences in the relationship between the quality of end-of-life care and complicated grief is recommended.
本研究旨在调查影响复杂性哀伤的变量并构建相关路径。
这项横断面描述性研究的参与者为164名癌症患者死亡至少12个月前的丧偶配偶。2016年10月至2017年2月期间,通过自填式结构化问卷收集数据,并使用IBM SPSS 21.0和AMOS 20.0进行分析。
影响癌症患者丧偶配偶复杂性哀伤的变量包括临终关怀质量(γ = 0.15,p < 0.001)、死亡准备情况(β = -0.06,p = 0.005)和丧亲应对方式(β = -0.24,p < 0.001),而死亡质量和濒死情况未显示出任何影响。死亡准备情况在临终关怀质量与复杂性哀伤之间的关系中具有多重中介作用(z = -2.20,p = 0.028),以及在临终关怀质量与丧亲应对方式之间的关系中也具有多重中介作用(z = 2.11,p = 0.035)。丧亲应对方式在死亡准备情况与复杂性哀伤之间的关系中具有中介作用(z = -2.39,p = 0.017)。
本研究表明,死亡准备情况和丧亲应对方式在复杂性哀伤中起着重要作用。因此,帮助为死亡做准备并增强为癌症患者提供临终关怀的配偶的丧亲应对能力非常重要。此外,建议研究临终关怀质量与复杂性哀伤之间关系的文化差异。