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癌症丧亲父母的遗憾和未竟之事:一项混合方法研究。

Regret and unfinished business in parents bereaved by cancer: A mixed methods study.

机构信息

Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Weill Cornell Medicine, New York, NY, USA.

出版信息

Palliat Med. 2020 Mar;34(3):367-377. doi: 10.1177/0269216319900301. Epub 2020 Feb 5.

Abstract

BACKGROUND

Prior research has demonstrated that the presence of regret and unfinished business is associated with poorer adjustment in bereavement. Though there is a growing literature on these constructs among caregivers of adult patients, the literature on regret and unfinished business in bereaved parents has been limited.

AIM

The aim of this study was to examine regret and unfinished business in parents bereaved by cancer, as well as their associations with caregiving experiences and prolonged grief.

DESIGN

This was a cross-sectional mixed methods study that utilized self-report questionnaires with open-ended items.

SETTING/PARTICIPANTS: The multisite study took place at a tertiary cancer hospital and pediatric cancer clinical research institution. Participants were 118 parents (mothers = 82, fathers = 36) who lost a child aged 6 months to 25 years to cancer between 6 months and 6 years prior.

RESULTS

Results showed that 73% of the parents endorsed regret and 33% endorsed unfinished business, both of which were more common among mothers than fathers ( ⩽ 0.05). Parents were on average moderately distressed by their regrets and unfinished business, and both regret-related and unfinished business-related distress were associated with distress while caregiving and prolonged grief symptoms.

CONCLUSION

Findings have implications for how providers work with families, including increasing treatment decision-making support, supporting parents in speaking to their child about illness, and, in bereavement, validating choices made. Grief interventions that use cognitive-behavioral and meaning-centered approaches may be particularly beneficial.

摘要

背景

先前的研究表明,后悔和未完成的事情与丧亲后的调整不良有关。尽管在成年患者的护理人员中,关于这些结构的文献越来越多,但关于丧亲父母的后悔和未完成事情的文献却有限。

目的

本研究旨在探讨丧亲父母的后悔和未完成的事情,并研究其与照顾经历和延长悲伤的关系。

设计

这是一项使用带有开放式问题的自我报告问卷的横断面混合方法研究。

地点/参与者:该多地点研究在一家三级癌症医院和儿科癌症临床研究机构进行。参与者为 118 名父母(母亲 82 名,父亲 36 名),他们的孩子在 6 个月至 25 岁之间因癌症死亡,死亡时间距离研究开始时间为 6 个月至 6 年。

结果

结果表明,73%的父母表示后悔,33%的父母表示有未完成的事情,母亲比父亲更常见(⩽0.05)。父母对自己的遗憾和未完成的事情平均感到中度困扰,与照顾和延长悲伤症状有关的遗憾相关和未完成的事情相关困扰。

结论

这些发现对提供者与家庭合作的方式具有启示意义,包括增加治疗决策支持、支持父母与孩子谈论疾病,以及在丧亲时验证所做的选择。使用认知行为和意义中心方法的悲伤干预可能特别有益。

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本文引用的文献

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"If only…": Counterfactual  thinking in bereavement.“要是……就好了”:丧亲之痛中的反事实思维。
Death Stud. 2021;45(9):692-701. doi: 10.1080/07481187.2019.1679959. Epub 2019 Oct 25.
6
Let's talk with children about life-threatening diseases.让我们和孩子们谈谈危及生命的疾病。
Lancet. 2019 Mar 16;393(10176):1072. doi: 10.1016/S0140-6736(19)30572-0. Epub 2019 Mar 14.
8
"What if?": Addressing uncertainty with families.“如果……会怎样?”:与家庭共同应对不确定性。
Pediatr Blood Cancer. 2019 Jun;66(6):e27699. doi: 10.1002/pbc.27699. Epub 2019 Mar 8.

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