Yu Wenhua, Lu Qian, Lu Yuhan, Yang Hong, Zhang Lichuan, Guo Renxiu, Hou Xiaoting
Department of Thoracic Surgical Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China.
School of Nursing, Peking University, Beijing, China.
Asia Pac J Oncol Nurs. 2021 May 31;8(4):369-376. doi: 10.4103/apjon.apjon-214. eCollection 2021 Jul-Aug.
The objective of this study was to explore the interrelationship between anticipatory grief (AG), caregiver burden, communication, preparation for death, and coping style.
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.
The final model fitted the data acceptably (χ = 25.79, degrees of freedom = 17, = 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.
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.
本研究旨在探讨预期性悲伤（AG）、照顾者负担、沟通、死亡准备和应对方式之间的相互关系。
2018年4月至2019年5月期间，从一家学术性癌症医院招募了256名中国晚期癌症患者的家庭照顾者作为便利样本。这项横断面调查包括AG量表、照顾者负担（照顾者反应评估）、沟通（照顾者与患者关于疾病和死亡的沟通量表）、死亡准备和应对方式（简易应对方式问卷）。结构方程模型检验了它们之间的相互关系。
最终模型对数据的拟合度尚可（χ = 25.79，自由度 = 17， = 0.08，近似均方根误差 = 0.05，拟合优度指数[GFI] = 0.98，调整后GFI[AGFI] = 0.95，简约GFI[PGFI] = 0.46，规范拟合指数 = 0.94，比较拟合指数 = 0.98）。沟通不畅导致死亡准备不足和照顾者负担加重，进而加剧预期性悲伤。沟通与预期性悲伤呈正相关。此外，沟通和积极的应对方式相互作用，进一步影响照顾者负担。
初步结果支持该模型，表明沟通不畅、死亡准备不足和照顾者负担会导致预期性悲伤，而积极应对可减轻预期性悲伤。研究结果表明，需要进一步研究探索针对照顾者的沟通、死亡准备、负担和应对方式的有效干预措施，以最终减轻预期性悲伤。
