Axelsson Lena, Alvariza Anette, Holm Maja, Årestedt Kristofer
Department of Nursing Science, Sophiahemmet University, Stockholm, Sweden.
Department of Health Care Sciences/Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden.
Palliat Med Rep. 2020 Sep 9;1(1):191-200. doi: 10.1089/pmr.2020.0033. eCollection 2020.
The intensity of predeath grief is associated with postdeath grief in family caregivers of patients in palliative care. Different factors during caregiving may influence this association. To examine (1) the intensity of grief in relation to preparedness for caregiving, caregiver burden, and social support, and (2) if these variables moderate associations between predeath and postdeath grief. This prospective correlational study used unpaired -test to compare grief in relation to preparedness for caregiving, caregiver burden, and social support. Hierarchical multiple linear regression analysis investigated moderation effects. Family caregivers were recruited from 10 palliative homecare facilities. The Anticipatory Grief Scale, Texas Revised Inventory of Grief, Preparedness for Caregiving Scale, Caregiver Burden Scale, and Multidimensional Scale of Perceived Social Support were used. Ethical approval for the study was granted by the Regional Ethical Review Board in Stockholm, Sweden. In total, 128 family caregivers participated. Those with high caregiver burden scored significantly higher intensity of predeath but not postdeath grief. Caregiver burden and social support moderated the association between intensity of predeath grief and postdeath grief. There was a stronger association between predeath and postdeath grief among caregivers with low caregiver burden or low social support. Preparedness for caregiving had no moderating effect. Attention should be directed to caregiver burden and social support during family caregiving, as these variables seem to be significant for the intensity of grief before and after the patient's death. Acknowledging predeath grief during caregiving and recognizing pre- and postdeath grief as parts of the same process are of importance in clinical practice and when designing supportive interventions.
在姑息治疗患者的家庭照护者中,死亡前悲伤的强度与死亡后悲伤相关。照护期间的不同因素可能会影响这种关联。为了研究(1)与照护准备、照护者负担和社会支持相关的悲伤强度,以及(2)这些变量是否调节死亡前和死亡后悲伤之间的关联。这项前瞻性相关性研究使用非配对t检验来比较与照护准备、照护者负担和社会支持相关的悲伤。分层多元线性回归分析研究了调节效应。家庭照护者从10个姑息家庭护理机构招募。使用了预期悲伤量表、德克萨斯修订悲伤量表、照护准备量表、照护者负担量表和感知社会支持多维量表。该研究获得了瑞典斯德哥尔摩地区伦理审查委员会的伦理批准。共有128名家庭照护者参与。照护者负担高的人在死亡前悲伤强度得分显著更高,但在死亡后悲伤强度得分并非如此。照护者负担和社会支持调节了死亡前悲伤强度与死亡后悲伤之间的关联。在照护者负担低或社会支持低的人群中,死亡前和死亡后悲伤之间的关联更强。照护准备没有调节作用。在家庭照护期间应关注照护者负担和社会支持,因为这些变量似乎对患者死亡前后的悲伤强度有重要影响。在临床实践和设计支持性干预措施时,承认照护期间的死亡前悲伤并将死亡前和死亡后悲伤视为同一过程的一部分非常重要。