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评估癌症护理中的悲伤情绪:使用心理测量工具的观察性研究的系统评价

Assessing Grief in Cancer Care: A Systematic Review of Observational Studies Using Psychometric Instruments.

作者信息

Mattson Rebecca, Henderson Margaret, Carlson Savitri Singh

机构信息

School of Nursing, San Diego State University, San Diego, CA 92182, USA.

San Diego State University Library, San Diego State University, San Diego, CA 92182, USA.

出版信息

Healthcare (Basel). 2025 Jul 17;13(14):1722. doi: 10.3390/healthcare13141722.

Abstract

: Grief in cancer patients represents a multidimensional psychological response encompassing anticipatory, existential, and identity-related distress. While the recent literature has examined grief in caregivers, family members, and even healthcare professionals, the psychological grief experienced by patients themselves following a cancer diagnosis remains comparatively understudied and insufficiently characterized in empirical research. This systematic review aims to evaluate observational studies that used validated psychometric instruments to measure grief in adult cancer patients and to synthesize findings on the significance of grief in this population. : Following PRISMA 2020 guidelines, a systematic search of PubMed, CINAHL, and PsycINFO was conducted to identify observational studies that employed validated tools to assess grief among adult cancer patients. The inclusion criteria required the use of psychometrically validated grief instruments and the collection of quantitative data. Fifteen studies met eligibility criteria and were included in the final analysis. : Grief symptoms were consistently present at moderate to high levels across diverse cancer types, care settings, and geographic regions. Preparatory Grief in Advanced Cancer (PGAC) scores often exceeded thresholds associated with clinical concern, with correlations observed between grief and psychological variables such as anxiety (r = 0.63), depression (r = 0.637), hopelessness (r = 0.63), and dignity (r = 0.654). Demographic factors (e.g., younger age, female gender) and illness perceptions (e.g., identity centrality, stigma) further intensified grief. Grief was a predominant psychological concern even when general distress measures failed to capture its presence. : Future research is essential to identify an effective public health strategy for addressing grief through structured screening conducted in primary care and outpatient medical settings, coupled with accessible referral pathways to community-based support groups and coordinated follow-up services to facilitate grief management.

摘要

癌症患者的悲伤代表了一种多维度的心理反应,包括预期性、存在性和与身份认同相关的痛苦。虽然最近的文献研究了照顾者、家庭成员甚至医护人员的悲伤,但癌症诊断后患者自身所经历的心理悲伤在实证研究中仍相对较少受到关注,且特征描述不足。本系统评价旨在评估使用经过验证的心理测量工具来测量成年癌症患者悲伤的观察性研究,并综合关于悲伤在该人群中的重要性的研究结果。

按照PRISMA 2020指南,对PubMed、CINAHL和PsycINFO进行了系统检索,以识别采用经过验证的工具评估成年癌症患者悲伤的观察性研究。纳入标准要求使用经过心理测量验证的悲伤工具并收集定量数据。15项研究符合纳入标准并被纳入最终分析。

悲伤症状在不同癌症类型、护理环境和地理区域中始终处于中度到高度水平。晚期癌症预备性悲伤(PGAC)评分常常超过与临床关注相关的阈值,悲伤与焦虑(r = 0.63)、抑郁(r = 0.637)、绝望(r = 0.63)和尊严(r = 0.654)等心理变量之间存在相关性。人口统计学因素(如年龄较小、女性)和疾病认知(如身份核心性、耻辱感)进一步加剧了悲伤。即使一般痛苦测量未能捕捉到悲伤的存在,悲伤仍是一个主要的心理问题。

未来的研究对于确定一项有效的公共卫生策略至关重要,该策略通过在初级保健和门诊医疗环境中进行结构化筛查来解决悲伤问题,同时提供通向社区支持小组的便捷转诊途径以及协调的后续服务,以促进悲伤管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9323/12294239/5adeb09f2383/healthcare-13-01722-g001.jpg

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