A Study On The Current Status And Influencing Factors Of Anticipatory Grief Among Primary Family Caregivers Of Gynecologic Cancer Patients

ObjectiveTo explore the current situation of anticipatory grief among the main caregivers of gynecological cancer patients in their families,and based on a comprehensive risk factor framework for predicting bereavement outcomes,this study delves into the influencing factors from multiple perspectives of stressors,personal factors,interpersonal factors,evaluation,and coping,in order to provide reference for medical and nursing authors to develop targeted intervention strategies to alleviate the anticipatory grief of caregivers and improve the health outcomes of patients and caregivers.MethodsUsing convenience sampling method,this study selected the primary family caregivers of gynecological cancer patients who were hospitalized in the gynecological wards of three tertiary first-class hospitals in Jinan from December 2021 to June 2022 as the survey subjects.A cross-sectional survey was conducted using the General Information Questionnaire,Anticipated Grief Scale(AGS),Caregiver Response Assessment Scale(CRA),Intimate Relationship Experience Scale(ECR),Social Support Rating Scale(SSRS),Simple Disease Perception Questionnaire(BIPQ),and Simple Coping Style Scale(SCSQ).Using Epidata 3.1 for data entry and SPSS 26.0 for data analysis.The main statistical methods include descriptive analysis,feature comparison,correlation analysis,and regression analysis.Results1.Anticipatory grief of primary family caregivers of gynecologic cancer patients and their scores on each dimensionIn this study,300 primary family caregivers of gynecological cancer patients were investigated.The results showed that the total average score of anticipatory grief was(84.87 ±18.11),which was generally at a high level.Among the items in the Caregiver’s Anticipated Grief Scale,the item of feeling lost scored the highest(4.23±0.63)and the item of being irritable scored the lowest(2.51±0.81).2.One-way ANOVA for anticipatory grief among primary family caregivers of gynecologic cancer patientsThe results showed that the anticipatory grief scores of the primary family caregivers of gynecological cancer patients were determined by their disease stage(F=4.816,P=0.003),cancer metastasis(t=2.241,P=0.026),cancer recurrence(t=2.615,P=0.010),age(F=5.201,P=0.006),gender(t=2.272,P=0.024),type of relationship with the patient(F=3.733,P=0.025),number of children(F=4.807,P=0.009).There was a statistically significant difference between the current residence(F=3.722,P=0.025)and the per capita monthly income of the family(F=2.972,P=0.020).3.Pearson correlation analysis of anticipatory grief in primary family caregivers of gynecologic cancer patientsThe results showed that anticipatory grief of primary family caregivers of gynecologic cancer patients were associated with caregiving stress(r=0.530,P<0.01),attachment avoidance(r=0.216,P<0.01),attachment anxiety(r=0.472,P<0.01),disease perception(r=0.246,P<0.01),and negative coping(r=0.407,P<0.01).It was negatively correlated with the total caregiver social support score(r=-0.218,P<0.01),objective support(r=-0.335,P<0.01),and utilization of support(r=-0.236,P<0.01).4.Multiple linear regression analysis of anticipatory grief among primary family caregivers of gynecologic cancer patientsThe results showed that the positive influencing factors of anticipatory grief in the primary caregivers of gynecological cancer patients were caregiver pressure(β=0.197,P=0.002),attachment anxiety(β=0.289,P<0.001),negative coping(β=0.229,P<0.001),and illness perception(β=0.138,P=0.015)of caregivers,the four variables collectively explain 39.8%of the total variance in anticipatory grief(adjusted R2=0.398).Conclusions1.In this study,there was a high level of anticipatory grief among primary family caregivers of gynecologic cancer patients,indicating that clinical healthcare workers should focus on the assessment and intervention of caregiver anticipatory grief.2.Anticipatory grief in primary caregivers of gynecologic cancer patients was not only related to the stage of the patient’s disease,whether the cancer metastasized and recurred,but also to various factors such as the caregiver’s age,gender,type of relationship with the patient,number of children,current residence and per capita monthly household income,caregiving stress,attachment anxiety,attachment avoidance,social support,negative coping,and illness perception.3.Caregiving stress of primary caregivers in families of gynecologic cancer patients positively affects the level of anticipatory grief,suggesting that clinical health care workers should pay attention to the physical and mental health of caregivers and help caregivers make reasonable caregiving plans to reduce the level of anticipatory grief of caregivers.4.Attachment anxiety of primary caregivers in families of gynecologic cancer patients positively influences the level of anticipatory grief,suggesting that clinical health care workers should actively engage in mental health education and use supportive therapeutic modalities such as narrative storytelling,externalizing problems,and reframing stories to reduce caregivers’ attachment anxiety and,in turn,their level of anticipatory grief.5.The perceived illness of primary family caregivers of gynecologic cancer patients positively influenced the level of anticipatory grief,suggesting that clinical health care workers should guide caregivers to view the illness correctly and enhance their ability to manage the patient’s illness,thereby improving the level of anticipatory grief of caregivers.6.Negative coping of primary caregivers in families of gynecologic cancer patients positively affects the level of anticipatory grief,suggesting that clinical health care workers should adopt intervention strategies to help caregivers shift their poor coping style in order to reduce the level of anticipatory grief in caregivers.