Research On The Influencing Factors Of Anticipatory Grief In Advanced Patients With Gastric Cancer

Objective:(1)Understand the current situation and characteristics of anticipatory grief in patients with advanced gastric cancer;(2)Through the evaluation and analysis of the general information,anxiety,depression,sleep status,and nutritional indicators of patients with advanced gastric cancer,and explore the influencing factors of anticipatory grief in patients with advanced gastric cancer,which provide a basis for the formulation of clinical psychological care and medical and health policies.Method:This study used the method of cross-sectional study to conduct PGAC scale,HADS,Athens Insomnia Scale(AIS-8),and Social demography data on patients with advanced gastric cancer hospitalized in four 3A-level hospital in Lanzhou City.The survey time is from July 2020 to October 2020,and 338 questionnaires returned were valid.We used SPSS 25.0 to analyze the questionnaire data.The descriptive analysis method was used to describe the status of anticipatory grief in patients with advanced gastric cancer;The single factor analysis and multivariate analysis were used to reveal the premonition of the influencing factors of anticipatory grief in patients with advanced gastric cancer.Results:(1)The 338 valid questionnaires were collected in this study,the median total score of PGAC is 31.5(21,45),indicating that anticipatory grief is common in patients with advanced gastric cancer;There are differences in the scores of the seven dimensions of PGAC,and the top three scores of dimensions are: sadness,illness adjustment,anger;and the last three are: self-awareness,religious comfort,and perceived social support;the median score of anxiety and depression are 6 and 7,indicating that anxiety and depression are common in patients with advanced gastric cancer;While the median score of AIS-8 is 6,indicating that insomnia is common among the research subjects.(2)The results of single factor analysis showed that the influencing factors of each dimension of PGAC are:(1)Self-awareness: family income per capita,sleep status,depression,anxiety,survey time;(2)Disease adjustment: BMI,survey time,physical symptoms,sleep status,Anxiety,depression;(3)Sadness: marriage,ethnicity,survey time,physical symptoms,sleep status,anxiety,depression;(4)Anger: family income per capita,physical symptoms,BMI,sleep status,anxiety,depression;(5)Religious comfort: education level,family income per capita,time to get a diagnosis,survey time,sleep disorder,anxiety,depression;(6)Physical symptoms:family income per capita,survey time,physical symptoms,sleep status,anxiety,depression;(7)Perceived social support: family income per capita,BMI,survey time,sleep quality,anxiety,depression.P <0.05,suggesting that the difference is statistically significant.(3)The results of multiple linear regression showed that the influencing factors of each dimension of PGAC:(1)Self-awareness: insomnia,anxiety,age and main caregivers are the main influencing factors,the difference is statistically significant(P<0.05).Self-awareness scores are positively correlated with patients’ insomnia and anxiety;(2)Disease adjustment: anxiety,payment methods are the main influencing factors,the difference is statistically significant(P <0.05).Disease adjustment ability is negatively correlated with anxiety degree,and self-paying method is a protective factor that affects the patient’s disease adjustment ability;(3)Sorrow: anxiety,physical symptoms(fatigue,2 or more physical symptoms)are the main influencing factors,the difference is statistically significant(P <0.05).Sadness degree and anxiety degree are positively correlated,the degree of grief in patients with pain is higher than that of patients with other physical symptoms;(4)Anger: insomnia,anxiety,physical symptoms(2 or more)are the main influencing factors,the difference is statistically significant(P <0.05).The degree of anger is proportional to the degree of insomnia and anxiety,accompanied by 2 types at the same time.The anger is most obvious in patients with physical symptoms and above;(5)Religious comfort: insomnia,anxiety,age,marital status(unmarried),main caregiver(couple)are the main influencing factors,the difference is statistically significant(P <0.05).Religious comfort is positively correlated with the patient’s insomnia,anxiety,and age;(6)Physical symptoms: insomnia,anxiety,depression,physical symptoms(fatigue)are the main influencing factors,the difference is statistically significant(P <0.05).The severity of the physical symptoms perceived by the patient is positively correlated with the degree of insomnia,anxiety and depression,and hair loss is a protective factor for the physical symptoms perceived by the patient;(7)Perceived social support: anxiety,physical symptoms(pain),main caregivers(others except immediate family members)are the main influencing factors,the difference is statistically significant(P<0.05).The social support perceived by the patient is negatively correlated with the degree of anxiety.Conclusions:(1)The psychological reaction of anticipatory sadness is widespread in patients with advanced gastric cancer,and is closely related to psychological problems such as anxiety,depression,and sleep status.Therefore,for the patients with malignant tumors,the hospital should develop a reasonable psychological screening and diagnosis mechanism,to give active intervention to the patients in need;(2)There are many factors influencing the anticipatory grief of patients with advanced gastric cancer,and there are differences in the performance of patients with different social attributes,and personalized psychological care should be given.