Current status and influencing factors of anticipatory grief among family caregivers of first stroke patients / 中国实用护理杂志

Objective:To investigate the current situation of expected sadness of family caregivers of first stroke patients and analyze its influencing factors, so as to provide reference for the formulation of psychological decompression intervention program for family caregivers of stroke patients.Methods:Convenience sampling method was used to conduct cross-sectional survey of 212 family caregivers of first stroke patients who were hospitalized in the First Affiliated Hospital of Shandong First Medical University from March 2020 to May 2021, using general information questionnaires and Anticipatory Grief Scale and Connor-Davidson Resilience Scale to investigate and anlalyzed its influencing factors.Results:The scare of anticipatory grief of the caregivers of first stroke patients was 87.93 ± 17.36. The results of multiple stepwise regression analysis showed that the age of family caregivers, psychological elasticity, the degree of relationship with patients, patients′ cognitive ability and self-care ability were the influencing factors of anticipatory grief of family caregivers of first stroke patients ( t values were -6.73 -11.77, P <0.05). Conclusions:The caregivers of first stroke patients have serious anticipatory grief. Staff should pay attention to the psychological conditions of the family caregivers and take effective measures to promote their physical and mental health.

O luto antecipatório e as estratégias de enfrentamento de familiares nos cuidados paliativos / Anticipatory grief and family's coping strategies in palliative care / Duelo anticipatorio y estrategias de enfrentamiento familiar en cuidados paliativos

O luto antecipatório coloca os familiares diante da necessidade de articular estratégias de enfrentamento em resposta às demandas nos Cuidados Paliativos. Este estudo, de abordagem qualitativa, teve como objetivo caracterizar as estratégias de enfrentamento de familiares no contexto dos Cuidados Paliativos e do luto antecipatório. Foram conduzidas entrevistas semiestruturadas com 14 familiares de pacientes em Cuidados Paliativos. Os dados foram analisados com base na Grounded Theory, com auxílio do software ATLAS.ti 7.5. Os resultados revelaram que as estratégias de enfrentamento foram atravessadas pelo processo marcado pelos significados atribuídos à morte, pelas conversações sobre esta, pelas implicações do processo de fim de vida, e pelo planejamento da morte. Observaram-se estratégias destinadas à resolução de problemas para contornar as emoções, com base nas relações interpessoais e na religiosidade/espiritualidade. Destaca-se a importância de reconhecer essas estratégias e sua expressão como indicadores do luto antecipatório, a fim de melhor subsidiar as intervenções no contexto dos cuidados paliativos

The anticipatory grief puts the relatives in front of the necessity to articulate coping strategies, in the face of the demands in the Palliative Care. This qualitative study aimed characterize the family members' strategies for coping in the context of Palliative Care and anticipatory grief. There were realized interviews with 14 relatives of patients in Palliative Care. The data were analyzed based on Grounded Theory, with assistance of ATLAS.ti 7.5. The results indicated that the strategies for coping were crossed by the process marked by the meanings assigned to death, by the conversations about this, by the implications of the end-of-life process. Strategies for solving problems were observed, to overcome emotions, based on interpersonal relationships and religiosity/spirituality. Stands out the importance of the recognition such strategies and their expression, as indicators of nticipatory grief, in order to subsidize the interventions in the palliative care context

Las demandas de los Cuidados Paliativos y el duelo anticipado ponen a los familiares ante la necesidad de articular estrategias de afrontamiento. Este estudio cualitativo tuvo como objetivo caracterizar las estrategias de afrontamiento de los miembros de la familia en el contexto de los cuidados paliativos y del duelo anticipatorio. Se realizaron 14 entrevistas a familiares de pacientes cuidadores. Los datos se analizaron en base a Grounded Theory, con la ayuda del software ATLAS.ti 7.5. Las estrategias de afrontamiento fueron atravesadas por los significados atribuidos a la muerte, por las conversaciones sobre ella, por as implicaciones del proceso del fin de la vida. Para superar las emociones se observó estrategias para la resolución de problemas, basadas en las relaciones interpersonales y la religiosidad/espiritualidad. Se destaca la importancia de reconocer tales estrategias y su expresión como indicadores de duelo anticipatorio, para mejor subsidiar intervenciones en los cuidados paliativos

Analysis of anticipatory grief and its influencing factors among the main caregivers of maintenance hemodialysis patients / 中国实用护理杂志

Objective:To investigate the status of anticipatory grief among the main caregivers of maintenance hemodialysis patients, and to analyze its influencing factors.Methods:From April 2021 to July 2021, the main caregivers of 180 patients undergoing maintenance hemodialysis in Xiangdong Hospital Affiliated to Hunan Normal University and Liling Traditional Chinese Medicine Hospital in Hunan Province, were selected by convenience sampling method for the research object. The survey was carried out using the General Information Questionnaire, the Anticipatory Grief Scale and the Zarit Caregiver Burden Interview, multiple linear regression was used to analyze the influencing factors of anticipatory grief in the main caregivers of maintenance hemodialysis patients.Results:The total score of Anticipatory Grief Scale in the main caregivers of maintenance hemodialysis patients was 84.43±12.02, and the total score of Zarit Caregiver Burden Interview was 24.92 ± 7.98, which were positively correlated ( r = 0.557, P<0.01).In the multiple linear regression analysis, the caregiver ′s education level, age, gender, care burden and per capita monthly income and the patient ′s age were the influencing factors of anticipatory grief for the main caregivers of maintenance hemodialysis patients ( t values were -5.54-8.75, all P<0.05), which could explain 54.1% of the total variance. Conclusions:The anticipatory grief of the main caregivers of maintenance hemodialysis patients is at a relatively serious level. Medical care should pay more attention to the caregivers and their sadness in their communication, so as to detect problems in time, so as to take targeted measures to the current situation, which is effective to improve their level of grief and improve the quality of care.

Current status and influencing factors of anticipatory grief among caregivers of major relatives of hospitalized patients with hematological malignancies / 中国实用护理杂志

Objective:To investigate the current status of anticipatory grief among caregivers of major relatives of hospitalized patients with hematological malignancies and analyze its influencing factors.Methods:Convenience sampling method was used to select 208 primary relatives and caregivers of patients with hematological malignancies who were hospitalized in the Department of Hematology, Nanjing Drum Tower Hospital from March to November 2020. Self-designed general information questionnaire, Chinese version of Anticipatory Grief Scale, caregiver burden scale and simple coping style questionnaire were used. The current status and influencing factors of anticipatory grief among caregivers of major relatives of hospitalized patients with hematological diseases were also analyzed.Results:The expected sadness score of caregivers of major relatives of hospitalized patients with hematological malignancies was 79(72, 91). The results of multiple linear regression analysis showed that the main influencing factors of anticipatory grief among caregivers of major relatives of hospitalized patients with hematological malignancies were the stage of treatment, the severity of subjective symptoms, whether to seek medical treatment in other places, the working status of caregivers of major relatives was unemployed, relationships with patients were parents, caregiver burden, and negative coping styles, which explained 83.1% of the total variation.Conclusions:Anticipatory grief is more serious among the caregivers of major relatives of hospitalized patients with hematological malignancies. It is recommended that nurses in the Hematology Department detect and assess the level of anticipatory grief of caregivers in a timely manner, and give corresponding interventions according to individual differences, so as to improve the physical and mental health of the caregivers, and then improve the quality of care and promote the recovery of patients.

The relationship between anticipatory grief and sleep disorder of parents with acute leukemia children: mediating effects of social support / 中国实用护理杂志

Objective:To explore the mediating effect of social support between anticipatory grief and sleep disorder of parents with acute leukemia children.Methods:By convenient sampling method, a total of 193 acute leukemia children and parents enrolled at Children`s hospital of Nanjing Medical University from January 2020 to August 2021 were enrolled as the research objects, the Pittsburgh Sleep Quality Index, Anticipatory Grief Scale and Perceived Social Support Scale were used for investigation. A structural equation model was established to evaluate the mediating effect of social support on anticipatory grief and sleep disorder.Results:The scores of Pittsburgh Sleep Quality Index, Anticipatory Grief Scale and Perceived Social Support Scale were 8.12 ± 4.95, 75.38 ± 13.91 and 62.09 ± 8.03 in parents with acute leukemia children, each demension scores and total scores of Pittsburgh Sleep Quality Index were positively correlated with Anticipatory Grief Scale, and negatively correlated with Perceived Social Support Scale ( r values were -0.184 - 0.916, all P<0.01). Anticipatory grief had a significantly indirect effect on the sleep disorder of parents with acute leukemia children through social support, which showed that the mediating effect of social support accounted for 79.6% of the total effect. Conclusions:Social support plays a mediating role in the relationship between anticipatory grief and sleep disorder, nurses can alleviate anticipatory grief and improve sleep disorder by promoting the levels of social support of parents with acute leukemia children.

Advances in research on anticipatory grief of patient caregivers / 中国实用护理杂志

Anticipatory grief is the grief that an individual feels about the imminent loss, which can cause adverse effects on the patient ,s family, such as psychology, physiology, and behavior. In order to fully understand the research progress of anticipated grief in the patient ,s family, this article starts with expectations. The concept of anticipatory grief, measurement tools, influencing factors, intervention programs, and study population are reviewed in order to provide references for the domestic research on anticipatory grief of patients , families.

Luto antecipatório do cuidador familiar no transplante de células tronco-hematopoéticas / Anticipatory grief of the family caregiver in hematopoietic stem cell transplatation / Luto anticipatorio del cuidador familiar en el transplante de células madre hematopoyeticas

Este estudo teve por objetivo conhecer as percepções e vivências do acompanhante familiar diante do adoecer e do transplante de células-tronco hematopoéticas (TCTH) à luz da teoria do luto antecipatório. Trata-se de um estudo exploratório com abordagem qualitativa, do qual participaram 11 familiares. As entrevistas individuais foram organizadas pela análise temática e interpretados em três níveis contextuais, envolvendo mudanças intrapsíquicas, interacionais com o paciente e no âmbito familiar/social. Constatou-se que o familiar experimenta sentimentos e reações emocionais consistentes com o processo de enlutamento. As mudanças na interação com o paciente acontecem desde os primeiros sintomas e intensificam-se com a necessidade de fornecer cuidado integral na enfermaria durante o transplante. Transformações na dinâmica familiar acontecem em resposta às perdas de papéis sociais, ocupacionais e seus impactos financeiros. Ademais, o sofrimento experimentado pelo cuidador durante esse processo não é legitimado, tanto pela família quanto pela equipe de saúde, já que do acompanhante se exige que seja uma fonte de apoio inabalável (AU).

This study aimed to know the perceptions and experiences of family companions facing illness and transplantation of hematopoietic stem cells (HSCT) in light of the theory of anticipatory grief. This is an exploratory study with a qualitative approach, in which 11 relatives participated. The individual interviews were organized by thematic analysis and interpreted at three contextual levels, involving intra-psychic, interactional with the patient and family / social changes. It was found that the family member experiences feelings and emotional reactions consistent with the bereavement process. Changes in patient interaction occur from the earliest symptoms and intensify with the need to provide comprehensive nursing care during transplantation. Transformations in family dynamics occur in response to the loss of social, occupational roles and their financial impacts. Moreover, the suffering experienced by the caregiver during this process is not validated, either by the family or by the healthcare providers, as the companion is required to be an unshakable source of support (AU).

Este estudio tuvo como objetivo conocer las percepciones y experiencias del compañero familiar cuando se enfrenta a una enfermedad y el trasplante de células madre hematopoyéticas (TCMH) a la luz de la teoría del duelo anticipatorio. Este es un estudio exploratorio con un enfoque cualitativo, en el que participaron 11 familiares. Las entrevistas individuales fueron organizadas por análisis temático e interpretadas en tres niveles contextuales, involucrando intrapsíquica, interacción con el paciente y cambios familiares / sociales. Se descubrió que el miembro de la familia experimenta sentimientos y reacciones emocionales consistentes con el proceso de duelo. Los cambios en la interacción con el paciente ocurren desde los primeros síntomas y se intensifican con la necesidad de proporcionar atención integral de enfermería durante el trasplante. Las transformaciones en la dinámica familiar ocurren en respuesta a la pérdida de roles sociales, ocupacionales y sus impactos financieros. Además, el sufrimiento experimentado por el cuidador durante este proceso no está legitimado, ni por la familia ni por el equipo de salud, ya que el acompañante debe ser una fuente de apoyo inquebrantable (AU).

Vivências de familiares de pacientes com câncer: revisitando a literatura / Family experiences of cancer patients: revisiting the literature / Vivencias de familiares de pacientes con cáncer: revisitando la literatura

O objetivo desta revisão integrativa consiste em sintetizar evidências existentes na literatura sobre luto antecipatório vivenciado por familiares de pacientes com câncer. A coleta dos dados foi realizada nas bases de dados LILACS, SciELO e PubMed, de 2008 a 2018. Depois de aplicados os critérios de inclusão/exclusão restaram nove artigos na amostra final. Os resultados evidenciam que a repercussão do luto antecipatório é significativa, implicando em elevado grau de sofrimento dos familiares e depreciação de sua qualidade de vida. O impacto tende a ser persistente em muitos casos, resultando em morbidades psicológicas. Fica evidente a lacuna de pesquisas sobre o tema e a necessidade de aprofundar a compreensão do fenômeno para oferecer subsídios que poderão nortear programas direcionados aos familiares enlutados.

The objective of this integrative review is to synthesize evidence from literature on anticipatory grief experienced by relatives of cancer patients. Data collection was carry out in the LILACS, SciELO and PubMed databases from 2008 to 2018. After the inclusion/exclusion criteria were applied, nine articles remained in the final sample. The results show that the repercussion of anticipatory mourning is significant, implying a high degree of family suffering and depreciation of their quality of life. The impact caused by this context tends to be persistent in many cases, resulting in psychological morbidities. It is evident the lack of research on the subject and the need to deepen the understanding of the phenomenon so that subsidies can be offered to guide programs directed to bereaved relatives.

El objetivo de esta revisión integrativa consiste en sintetizar evidencias existentes en la literatura sobre luto anticipatorio vivido por familiares de pacientes con cáncer. La recolección de los datos se realizó en las bases de datos LILACS, SciELO y PubMed, de 2008 a 2018. Después de aplicados los criterios de inclusión / exclusión que daron nueve artículos en la muestra final. Los resultados evidencian que la repercusión del luto anticipatorio es significativa, implicando en alto grado de sufrimiento de los familiares y depreciación de su calidad de vida. El impacto tiende a ser persistente en muchos casos, resultando en morbilidad psicológica. Es evidente la brecha de investigaciones sobre el tema y la necesidad de profundizar la comprensión del fenómeno para que puedan ofrecerse subsidios para orientar programas dirigidos a los familiares enlutados.

Anticipatory grief and its influencing factors in major caregivers of patients with advanced cancer / 中国实用护理杂志

Objective@#To explore the status of anticipatory grief in major caregivers of patients with advanced cancer and its influencing factors.@*Methods@#There were 329 major caregivers of patients with advanced cancer recruited between October 2017 and May 2018. The basic data questionnaire, Anticipatory Grief Scale and Perceived Social Support Scale were used in the investigation.@*Results@#The scores of anticipatory grief and perceived social support were 88.49±16.47 and 60.33±11.58 respectively. The result of multiple linear regression revealed that relationship with patients, perceived social support, gender and religion were associated with anticipatory grief and could explain 54.2% of the total variance.@*Conclusions@#Medical workers should provide assistance to the major caregivers of patients with advanced cancer, respect and encourage the appropriate participation of religious activities, encourage caregivers to fully express their feelings, decrease their adverse emotional reactions and improve their bereavement outcome.

Anticipatory grief and its influencing factors in major caregivers of patients with advanced cancer / 中国实用护理杂志

Objective To explore the status of anticipatory grief in major caregivers of patients with advanced cancer and its influencing factors. Methods There were 329 major caregivers of patients with advanced cancer recruited between October 2017 and May 2018. The basic data questionnaire, Anticipatory Grief Scale and Perceived Social Support Scale were used in the investigation. Results The scores of anticipatory grief and perceived social support were 88.49 ± 16.47 and 60.33 ± 11.58 respectively. The result of multiple linear regression revealed that relationship with patients, perceived social support, gender and religion were associated with anticipatory grief and could explain 54.2％of the total variance. Conclusions Medical workers should provide assistance to the major caregivers of patients with advanced cancer, respect and encourage the appropriate participation of religious activities, encourage caregivers to fully express their feelings, decrease their adverse emotional reactions and improve their bereavement outcome.

Luto antecipatório/preparatório em pacientes com câncer: análise da produção científica / Anticipatory / prepatory grief in patients with cancer: analysis of scientific production / Luto anticipatorio/preparatorio en pacientes con cáncer: análisis de la producción científica

O objetivo do presente estudo é apresentar uma revisão integrativa da literatura sobre luto antecipatório no paciente com câncer, tendo como recorte temporal o período de 2007 a 2017. A coleta dos dados foi realizada em periódicos indexados em bases regionais e internacionais de dados bibliográficos (LILACS, SciELO e PubMed). De acordo com os critérios de inclusão e exclusão adotados, foram selecionados dez artigos, sendo sete com uma abordagem quantitativa. Os resultados apontam a necessidade de conhecer o processo desse enlutamento específico, cuja vivência pode ser compreendida como positiva ou prejudicial ao paciente. Ressalta-se a importância das intervenções da equipe para o melhor enfrentamento desse que pode ser um momento de amadurecimento e preparo para a morte.

The objective of the present study is to introduce an integrative review of the literature on anticipatory grief in the cancer patient, having as a cut-off the period from 2007 to 2017. The data collection was carried out in periodicals indexed in regional and international databases of bibliographic data (LILACS, SciELO and PubMed). According to the inclusion and exclusion criteria adopted, ten articles were selected, seven of which with a quantitative approach. The results point out the need to know the process of this specific grief, whose experience can be understood either as positive or detrimental to the patient. The importance of the multiprofessional team interventions is emphasized for the best coping of this moment, which can be a time of maturity and preparation for death.

El objetivo del presente estudio es presentar una revisión integrativa de la literatura sobre luto anticipatorio en el paciente con cáncer, teniendo como recorte temporal el período de 2007 a 2017. La recolección de los datos fue realizada en periódicos indexados en bases regionales e internacionales de datos bibliográficos (LILACS, SciELO y PubMed). De acuerdo con los criterios de inclusión y exclusión adoptados, se seleccionaron diez, siendo siete con un abordaje cuantitativo. Los resultados apuntan a la necesidad de conocer el proceso de esa enlutación específica, cuya vivencia puede ser comprendida como positiva o perjudicial para el paciente. Se resalta la importancia de las intervenciones del equipo para el mejor enfrentamiento de ese que puede ser un momento de maduración y preparación para la muerte.

Cuidados paliativos e luto antecipatório: um estudo à luz do modelo Calgary de avaliação da família / Palliative care and anticipatory grief: a study in the light of Calgary model for assessment of families

Introdução: Os cuidados paliativos constituem uma filosofia de cuidado interdisciplinar que objetiva aprimorar a qualidade de vida de pacientes e famílias que vivem e convivem com doenças ameaçadoras de vida, nas dimensões física, psicológica, social e espiritual e apoio ao luto. A presente dissertação é constituída de dois diferentes artigos, um teórico e um empírico, cujo enfoque temático central entre eles são os cuidados paliativos e o luto. O primeiro, teórico, intitula-se Cuidados paliativos e luto: um estudo bibliométrico. Objetivo: Analisar a produção científica publicada em periódicos online sobre os cuidados paliativos e o luto. Metodologia: Revisão bibliométrica, cuja amostra foi constituída de artigos, publicados no período de 2005 a 2014, e disponibilizados na LILACS, MEDLINE, IBECS, PUBMED, SciELO e DOAJ. Resultados: Foram identificados 48 estudos disseminados em 37 periódicos, dos quais, a Revista Medicina Paliativa Journal foi a que mais publicou sobre a temática, e o American Journal of Psychiatry apresentou o maior fator de impacto. A maioria das publicações foi produzida por pesquisadores da área de Medicina e predominaram autores com o título de doutor. Conclusão: Verificou-se que a produção do conhecimento que envolve os cuidados paliativos e o luto mantém-se reduzida no período investigado, o que demanda a ampliação do conhecimento acerca dessa temática e das questões que a envolvem. O segundo estudo é uma pesquisa original, intitulada: Estrutura de famílias de pacientes em cuidados paliativos acerca do luto antecipatório: estudo à luz do Modelo Calgary. Objetivo: Analisar a estrutura de famílias de pacientes sob cuidados paliativos acerca do luto antecipatório à luz do Modelo Calgary de Avaliação da Família.

Introduction: Palliative care is a philosophy of interdisciplinary care that aims to improve the quality of life of patients with life threatening diseases and families, acting in the physical, psychological, social and spiritual dimensions and bereavement support. This dissertation consists of two different articles, theoretical and empirical, whose central thematic focus between them are palliative care and bereavement. The first, theoretical, is entitled palliative and bereavement care: a bibliometric study. Objective: To analyze the scientific production published in online journals on palliative care and bereavement. Methodology: bibliometric review, whose sample consisted of articles published in the period from 2005 to 2014, available in LILACS, MEDLINE, IBECS, PubMed, SciELO and DOAJ. Results: We identified 48 studies disseminated in 37 journals, including the Journal Palliative Medicine Journal that was the most published on the subject, and the American Journal of Psychiatry showed the highest impact factor. Most of the papers produced by researchers of the medical area and predominated authors with the title of doctor. Conclusion: It was found that the production of knowledge involving palliative care and bereavement remains weak in the investigated period, which requires the expansion of knowledge on this theme and the issues surrounding it. The second study is a unique research, entitled: patients families Structure in palliative care about anticipatory grief: study based on the Calgary model. Objective: To analyze the structure of families of patients under palliative care about anticipatory grief in the light of Calgary Model.