A Review of Grief Counselling Practices for Family Members of Oncology Patients in Hospice Care

In cancer patients, especially terminal patients, the family members of the patients will develop more serious sadness and find it difficult to face death rationally, which affects the quality of life and activities. Because of this, in the clinical treatment of oncology patients, strengthening hospice care for family members, doing a good job of death education, assisting them to face and participate in the clinical treatment of oncology in a positive way, and avoiding excessive grief can simultaneously improve the quality of life of patients and their families.

Prevalence and risk factors of prolonged grief disorder among bereaved survivors seven years after the Wenchuan earthquake in China: A cross-sectional study

Background:This study aimed to determine the prevalence and predictive factors of prolonged grief disorder(PGD)among those bereaved by the Wenchuan earthquake in Southwestern China seven years after the event.Methods:A cross-sectional survey based on census tracts was conducted on the bereaved earthquake survivors.Responses to the questionnaire regarding PGD and its potential associated factors were obtained either through face-to-face or telephone interview.PGD was screened by a validated Chinese version of the PGD questionnaire-13(PG-13).Bivariate and multivariate regression analyses were used to determine the prevalence and associated risk factors of PGD.Results:A total of 1464 bereaved earthquake survivors,with a response rate of 97.6%,were included in the study.Of the 1464 respondents studied,124(8.47%)were diagnosed with PGD.Multivariate regression analysis demonstrated that PGD in the bereaved earthquake individuals was significantly associated with several factors,including age,economic burden,close kinship with the deceased,and living with the deceased before the loss.Wenchuan earthquake bereaved aged 41e60 years were more likely to develop PGD compared to those aged younger than 40 or older than 60(OR=2.075,95%CI=1.297e3.319).Those who had a close kinship with the deceased had a higher tendency to develop PGD(OR=5.144,95%CI=2.716e9.740).The odds of PGD among the earthquake bereaved with economic burdens were higher relative to those who did not experience an economic burden(OR=8.123,95%CI=2.657e24.831).Those who living with the deceased before loss also had a higher tendency to develop PGD(OR=0.179,95%CI=0.053e0.602).Conclusions:This study revealed that a significantly high proportion(8.47%)of the Wenchuan earthquake-bereaved remain grieving seven years after the event.Those diagnosed with PGD should receive appropriate interventions from clinical psychologists.The risk factors identified in this study are crucial for the early screening and prevention of PGD in future nursing and psycho-clinical practices.

Is There Growth in Grief: Measuring Posttraumatic Growth in the Grief Response

Introduction: Grief is considered to be negative manifestations of affect, cognition, and behavior. However, persons who experience grief have also reported enduring positive outcomes in such domains as interpersonal relationships, personal strengths, and life perspectives. This review evaluated current measures of grief to determine if such positive outcomes can be adequately assessed. Methods: The Texas Revised Inventory of Grief, Grief Experience Inventory, Bereavement Phenomenology Questionnaire, Core Bereavement Items, Continuing Bonds Scale, and Hogan Grief Reaction Checklist (currently the most common measures of grief) are reviewed. Results: Only one of the reviewed measures assessed posttraumatic growth as a component of grief (i.e., Hogan Grief Reaction Checklist). Conclusion: Since posttraumatic growth and negative psychological adjustment after traumatic events can coexist, it is important that measures of grief used in both clinical and research domains allow an assessment of positive response.

Characteristics and Social Support Needs Predicting Anticipatory Grief in the Spouses of Patients with Cancer at the End of Life

Background: Medical staff provide care to spouses of terminal cancer patients through trial and error by meeting their various support needs and spousal factors regarding their anticipatory grief. Studies on the association between spousal characteristics and anticipatory grief have been inconclusive;additionally, there has been insufficient research on support needs for anticipatory grief of spouses. This study aimed to explore the spousal characteristics and social support needs predicting anticipatory grief in spouses of patients with cancer at the end of life. Methods: This was a cross-sectional study. Eligible spouses (n = 102) completed a self-report questionnaire in two hospitals with palliative care units in Japan. The questionnaire included demographic information, a tool assessing social support needs of spouses, and the Anticipatory Grief Scale for Family Caregivers. Results: Simple regression analyses indicated that patient age, chemotherapy, no treatment, ECOG PS3, children aged under 20 years, total score of “social support needs regarding the disease and treatment of the patients” and subscale scores (“medical condition and cure,” “daily life and social support,” and “intimacy and employment”), and total score of “social support needs of the spouses” and subscale scores (“family psychological issues and social support” and “intimacy, employment, and society”) were significant variables (all p p Conclusions: Patients having no experience of “chemotherapy” and higher “social support needs of the spouses” in Model 1, and greater spousal needs of “family psychological issues and social support” in Model 2 were significant predictors of severe anticipatory grief. Medical staff should pay attention to these risk factors that predict anticipatory grief among spouses.

A GIANT OF OUR ERA AND BOSOM FRIEND OF CHINESE SCIENTISTS-Mourning with deep grief over the death of comrade Deng Xiaoping

One of great leaders of our era, comrade Deng Xiaoping has passed away and left us forever.Chinese circles of science and technology were especially filled with the deepest sorrow when we heard the sad news of his death because we since then lost a leader of foresight and sagacity, a venerable elder as well as a good teacher and a helpful friend. But his enduring contribution to Chinese science, and his earnest teachings to Chinese scientists have been, and will be, a far-reaching and unflagging influence in the years to come.

Nation in grief for the killed

China's national flag flies at half-mast after the flag-raising ceremony on Tian'anmen Square in Beijing

晚期卵巢癌患者预期性悲伤现状及其影响因素的研究

目的:分析晚期卵巢癌患者预期性悲伤(AG)现状及其影响因素,为临床干预提供一定的理论参考。方法:选取2020年1月—2023年6月常州市第一人民医院收治的192例晚期卵巢癌患者作为研究对象,采用一般资料调查表、癌症患者AG问卷、焦虑自评量表、抑郁自评量表、癌症疼痛评估和生活质量测定量表对其进行调查。结果:所有患者的AG总分为(54.25±18.82)分,处于较高水平。不同年龄、学历、家庭人均月收入、婚姻状态、职业状态、有无子女、恶性肿瘤家族史、感觉女性特征减弱、疼痛反应和生活质量评分晚期卵巢癌患者AG得分比较,差异有统计学意义(P<0.05)。不同严重程度焦虑、抑郁晚期卵巢癌患者AG得分比较,差异有统计学意义(P<0.05)。Spearman相关系数分析显示,焦虑、抑郁程度与AG得分呈正相关(rs=0.99、0.96,P=0.036、0.042)。家庭人均月收入、疼痛反应、感觉女性特征减弱、焦虑程度、抑郁程度和生活质量评分均为晚期卵巢癌患者AG的影响因素(P<0.001)。结论:晚期卵巢癌患者的AG处于较高水平,临床需要关注相关影响因素,缓解患者的不良心理应激,改善其生活质量。

ICU护士职业幸福感现状及其影响因素分析

目的:调查青岛市重症监护室(ICU)护士职业幸福感、职业悲伤及体面劳动现状,分析ICU护士职业幸福感的影响因素及其与职业悲伤、体面劳动感的相关性。方法:采用一般资料调查表、医务人员职业幸福感量表、修订版悲伤体验量表、体面劳动感知量表对青岛市235名ICU护士进行调查研究。采用Pearson相关性分析、线性回归分析三者之间关系。结果:235名ICU护士职业幸福感、职业悲伤及体面劳动感得分分别为(71.33±9.18)分、(36.00±7.01)分、(50.20±15.64)分。相关分析显示,职业幸福感总分及各维度得分与职业悲伤总分及各维度得分呈负相关(均P<0.01),与体面劳动感总分及各维度得分呈正相关(均P<0.01);回归分析结果显示,月收入(β=0.238,P<0.01)、职业悲伤(β=-0.133,P<0.05)、体面劳动感(β=0.491,P<0.01)是ICU护士职业幸福感的影响因素。结论:ICU护士职业幸福感处于中等水平,提高护士收入,采取有效措施,减少护士职业悲伤感,从各方面尊重护理工作,能在一定程度上提高护士职业幸福感,以稳定急危重症护理队伍。

安宁疗护患者家庭照顾者出院过渡期照护困境的质性研究

目的深入探讨安宁疗护患者家庭照顾者出院过渡期的照护困境,为制定过渡期安宁疗护干预方案提供依据。方法以目的抽样法抽取安宁疗护患者家庭主要照顾者12人,采用现象学研究方法,以一对一形式进行半结构深入访谈,采用Colaizzi七步分析法分析访谈资料,提炼主题。结果提炼出3个主题9个亚主题,即角色应对困难(难以适应环境转变、难以独立照护患者、难以应对情感压力)、缺乏以家庭为中心的支持(出院照护准备不足、家庭社会支持不足、信息资源匮乏)、照护需求多样化(希望获得连续性护理服务、渴望获得居家照顾知识和技能、有意识的心理准备和哀伤辅导)。结论安宁疗护患者家庭照顾者出院过渡期照护困境复杂多样,存在多维度护理需求。医护人员应组建安宁疗护多学科团队,联合社会各方力量共同帮助照顾者克服患者出院过渡期照护困境,改善照顾者身心健康。

医务人员对丧亲家属丧亲支持的最佳证据总结

目的总结医务人员对丧亲家属丧亲支持的最佳证据,为临床医务人员对丧亲家属开展丧亲支持服务提供参考。方法按照“6S”证据金字塔模型,系统检索国内外相关数据库中关于医务人员对丧亲家属丧亲支持的临床决策、指南、证据总结、系统评价、专家共识、随机对照试验,检索时限为建库至2023年6月30日,由2名研究人员选取符合纳入标准的文献,对文献质量进行评价,根据主题提取和汇总证据。结果共纳入13篇文献,包括1篇指南、6篇系统评价、3篇专家共识、3篇随机对照试验。从丧亲支持团队要求、丧亲支持原则、丧亲支持评估、通用丧亲支持策略、专业丧亲支持策略5个方面总结形成25条最佳证据。结论总结的医务人员对丧亲家属提供丧亲支持的最佳证据内容较全面,可为临床开展高质量的丧亲支持提供循证依据。

丧亲者哀伤辅导及其干预模式的研究进展

对安宁疗护服务中丧亲者的哀伤状态、哀伤评估和干预方式进行综述,并提出在安宁疗护实践中哀伤辅导所需的关键结构和过程,为临床探索哀伤干预模式奠定理论基础。

中青年重症脑卒中患者主要照顾者预期性悲伤影响因素的结构方程模型构建

目的构建结构方程模型,探讨中青年重症脑卒中患者主要照顾者预期性悲伤影响因素的作用机制,为探索预期性悲伤的干预模式提供依据。方法2022年6月至2023年6月,选取于湖北医药学院附属襄阳市第一人民医院就诊的300例中青年重症脑卒中患者主要照顾者作为研究对象,采用一般资料调查表、预期性悲伤量表(AGS)、照顾者负担量表(ZBI)、社会支持评定量表(SSRS)和简易应对方式量表(SCSQ)进行调查。采用Pearson相关分析探讨各量表评分之间的相关性,采用AMOS 25.0进行模型拟合、路径及中介效应分析。结果中青年重症脑卒中患者主要照顾者AGS评分为(88.35±9.02)分,ZBI评分为(42.32±7.41)分,SSRS评分为(41.52±5.43)分,应对方式中采取积极应对方式的照顾者占39.3%,消极应对方式占60.7%。AGS评分与SCSQ消极应对评分(r=0.357)、ZBI评分(r=0.381)呈正相关(P<0.01),与SSRS评分(r=-0.436)、SCSQ积极应对评分(r=-0.369)呈负相关(P<0.01)。结构方程模型显示,照顾者负担对预期性悲伤的直接效应显著(效应值为0.458),社会支持、积极应对和消极应对在照顾者负担与预期性悲伤之间的中介效应显著(效应值分别为0.113、0.061、0.060)。结论中青年重症脑卒中患者主要照顾者预期性悲伤水平较高,各影响因素对主要照顾者的预期性悲伤显示出较强的预测和解释功能,医护人员可制定针对性的干预措施,从而降低预期性悲伤水平。

Factors Related to Complicated Grief among Bereave Individuals after the Wenchuan Earthquake in China

Background： The Wenchuan earthquake in China caused shock and grief worldwide. Sudden bereavement caused by the earthquake led to physical disorders as well as psychological disturbances in the bereaved individuals. The bereaved had a high risk for complicated grief （CG）, which may have led to significant distress and impairment in their health. However, there was few available studies on CG among disaster-bereaved individuals in China after the disaster. The aim of this study was to identify factors （demographic characteristics and disaster-related variables） associated with symptoms of CG among the bereaved 18 months after the Wenchuan earthquake. Methods： This study was conducted with a cross-sectional design and a convenience sample of 271 bereaved individuals from three of the hardest hit areas. Data were collected by questionnaires and the instruments used in the study were： General questionnaire and Inventory of CG （ICG）. Multivariate linear regression analysis was used to identify factors associated with symptoms of CG. Results： The mean score on ICG was 52.77 （standard deviation： 10.00）. Being female and loss of a child were related to higher level of CG while having another child after the disaster and receiving psychological counseling experience were associated with lower level of CG. Forty-nine percent of the variance of CG was explained by these identified factors. Conclusions： Eighteen months after the Wenchuan earthquake, the symptoms of CG among the bereaved were higher than the previous studies with bereaved individuals. This study uncovers a vulnerable population of the bereaved at high risk for CG. Early assessments, targeted interventions, and policy support tailored for the disaster-bereaved individuals are necessary to identify and alleviate symptoms of CG and to improve their well-being.

认知行为治疗对延长哀伤障碍患者效果的Meta分析

背景 延长哀伤障碍(PGD)严重影响患者的工作和生活质量。既往研究探讨了认知行为治疗(CBT)对PGD的干预效果,但由于干预的频率、时间和具体内容不同,CBT对PGD干预效果的结论存在争议。目的 通过Meta分析,探讨CBT对PGD的干预效果,为临床治疗提供参考。方法 于2022年10月22日,以维普、中国生物医学文献数据库、万方、中国知网、Embase、Cochrane Library、PubMed、Web of Science为数据源进行检索,收集CBT治疗PGD的随机对照试验(RCTs)。结局指标包括哀伤、抑郁、焦虑或躯体化症状。采用RevMan 5.3进行Meta分析。结果 共纳入7篇文献,包括528例PGD患者。Meta分析结果显示,干预后,研究组哀伤症状(SMD=-0.78,95%CI:-1.27~-0.29)、抑郁症状(SMD=-0.45,95%CI:-0.73~-0.17)以及焦虑症状评分(SMD=-0.38,95%CI:-0.59~-0.18)均低于对照组,差异均有统计学意义,但两组躯体化症状评分比较,差异无统计学意义(SMD=-0.01,95%CI:-0.26~0.25)。结论 CBT可能有助于改善PGD患者的哀伤、抑郁及焦虑症状,但对躯体化症状的改善效果欠佳。

正念减压疗法对中青年晚期癌症患者配偶预期性悲伤的影响

目的探讨正念减压疗法对中青年晚期癌症患者配偶预期性悲伤的影响。方法选取2021年4月至6月江西省肿瘤医院就诊的74例患者配偶作为研究对象,采用随机数字表法将其分为对照组、观察组,每组各37例。对照组给予常规健康教育及心理护理,观察组在此基础上实施正念减压疗法。分别于干预前1天、干预8周结束后当天采用预期性悲伤量表(AGS)、照顾者负担量表(CBI)以及正念注意觉知量表(MAAS)对患者配偶进行干预效果的评估。结果干预后观察组配偶AGS总分、CBI总分低于对照组,且差异有统计意义(P<0.05);观察组干预后MAAS总分高于对照组,差异有统计意义(P<0.05)。结论正念减压疗法可降低中青年晚期癌症患者配偶预期性悲伤水平,并减轻配偶的照顾负担、提高其生存质量及正念水平,值得推广。

哀伤辅导视角下儿童丧亲主题绘本的疗愈效用——基于对9本绘本的叙事分析

为探究儿童丧亲主题绘本的疗愈效用,以哀伤辅导理论为指导框架对《小伤疤》等9本丧亲主题绘本进行叙事分析。研究发现,丧亲主题绘本多数都构建了完整的哀伤历程,分为5个阶段:“故事开端:叙述过去映射正向情感联结;第一次转折:以委婉言语表达死亡事实;情绪高潮:主人公强烈宣泄负面情绪;第二次转折:寻求超越死亡的生命意义;故事结尾:与过去挥手告别开启新生活。”但仍存在一些不足之处可以优化。例如,绘本创作要直面亲人死亡的生物性事实,建构亲人“永生”的现实意义,结合中国本土文化进行创新。作为家长及教育工作者,要关注丧亲儿童的心理健康,灵活运用绘本对儿童进行死亡教育,帮助丧亲儿童走出哀伤。

新生儿科护士哀伤护理知信行问卷的编制及信效度检验

目的:编制新生儿科护士哀伤护理知信行调查问卷,并进行信效度检验。方法:以知信行理论为指导构建问卷框架,通过文献回顾、课题小组讨论、半结构式访谈、德尔菲专家函询、预调查形成知信行问卷初稿。采用便利抽样法,调查6所三级甲等医院工作的234名新生儿科护士并进行信效度检验。结果:两轮专家函询均发放专家函询表19份,第1轮函询回收19份,回收率为100.0%,第2轮函询回收17份,回收率为89.5%。两轮专家对各条目的权威系数分别为0.85~0.96和0.89~0.96。最终形成的新生儿科护士哀伤护理知信行调查问卷包括知识、态度、行为3个维度,共28个条目。问卷总的Cronbach′s α系数为0.934,知识、态度、行为3个维度的Cronbach′s α系数分别为0.743,0.935,0.924。探索性因子分析共提取4个公因子,累计方差贡献率为64.412%。结论:新生儿科护士哀伤护理知信行问卷具有良好的信效度,可作为评估新生儿科护士哀伤护理认知、态度、行为状况的可靠工具。

叙事医学语境下癌末患者家庭照护者预期性悲伤影响因素的质性研究

目的探讨晚期癌症患者家庭照护者预期性悲伤的影响因素,为制订预期性悲伤的干预方案提供参考。方法设计访谈提纲,采用描述性质性研究的方法,目的选取11名就诊于南方医科大学南方医院肿瘤内科的患者家庭叙事照护者进行半结构化深度访谈。基于社会生态学模型,以生命健康叙事理论为框架,采取内容分析法进行资料分析。结果共提炼出3个主题,12个亚主题,即个体层面影响因素(叙事素养、对死亡的认知程度、自我价值感)、人际层面影响因素(患者疾病情况、受教育程度、经济状况、家庭叙事连接、同伴叙事连接、医者与家属间叙事连接)、文化政策层面影响因素(社会文化、病房物理环境、政策层面)。结论预期性悲伤受多层面因素的共同影响,应从个体、人际、家庭、社会等各层面展开多维度的叙事连接构建,预防照护者陷入单一照护者身份叙事闭锁,减轻照护者预期性悲伤影响,提高生活质量。