Exploring the factors influencing anticipatory grief in esophageal cancer patients: A cross-sectional study.

PURPOSE: This study aimed to examine the level of anticipatory grief (AG) and its influencing factors among hospitalized patients with esophageal cancer in China, with a specific focus on psychological distress, clinical symptoms, coping strategies, and social support.

METHODS

This cross-sectional study was conducted with 324 hospitalized esophageal cancer patients recruited from a tertiary hospital in Shanghai. Data were collected using validated instruments including the Preparatory Grief in Advanced Cancer Patients Scale, Distress Thermometer and Problem List, Social Support Rating Scale, and Medical Coping Modes Questionnaire. Multiple linear regression was employed to identify predictors of AG.

RESULTS

The AG score ranged from 0 to 66, with a median of 7 (interquartile range: 3-15), indicating a moderate-to-low level of AG. Psychological distress (β = 0.368, p < 0.001) emerged as the strongest predictor of AG. Other significant predictors included sadness, loss of interest in daily life, nervousness, pathological type, fever, and work/school-related problems. Notably, avoidance coping style was negatively associated with AG (β = -0.149, p < 0.001), suggesting a possible short-term protective effect. Although social support was negatively correlated with AG, this association was not statistically significant.

CONCLUSIONS

Psychological distress score plays a pivotal role in shaping AG among esophageal cancer patients. While avoidance coping may provide temporary relief, it may hinder emotional processing in the long run. These findings underscore the need for early psychological screening and the promotion of adaptive coping strategies to support emotional well-being in this population.