Factors associated with anticipatory grief in family caregivers of patients with esophageal cancer: a cross-sectional study.

purposeTo assess the level of anticipatory grief (AG) among family caregivers of patients with esophageal cancer and to identify associated factors.

methodsA cross-sectional study was conducted with 312 caregivers recruited from a tertiary hospital in Shanghai, China. Data were collected using the Anticipatory Grief Scale, the Knowledge and Skills of Caregiving Scale, Zarit Burden Interview, Positive Aspects of Caregiving, the Simplified Coping Style Questionnaire, and the Multidimensional Scale of Perceived Social Support. Descriptive statistics, univariate analyses, and multiple linear regression were performed. An exploratory mediation analysis was further conducted to examine whether caregiver burden mediated the association between perceived social support and AG.

resultsThe mean AGS score was 75.55 ± 14.24, indicating a moderate level of AG. Higher AG was independently associated with greater caregiver burden (β = 0.352, p < 0.001), more negative coping (β = 0.301, p < 0.001), higher perceived social support (β = 0.168, p = 0.003), greater positive aspects of caregiving (β = 0.113, p = 0.032), and no prior bereavement experience (β = 0.114, p = 0.040), whereas positive coping was protective (β =  - 0.210, p = 0.001). The model explained 44.1% of the variance in AG. Mediation analysis showed that caregiver burden partially mediated the association between perceived social support and AG (indirect effect = 0.113, 95% bootstrap CI [0.035, 0.211]), while the direct effect remained significant.

conclusionAG is common among caregivers of patients with esophageal cancer in the perioperative period. Interventions should prioritize reducing caregiver burden and promoting adaptive coping strategies, particularly for caregivers without prior bereavement experience.