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Pre-Post Changes in Anticipatory Grief Following a Blended Narrative Nursing Intervention Among Family Caregivers of

In Hye Park1, Longfei Tao2, Yingchun Chen3

  • 1College of Nursing, Ajou University, Suwon-si, Gyeonggi-do, South Korea.

The American Journal of Hospice & Palliative Care
|August 14, 2026
PubMed

PurposeFamily caregivers of terminal cancer patients experience anticipatory grief. Blended narrative nursing interventions remain insufficiently evaluated in palliative care. This single-group pre-post study examined changes in anticipatory grief following a four-week blended narrative nursing intervention and secondarily explored caregiver characteristics associated with the magnitude of change.MethodsSixty-three caregivers were recruited from five Chinese hospice and palliative care institutions; 55 completed the intervention and were included in the pre-post analyses. The intervention combined daily asynchronous online narrative activities with weekly in-person group workshops facilitated by nurses. Anticipatory grief was assessed using the 27-item Anticipatory Grief Scale at baseline (T0) and post-intervention (T1). Pre-post changes were examined using paired-samples t tests with Bonferroni correction and the absolute values of within-subject Cohen's dz (|dz|). Exploratory stepwise multiple linear regression examined caregiver characteristics associated with reduction scores. Engagement was summarized.ResultsStatistically significant pre-post reductions were observed across all seven anticipatory grief subdomains (all P < .001), with absolute within-subject Cohen's dz values ranging from 0.58 for anxiety to 2.08 for anger. Mean online completion was 78.5%; mean workshop attendance was 3.6 of 4 sessions. Higher caregiver-patient intimacy was associated with smaller reductions in five subdomains, whereas extraversion, religious affiliation, and socioeconomic characteristics were associated with larger reductions in specific domains.ConclusionsSubstantial pre-post reductions in anticipatory grief were observed following the intervention. However, the single-group design precludes causal attribution. Controlled studies with longer follow-up and prespecified moderator analyses are needed to evaluate intervention effectiveness and response heterogeneity.

Keywords:
anticipatory griefblended narrative interventionfamily caregiversnarrative nursingpalliative carepre-post studyterminal cancer

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