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

Purpose Family 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. Methods Sixty-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 (T 0 ) and post-intervention (T 1 ). Pre-post changes were examined using paired-samples t tests with Bonferroni correction and the absolute values of within-subject Cohen’s d z (|d z |). Exploratory stepwise multiple linear regression examined caregiver characteristics associated with reduction scores. Engagement was summarized. Results Statistically significant pre–post reductions were observed across all seven anticipatory grief subdomains (all P < .001), with absolute within-subject Cohen’s d z 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. Conclusions Substantial 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.