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Randomized Clinical Trial
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Oct 19, 2025; 15(10): 110643
Published online Oct 19, 2025. doi: 10.5498/wjp.v15.i10.110643
Effect of grief counseling on psychological distress and negative emotions among family members of patients with terminal tumors
Hui Lu, Wen-Jing Xu, Ying Chen, Ling-Yun Zhu, Yu-Ling Yang, Yao-Yao Hu, Yan-Jie Zhang, Yi Cheng, Yu-Hong Yang, Rui-Rong Wu
Hui Lu, Ying Chen, Yan-Jie Zhang, Yi Cheng, Rui-Rong Wu, Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi 214122, Jiangsu Province, China
Wen-Jing Xu, Wuxi School of Medicine, Jiangnan University, Wuxi 214122, Jiangsu Province, China
Ling-Yun Zhu, Department of General Medicine, Jiangnan University, Wuxi 214122, Jiangsu Province, China
Yu-Ling Yang, Department of Medical Psychology, Affiliated Hospital of Jiangnan University, Wuxi 214122, Jiangsu Province, China
Yao-Yao Hu, Department of Cardiology, Affiliated Hospital of Jiangnan University, Wuxi 214122, Jiangsu Province, China
Yu-Hong Yang, Jiangsu Annen Management Service Co., Wuxi 214122, Jiangsu Province, China
Co-first authors: Hui Lu and Wen-Jing Xu.
Author contributions: Lu H, Xu WJ, Chen Y, Zhu LY, and Wu RR designed the research study; Yang YL, Hu YY, Zhang YJ, Cheng Y, and Yang YH performed the research; Zhu LY and Yang YL contributed new reagents and analytic tools; Lu H, Xu WJ, Chen Y, and Wu RR analyzed the data and wrote the manuscript. Lu H and Xu WJ contributed equally to this manuscript and are co-first authors. All authors have read and approve the final manuscript.
Supported by Wuxi Institute of Translational Medicine Project Program, No. LCYJ202336; the Scientific and Technological Achievements Promotion Project of Wuxi Municipal Health Commission Project Program, No. T202336; Hospital Management Innovation Research Project of Jiangsu Hospital Association, No. JSYGY-3-2024-601; and Jiangsu Provincial Traditional Chinese Medicine Science and Technology Development Plan Project, No. MS2024063.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of the Affiliated Hospital of Jiangnan University (Approval No. LS2023101).
Clinical trial registration statement: This study is registered at Chictr.org.cn, No. ChiCTR2500100727 (https://www.chictr.org.cn/bin/home).
Informed consent statement: Informed consent was obtained from all subjects involved in the study. Written informed consent has been obtained from the patients to publish this paper.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: The datasets used during the current study available from the corresponding author on reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rui-Rong Wu, Associate Chief Physician, Department of Oncology, Affiliated Hospital of Jiangnan University, No. 1000 Hefeng Road, Wuxi 214122, Jiangsu Province, China. 18205039231@163.com
Received: June 12, 2025
Revised: July 10, 2025
Accepted: August 6, 2025
Published online: October 19, 2025
Processing time: 107 Days and 7.5 Hours
Abstract
BACKGROUND

Grief counseling has become relatively established and is widely used among the families of cancer patients, effectively alleviating their psychological pain. However, in China, due to the influence of Confucianism and other traditional cultures, people generally adhere to the belief of “reincarnation to avoid death”, focusing more on themes of life, such as eugenics and longevity, and paying less attention to matters related to death, including death education and grief counseling. Currently, grief counseling in China is still in an exploratory stage, and there is relatively little research on the psychological status of family members of patients with terminal tumors.

AIM

To investigate the psychological effects of grief counseling on family members of terminal cancer patients.

METHODS

This study was designed as a randomized controlled trial that utilized convenience sampling to select family members of terminal tumor patients who were admitted to the hospice ward of the Affiliated Hospital of Jiangnan University from January to June 2025 as research subjects. All participants received conventional symptomatic supportive treatment and palliative care. Additionally, the intervention group benefited from extra grief counseling.

RESULTS

The Distress Thermometer (DT) score of the control group slightly decreased compared to before the intervention, but the difference was not statistically significant (P > 0.05). In contrast, the DT score of the intervention group decreased significantly compared to before the intervention, with a statistically significant difference (P < 0.05). After the intervention, the DT score of the intervention group was lower than that of the control group, and the difference was also statistically significant (P < 0.05). After the intervention, the intervention group performed better DT level than the control group, with a statistically significant difference (P < 0.05), the intervention group outperformed the control group in terms of depression and anxiety, and the difference was statistically significant (P < 0.05).

CONCLUSION

Grief counseling can help alleviate the psychological pain and negative emotions experienced by family members of patients with terminal malignant tumors.

Keywords: Grief counseling; Psychological distress; Negative emotions; Family members of tumor patients; Terminal tumors

Core Tip: This study extensively reviewed relevant literature and clinical practice to provide grief counseling to the families of patients with advanced cancer in China. The aim is to explore the role of grief counseling in alleviating the psychological distress and negative emotions experienced by family members. This study aims to help grieving individuals regain confidence in life and enrich the content of hospice care in China.