An interpretive phenomenological study exploring cognitive experiences of anticipatory grief among primary family caregivers of patients with advanced lung cancer

Anticipatory grief is a major psychological challenge for family caregivers of patients with advanced lung cancer. Understanding how caregivers make sense of this experience is essential for providing targeted support to this population. To explore the cognitive experiences of anticipatory grief among primary family caregivers of patients with advanced lung cancer in China.

An interpretive phenomenological design was used. From July 2024 to September 2024, 19 primary family caregivers of patients with advanced lung cancer (age M = 63.42 years, SD = 12.25) were recruited and interviewed in two regional hospitals in Zhejiang, China. Transcripts were analysed inductively, with mental time travel used as a sensitising and interpretive lens.

Three themes were identified: “Fading and mourning”, “Ambivalent choices”, and “Acceptance and meaning reconstruction”. Caregivers’ anticipatory grief was reflected in memories of the patient’s former health and shared life, present perceptions of relational separation and role disruption, and imagined futures marked by loss. They also described a continuing tension between holding on and letting go, while gradually reconstructing meaning through companionship, filial responsibility, acceptance of death, and the pursuit of a good death and good farewell.

Interpreted through the lens of mental time travel, anticipatory grief among primary family caregivers of patients with advanced lung cancer is a cognitively and temporally organized experience, not merely an emotional response. Supportive care should attend to caregivers’ memories of past relationships, present role changes, future-oriented fears, and culturally embedded meaning-making. We would like to acknowledge the family caregivers for their assistance in this research.

This study was funded by grants from the Construction Fund of Key Medical Disciplines of Hangzhou(2025HZZD05), Zhejiang Provincial Medical and Health Science Technology Plan (No.2024KY174) and the Zhejiang Provincial Traditional Chinese Medicine Science and Technology Plan (No.2024ZF110). The funders had no part in the study design, conduct or data analysis and did not have any authority over these activities. These authors contributed equally: Ning Jiang and Yuwei Mo.

Department of Nursing, Hangzhou First People’s Hospital, Hangzhou, China Ning Jiang, Yujing Chen, Li Wang & Li Ning College of Nursing, Zhejiang Chinese Medical University, Hangzhou, China Ning Jiang, Yuwei Mo, Wenjie Wang & Yuxing Xie Department of Critical Care Medicine, Huzhou Normal University Affiliated First Hospital (Huzhou First People’s Hospital), Huzhou, China Department of Respiratory Medicine, Hangzhou First People’s Hospital, Hangzhou, China The authors declare no competing interests. Ethical approval was obtained from the ethics committee of the First Affiliated Hospital of Zhejiang Chinese Medical University (approval number: 2024-KLS-425-01) and Hangzhou First People’s Hospital (approval number: IIT-20231228-0314-01). All methods were performed in accordance with relevant guidelines and regulations.