Impact of “four-step” death education on life quality and negative emotions in advanced esophageal cancer patients and families
Year: 2026
Type: article
Study design: Clinical Trial
Abstract: BACKGROUND: Patients with advanced esophageal cancer and their families often experience reduced quality of life (QoL) and heightened negative emotions. Death education may offer benefits, but evidence in this context is limited. AIM: To investigate the impact of a systematic "four-step death education" intervention on the QoL and negative emotions of postoperative patients with advanced esophageal cancer and their primary caregivers. METHODS: = 108) on the basis of the received intervention. SCG received standard care and basic psychological support, and FDEG additionally received a four-stage death education program encompassing information provision, emotional support, life review and meaning exploration, and end-of-life care preparation. QoL and negative emotion levels were measured using validated instruments: The European Organization for Research and Treatment of Cancer QoL Questionnaire Core 30 for patient QoL, the Family QoL Survey, the Zarit Burden Interview for caregiver burden, the Pittsburgh Sleep Quality Index, the Self-Rating Anxiety Scale, the Self-Rating Depression Scale, and the Attitudes Toward Life and Death Scale. Assessments were conducted at baseline and 3 months post-intervention. RESULTS: Baseline characteristics were comparable between groups. At 3 months, FDEG demonstrated significantly improved symptom and functional domain QoL scores in several areas, including fatigue, nausea, insomnia, loss of appetite, and physical and emotional functioning. FDEG reported increased family QoL and reduced caregiver burden. The patients and caregivers in FDEG showed superior improvements in sleep quality and greater reductions in anxiety and depression scores than those in SCG. Post-intervention, FDEG exhibited more positive attitudes toward death. CONCLUSION: The postoperative "four-step death education" intervention enhances QoL, relieves caregiver burden, and reduces negative emotions among patients with advanced esophageal cancer and their caregivers, supporting broadened implementation of structured death education programs in palliative care settings.
Authors: Li-Li Wen, Jian-Yu Li, Shu-Ying Zhang
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7125156138