Effect of Legacy-Making on Anticipatory Grief and Coping Among Mothers of Children with Cancer: A Randomized Clinical Trial.

OBJECTIVES One of the complex and challenging parental experiences when facing a child's cancer is anticipatory grief. This study aimed to evaluate the effect of legacy-making on anticipatory grief and coping strategies among mothers of children with cancer.

METHODS This parallel-group randomized clinical trial was conducted among 70 mothers of hospitalized children with cancer. Participants were randomly allocated to the intervention or control group. The intervention group participated in a structured legacy-making program consisting of five sessions, each lasting 60 to 90 minutes. Anticipatory grief and coping were assessed using the Marwit-Meuser Caregiver Grief Inventory and the Coping Health Inventory for Parents, respectively. Data were analyzed using SPSS version 26.

RESULTS At baseline, no statistically significant differences were observed between the two groups. Following the intervention, intervention group demonstrated a significant reduction in anticipatory grief compared with the control group (180.14 ± 24.88 vs 154.14 ± 27.44; Cohen's d = 0.99, P < .001). Analysis of covariance confirmed this effect (F = 18.42, P < .001, η² = 0.22). Coping scores increased significantly in the intervention group (92.65 ± 14.38 vs 104.94 ± 10.86; Cohen's d = 0.97, P < .001), with analysis of covariance indicating significantly greater improvement compared with the control group (F = 16.75, P < .001, η² = 0.20).

CONCLUSION The legacy-making was effective in reducing anticipatory grief and enhancing coping among mothers of children with cancer. These findings support the incorporation of legacy-making into pediatric palliative care to promote family support.

IMPLICATIONS FOR NURSING PRACTICE By fostering emotional expression, enhancing meaning-making, and reinforcing family cohesion during a highly distressing period, nurses can use the intervention to improve psychological, social, and overall well-being outcomes for both children with cancer and their parents.