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