Abstract: Objective: To explore the status and influencing factors of death anxiety in patients with advanced primary liver cancer, to provide the reference for the end-of-life care of patients with advanced primary liver cancer. Methods: Using convenience sampling method, 190 patients with advanced primary liver cancer from January 2022 to May 2023 were included. The survey was conducted using a general information questionnaire, death anxiety scale, psychological stress scale, family care scale, and disease burden scale. Pearson correlation analysis was used to analyze the correlation between death anxiety, psychological stress, and family care, multiple linear regression analysis was used to analyze the factors that affect the level of death anxiety. Results: The score of patients with advanced primary liver cancer was 7.79±1.57, indicating a high level of death anxiety. The score of psychological stress was 92.73±11.33, indicating a high level of psychological stress. The score of family care was 2.54±0.36, indicating a low level of lack of family care. The total score of disease burden was 7.39±1.15, indicating a severe disease burden. Pearson correlation analysis showed that the total score and dimensions of death anxiety were positively correlated with psychological stress and disease burden (P<0.05), while the total score and dimensions of death anxiety were negatively correlated with the total score of family care (P<0.05). Multiple linear regression analysis showed that religious belief, children′s situation, symptom burden, psychological stress, and family care were the influencing factors of death anxiety in patients with advanced primary liver cancer (P<0.05). Conclusion: The high level of death anxiety in advanced primary liver cancer patients is closely related to psychological stress and family care. Religious belief, children′s condition, symptom burden, psychological stress and family care as risk factors affecting the level of death anxiety should be paid attention to during clinical intervention.

Key words: Advanced primary liver cancer, Death anxiety, Psychological stress, Family care；Symptom burden

摘要： 目的：探讨晚期原发性肝癌患者死亡焦虑现状，并分析其影响因素，为晚期原发性肝癌患者的临终关怀提供参考。方法：采取便利抽样法，选取2022年1月至2023年5月收治的晚期原发性肝癌190例患者为研究对象，采用一般资料调查表、死亡焦虑量表、心理应激量表、家庭关怀量表及疾病负担量表进行调查，采用Pearson相关分析死亡焦虑与心理应激、家庭关怀及症状负担的相关性，采用多元线性回归分析影响死亡焦虑水平的因素。结果：晚期原发性肝癌患者死亡焦虑量表得分为（7.79±1.57）分，处于高死亡焦虑水平；心理应激得分为（92.73±11.33）分，处于高心理应激水平状态；家庭关怀水平得分为（2.54±0.36）分，严重缺乏家庭关怀；症状负担总分为（7.39±1.15）分，为重度症状负担；死亡焦虑总分及各维度与心理应激各维度及总分、症状负担呈正相关（P＜0.05），与家庭关怀总分呈负相关（P＜0.05）；多元线性回归分析结果显示，宗教信仰、子女情况、心理应激、家庭关怀及症状负担是晚期原发性肝癌患者死亡焦虑的影响因素（P<0.05）。结论：晚期原发性肝癌患者死亡焦虑水平较高，宗教信仰、子女情况、心理应激、家庭关怀度以及症状负担是影响死亡焦虑水平的因素，临床应采取针对性干预以降低其死亡焦虑水平。

关键词: 晚期原发性肝癌, 死亡焦虑, 心理应激, 家庭关怀, 症状负担