Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
Department of Palliative and Supportive Care, Palliative Care Team, Seirei Mikatahara General Hospital, Hamamtsu, Shizuoka, Japan.
Psychooncology. 2024 Jan;33(1):e6276. doi: 10.1002/pon.6276.
Insufficient preparedness for bereavement can affect a family's psychological health status after bereavement. However, factors associated with preparedness remain unclear. This study aimed to identify factors associated with preparedness for bereavement in families of patients with cancer.
We conducted a secondary analysis of a nationwide bereaved family survey in Japan, analyzing data from 9123 family members of patients with cancer. Logistic regression analysis was conducted to explore how sociodemographic factors, health status, and perceived care for patients and families were associated with preparedness for bereavement.
Of the 9123 families, 1338 (15.1%) were not prepared for bereavement. Factors associated with insufficient preparedness for bereavement (all p < 0.001) were found as follows: patients' spouses (OR = 2.54), receiving care in acute hospitals (OR = 1.83), worse psychological health status during caregiving (OR = 2.13), lower social support for family members (OR = 1.90), wrong patients' awareness of medical condition from family's perspective (OR = 1.75-2.12), family preference of more aggressive treatment rather than palliative care (OR = 1.71) or not sure (OR = 2.31), not wanting to know information about the patient's prognosis (OR = 1.64-1.77), end-of-life discussion with physician 1 month before patient's death (OR = 1.45), and late or early end-of-life discussions with physician and family (OR = 1.78-1.95).
This study's results might assist clinicians in assessing and identifying families who are not prepared for bereavement; however, preparedness for bereavement may have been associated with other factors.
对丧亲的准备不足可能会影响丧亲家庭的心理健康状况。然而，与准备情况相关的因素仍不清楚。本研究旨在确定与癌症患者家庭对丧亲的准备情况相关的因素。
我们对日本全国性丧亲家庭调查进行了二次分析，分析了 9123 名癌症患者家属的数据。采用 logistic 回归分析探讨了社会人口统计学因素、健康状况以及对患者和家庭的护理感知如何与对丧亲的准备情况相关。
在 9123 个家庭中，有 1338 个（15.1%）对丧亲没有准备。与准备不足相关的因素（均 p<0.001）如下：患者的配偶（OR=2.54）、在急性医院接受护理（OR=1.83）、在护理期间心理健康状况较差（OR=2.13）、家庭成员的社会支持较低（OR=1.90）、从家庭角度看患者对病情的认识有误（OR=1.75-2.12）、家庭更倾向于积极治疗而非姑息治疗（OR=1.71）或不确定（OR=2.31）、不想了解患者预后的信息（OR=1.64-1.77）、在患者死亡前 1 个月与医生进行临终讨论（OR=1.45）以及与医生和家庭的临终讨论时间较晚或较早（OR=1.78-1.95）。
本研究结果可能有助于临床医生评估和识别对丧亲没有准备的家庭；然而，对丧亲的准备情况可能与其他因素有关。
