The relationship between cancer patients' place of death and bereaved caregivers' mental health status

Yutaka Hatano, Maho Aoyama, Tatsuya Morita, Takuhiro Yamaguchi, Isseki Maeda, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

Background: Although place of death has been recognized as a risk factor in caregivers' bereavement adjustment, the estimation of the effect of the place of death needs careful consideration about many potential cofounders. Patients and methods: This study was a nationwide cross-sectional questionnaire survey for bereaved family caregivers of patients with cancer who died in 3 settings: (1) hospice at home; (2) palliative care units (PCUs); and (3) acute hospitals. We assessed bereaved caregivers' depression, grief, insomnia, and the quality of dying of deceased patients across the 3 groups using propensity score weighting. Results: A total of 8968 responses were analyzed. According to scores on Patient Health Questionnaire 9, depressive symptoms were significantly higher in bereaved caregivers of patients who had died in acute hospitals (5.7; 95% confidence interval [CI]: 5.3-6.2) than for those of patients who had died in hospice at home (4.8; 95% CI: 4.4-5.1) or PCU (5.1; 95% CI: 5.0-5.2). Grief symptoms measured by Brief Grief Questionnaire were also significantly higher in caregivers of patients who had died in acute hospitals (5.0; 95% CI: 4.8-5.2) than those of patients who had died in hospice at home (4.7; 95% CI: 4.5-4.9) or PCU (4.7; 95% CI: 4.7-4.8). Deceased patients' quality of dying was highest in hospice at home, and worst in acute hospital. Conclusions: The place where a cancer patient dies influences not only their quality of dying and death but also the mental health of their family caregivers. However, the absolute difference is not large after adjustment of multiple variables.

Original languageEnglish
Pages (from-to)1959-1964
Number of pages6
JournalPsycho-Oncology
Volume26
Issue number11
DOIs
Publication statusPublished - 2017 Nov

Keywords

  • bereavement
  • cancer
  • caregiver
  • oncology
  • place of death
  • propensity score
  • quality of death and dying

ASJC Scopus subject areas

  • Experimental and Cognitive Psychology
  • Oncology
  • Psychiatry and Mental health

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