Psychological Distress among Caregivers for Patients Who Die of Cancer: A Preliminary Study in Japan

Background: In Japan, little is known of the severity of and factors associated with psychological distress among caregivers of patients with advanced or recurrent cancer who die. Methods: This prospective cohort study of cancer patients at the National Cancer Center Hospital East, Japan, and their...

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Veröffentlicht in:Journal of Nippon Medical School 2022/08/25, Vol.89(4), pp.428-435
Hauptverfasser: Asai, Mariko, Matsumoto, Yoshihisa, Miura, Tomofumi, Hasuo, Hideaki, Maeda, Isseki, Ogawa, Asao, Morita, Tatsuya, Uchitomi, Yosuke, Kinoshita, Hiroya
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container_end_page 435
container_issue 4
container_start_page 428
container_title Journal of Nippon Medical School
container_volume 89
creator Asai, Mariko
Matsumoto, Yoshihisa
Miura, Tomofumi
Hasuo, Hideaki
Maeda, Isseki
Ogawa, Asao
Morita, Tatsuya
Uchitomi, Yosuke
Kinoshita, Hiroya
description Background: In Japan, little is known of the severity of and factors associated with psychological distress among caregivers of patients with advanced or recurrent cancer who die. Methods: This prospective cohort study of cancer patients at the National Cancer Center Hospital East, Japan, and their caregivers followed the participants from the initial palliative care consultation (T1) to 6 months (T2) and 13 months (T3) after the patient's death. At T1, patients and caregivers were interviewed separately. After T1, telephone interviews were conducted periodically, and a mail survey was distributed at T2 and T3. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depression, and the Distress and Impact Thermometer (DIT) was used to screen for psychological distress. Items on end-of-life attitudes, including awareness, discussion, and willingness of cancer care and death, were developed. Results: Thirty-one of 86 eligible pairs participated in this study. The participation rate was low (36%) and enrollment was thus halted. Data were collected up to T3 for 22 pairs (completion rate 71%). PHQ-9 scores at T2 and T3 were higher than at T1, but the difference was not significant (p = 0.07). PHQ-9 score at T3 was significantly associated with caregiver PHQ-9 and distress at T1, with patient distress and impact at T1, and with caregiver health problems at T2. Conclusions: Caregiver depression persisted up to 13 months after the patient's death, which suggests that pre-bereavement screening with the DIT might be useful. The present paired enrollment process requires improvement.
doi_str_mv 10.1272/jnms.JNMS.2022_89-410
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Methods: This prospective cohort study of cancer patients at the National Cancer Center Hospital East, Japan, and their caregivers followed the participants from the initial palliative care consultation (T1) to 6 months (T2) and 13 months (T3) after the patient's death. At T1, patients and caregivers were interviewed separately. After T1, telephone interviews were conducted periodically, and a mail survey was distributed at T2 and T3. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depression, and the Distress and Impact Thermometer (DIT) was used to screen for psychological distress. Items on end-of-life attitudes, including awareness, discussion, and willingness of cancer care and death, were developed. Results: Thirty-one of 86 eligible pairs participated in this study. The participation rate was low (36%) and enrollment was thus halted. Data were collected up to T3 for 22 pairs (completion rate 71%). PHQ-9 scores at T2 and T3 were higher than at T1, but the difference was not significant (p = 0.07). PHQ-9 score at T3 was significantly associated with caregiver PHQ-9 and distress at T1, with patient distress and impact at T1, and with caregiver health problems at T2. Conclusions: Caregiver depression persisted up to 13 months after the patient's death, which suggests that pre-bereavement screening with the DIT might be useful. The present paired enrollment process requires improvement.</description><identifier>ISSN: 1345-4676</identifier><identifier>EISSN: 1347-3409</identifier><identifier>DOI: 10.1272/jnms.JNMS.2022_89-410</identifier><language>eng</language><publisher>The Medical Association of Nippon Medical School</publisher><subject>cancer patient ; caregiver ; post-bereavement ; prospective cohort study ; psychological distress</subject><ispartof>Journal of Nippon Medical School, 2022/08/25, Vol.89(4), pp.428-435</ispartof><rights>2022 by the Medical Association of Nippon Medical School</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c604t-d3546548688bfd65e6534966ff0437c502f380d895f561366ac1de9f8da6c8b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1876,27903,27904</link.rule.ids></links><search><creatorcontrib>Asai, Mariko</creatorcontrib><creatorcontrib>Matsumoto, Yoshihisa</creatorcontrib><creatorcontrib>Miura, Tomofumi</creatorcontrib><creatorcontrib>Hasuo, Hideaki</creatorcontrib><creatorcontrib>Maeda, Isseki</creatorcontrib><creatorcontrib>Ogawa, Asao</creatorcontrib><creatorcontrib>Morita, Tatsuya</creatorcontrib><creatorcontrib>Uchitomi, Yosuke</creatorcontrib><creatorcontrib>Kinoshita, Hiroya</creatorcontrib><creatorcontrib>Department of Palliative Medicine</creatorcontrib><creatorcontrib>Department of Psychosomatic Medicine</creatorcontrib><creatorcontrib>Teikyo Heisei University</creatorcontrib><creatorcontrib>Psycho-Oncology Division</creatorcontrib><creatorcontrib>Department of Medical Psychology</creatorcontrib><creatorcontrib>National Cancer Center Hospital</creatorcontrib><creatorcontrib>National Cancer Center Hospital East</creatorcontrib><creatorcontrib>Nippon Medical School</creatorcontrib><creatorcontrib>Palliative and Supportive Care</creatorcontrib><creatorcontrib>National Cancer Center</creatorcontrib><creatorcontrib>Department of Palliative Care</creatorcontrib><creatorcontrib>Senri-Chuo Hospital</creatorcontrib><creatorcontrib>Graduate School of Clinical Psychology</creatorcontrib><creatorcontrib>Institute for Cancer Control</creatorcontrib><creatorcontrib>Tokatsu Hospital</creatorcontrib><creatorcontrib>Seirei Mikatahara Hospital</creatorcontrib><creatorcontrib>Kansai Medical University</creatorcontrib><title>Psychological Distress among Caregivers for Patients Who Die of Cancer: A Preliminary Study in Japan</title><title>Journal of Nippon Medical School</title><addtitle>J Nippon Med Sch</addtitle><description>Background: In Japan, little is known of the severity of and factors associated with psychological distress among caregivers of patients with advanced or recurrent cancer who die. Methods: This prospective cohort study of cancer patients at the National Cancer Center Hospital East, Japan, and their caregivers followed the participants from the initial palliative care consultation (T1) to 6 months (T2) and 13 months (T3) after the patient's death. At T1, patients and caregivers were interviewed separately. After T1, telephone interviews were conducted periodically, and a mail survey was distributed at T2 and T3. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depression, and the Distress and Impact Thermometer (DIT) was used to screen for psychological distress. Items on end-of-life attitudes, including awareness, discussion, and willingness of cancer care and death, were developed. Results: Thirty-one of 86 eligible pairs participated in this study. The participation rate was low (36%) and enrollment was thus halted. Data were collected up to T3 for 22 pairs (completion rate 71%). PHQ-9 scores at T2 and T3 were higher than at T1, but the difference was not significant (p = 0.07). PHQ-9 score at T3 was significantly associated with caregiver PHQ-9 and distress at T1, with patient distress and impact at T1, and with caregiver health problems at T2. Conclusions: Caregiver depression persisted up to 13 months after the patient's death, which suggests that pre-bereavement screening with the DIT might be useful. The present paired enrollment process requires improvement.</description><subject>cancer patient</subject><subject>caregiver</subject><subject>post-bereavement</subject><subject>prospective cohort study</subject><subject>psychological distress</subject><issn>1345-4676</issn><issn>1347-3409</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNpdkEtv1DAQxyMEUkvhI1TykUuWSfyIw61aoPRBu1IrcbRcZ7zrKLEXOwvab4_TVD1wGfvwf8z8iuK8glVVN_Xn3o9pdX3382FVQ10r2ZasgjfFaUVZU1IG7dvnPy-ZaMRJ8T6lHoBSzsVp0W3S0ezCELbO6IF8dWmKmBLRY_BbstYRt-4PxkRsiGSjJ4d-SuTXLmQpkmCzxBuMX8gF2UQc3Oi8jkfyMB26I3GeXOu99h-Kd1YPCT--vGfF4_dvj-sf5e395dX64rY0AthUdpQzwZkUUj7ZTnAUnLJWCGuB0cZwqC2V0MmWWy4qKoQ2VYetlZ0WRj7Rs-LTEruP4fcB06RGlwwOg_YYDknVDTSykayVWcoXqYkhpYhW7aMb8-aqAjVDVTNUNUNVL1BVhpp9l4tvxG4GFvzgPKo-HKLPlynzt-rD7Hw2AcgWmIKcCayWeeQLgUvW1DnpZknq06S3-Nqv4-TMgEv_3DqP__d4VZmdjgo9_QeSPp1M</recordid><startdate>20220825</startdate><enddate>20220825</enddate><creator>Asai, Mariko</creator><creator>Matsumoto, Yoshihisa</creator><creator>Miura, Tomofumi</creator><creator>Hasuo, Hideaki</creator><creator>Maeda, Isseki</creator><creator>Ogawa, Asao</creator><creator>Morita, Tatsuya</creator><creator>Uchitomi, Yosuke</creator><creator>Kinoshita, Hiroya</creator><general>The Medical Association of Nippon Medical School</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20220825</creationdate><title>Psychological Distress among Caregivers for Patients Who Die of Cancer: A Preliminary Study in Japan</title><author>Asai, Mariko ; Matsumoto, Yoshihisa ; Miura, Tomofumi ; Hasuo, Hideaki ; Maeda, Isseki ; Ogawa, Asao ; Morita, Tatsuya ; Uchitomi, Yosuke ; Kinoshita, Hiroya</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c604t-d3546548688bfd65e6534966ff0437c502f380d895f561366ac1de9f8da6c8b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>cancer patient</topic><topic>caregiver</topic><topic>post-bereavement</topic><topic>prospective cohort study</topic><topic>psychological distress</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Asai, Mariko</creatorcontrib><creatorcontrib>Matsumoto, Yoshihisa</creatorcontrib><creatorcontrib>Miura, Tomofumi</creatorcontrib><creatorcontrib>Hasuo, Hideaki</creatorcontrib><creatorcontrib>Maeda, Isseki</creatorcontrib><creatorcontrib>Ogawa, Asao</creatorcontrib><creatorcontrib>Morita, Tatsuya</creatorcontrib><creatorcontrib>Uchitomi, Yosuke</creatorcontrib><creatorcontrib>Kinoshita, Hiroya</creatorcontrib><creatorcontrib>Department of Palliative Medicine</creatorcontrib><creatorcontrib>Department of Psychosomatic Medicine</creatorcontrib><creatorcontrib>Teikyo Heisei University</creatorcontrib><creatorcontrib>Psycho-Oncology Division</creatorcontrib><creatorcontrib>Department of Medical Psychology</creatorcontrib><creatorcontrib>National Cancer Center Hospital</creatorcontrib><creatorcontrib>National Cancer Center Hospital East</creatorcontrib><creatorcontrib>Nippon Medical School</creatorcontrib><creatorcontrib>Palliative and Supportive Care</creatorcontrib><creatorcontrib>National Cancer Center</creatorcontrib><creatorcontrib>Department of Palliative Care</creatorcontrib><creatorcontrib>Senri-Chuo Hospital</creatorcontrib><creatorcontrib>Graduate School of Clinical Psychology</creatorcontrib><creatorcontrib>Institute for Cancer Control</creatorcontrib><creatorcontrib>Tokatsu Hospital</creatorcontrib><creatorcontrib>Seirei Mikatahara Hospital</creatorcontrib><creatorcontrib>Kansai Medical University</creatorcontrib><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of Nippon Medical School</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Asai, Mariko</au><au>Matsumoto, Yoshihisa</au><au>Miura, Tomofumi</au><au>Hasuo, Hideaki</au><au>Maeda, Isseki</au><au>Ogawa, Asao</au><au>Morita, Tatsuya</au><au>Uchitomi, Yosuke</au><au>Kinoshita, Hiroya</au><aucorp>Department of Palliative Medicine</aucorp><aucorp>Department of Psychosomatic Medicine</aucorp><aucorp>Teikyo Heisei University</aucorp><aucorp>Psycho-Oncology Division</aucorp><aucorp>Department of Medical Psychology</aucorp><aucorp>National Cancer Center Hospital</aucorp><aucorp>National Cancer Center Hospital East</aucorp><aucorp>Nippon Medical School</aucorp><aucorp>Palliative and Supportive Care</aucorp><aucorp>National Cancer Center</aucorp><aucorp>Department of Palliative Care</aucorp><aucorp>Senri-Chuo Hospital</aucorp><aucorp>Graduate School of Clinical Psychology</aucorp><aucorp>Institute for Cancer Control</aucorp><aucorp>Tokatsu Hospital</aucorp><aucorp>Seirei Mikatahara Hospital</aucorp><aucorp>Kansai Medical University</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Psychological Distress among Caregivers for Patients Who Die of Cancer: A Preliminary Study in Japan</atitle><jtitle>Journal of Nippon Medical School</jtitle><addtitle>J Nippon Med Sch</addtitle><date>2022-08-25</date><risdate>2022</risdate><volume>89</volume><issue>4</issue><spage>428</spage><epage>435</epage><pages>428-435</pages><artnum>JNMS.2022_89-410</artnum><issn>1345-4676</issn><eissn>1347-3409</eissn><abstract>Background: In Japan, little is known of the severity of and factors associated with psychological distress among caregivers of patients with advanced or recurrent cancer who die. Methods: This prospective cohort study of cancer patients at the National Cancer Center Hospital East, Japan, and their caregivers followed the participants from the initial palliative care consultation (T1) to 6 months (T2) and 13 months (T3) after the patient's death. At T1, patients and caregivers were interviewed separately. After T1, telephone interviews were conducted periodically, and a mail survey was distributed at T2 and T3. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depression, and the Distress and Impact Thermometer (DIT) was used to screen for psychological distress. Items on end-of-life attitudes, including awareness, discussion, and willingness of cancer care and death, were developed. Results: Thirty-one of 86 eligible pairs participated in this study. The participation rate was low (36%) and enrollment was thus halted. Data were collected up to T3 for 22 pairs (completion rate 71%). PHQ-9 scores at T2 and T3 were higher than at T1, but the difference was not significant (p = 0.07). PHQ-9 score at T3 was significantly associated with caregiver PHQ-9 and distress at T1, with patient distress and impact at T1, and with caregiver health problems at T2. Conclusions: Caregiver depression persisted up to 13 months after the patient's death, which suggests that pre-bereavement screening with the DIT might be useful. The present paired enrollment process requires improvement.</abstract><pub>The Medical Association of Nippon Medical School</pub><doi>10.1272/jnms.JNMS.2022_89-410</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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subjects cancer patient
caregiver
post-bereavement
prospective cohort study
psychological distress
title Psychological Distress among Caregivers for Patients Who Die of Cancer: A Preliminary Study in Japan
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