Caregiver bereavement outcomes in advanced cancer: associations with quality of death and patient age
Menée au Canada auprès de 157 aidants d'un patient décédé d'un cancer de stade avancé, cette étude analyse l'association entre la préparation à la fin de vie, les symptômes et l'âge du patient, et la détresse psychique de l'aidant lors du processus de deuil
Purpose : We investigated relationships between domains of quality of dying and death in patients with advanced cancer and their caregivers’ bereavement outcomes and the moderating effect of patient age at death. Methods : Bereaved caregivers of deceased patients with advanced cancer who had participated in an early palliative care trial completed measures of grief (Texas Revised Inventory of Grief [TRIG]), complicated grief (Prolonged Grief Inventory [PG-13]), and depression (Center for Epidemiologic Studies-Depression [CESD-10]). They also completed the Quality of Dying and Death measure (QODD), which assesses patients’ symptom control, preparation for death, connectedness with loved ones, and sense of peace with death. Results : A total of 157 bereaved caregivers completed the study. When patient age × QODD subscale interactions were included, greater death preparation was related to less grief at patient death (past TRIG:
β
= − .25, p = .04), less current grief (present TRIG:
β
= − .26, p = .03), less complicated grief (PG-13:
β
= − .37, p = .001), and less depression (CESD-10:
β
= − .35, p = .005). Greater symptom control was related to less current grief (present TRIG:
β
= − .27, p = .02), less complicated grief (PG-13:
β
= − .24, p = .03), and less depression (CESD-10:
β
= − .29, p = .01). Significant patient age × connectedness interaction effects for current grief (present TRIG:
β
= .30, p = .02) and complicated grief (PG-13:
β
= .29, p = .007) indicated that, with less connectedness, younger patient age at death was associated with greater caregiver grief. Conclusion : Better end-of-life death preparation and symptom control for patients with cancer may attenuate later caregiver grief and depression. Less connectedness between younger patients and their families may adversely affect caregiver grief.