The impact of resilience on psychological distress before and after bereavement in family caregivers of patients in palliative care units

2022 Fiscal Year Final Research Report

• Project/Area Number: 17K17460
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Clinical nursing
• Research Institution: National Center for Global Health and Medicine (2022); National Cancer Center Japan (2017-2021)
• Principal Investigator: Shimizu Yoichi 国立研究開発法人国立国際医療研究センター, 国立看護大学校, 講師 (50791935)
• Project Period (FY): 2017-04-01 – 2023-03-31
• Keywords: レジリエンス / 抑うつ / 緩和ケア / 家族介護者 / 遺族 / 悲嘆

Outline of Final Research Achievements

We conducted the self-reported questionnaire survey for family caregivers of patients with terminally ill cancer in four palliative care wards to determine whether their pre-loss resilience affects changes in depression before and after bereavement, complexity grief, and posttraumatic growth after bereavement. Data were obtained from 291 family caregivers at the pre-loss time. Subsequently, we conducted a survey of bereaved family members in the same facilities. Among them, 71 were able to link their data before and after bereavement. The proportion of family caregivers with a high risk for major depressive disorder was 47.0% before bereavement and 15.2% after bereavement. Their pre-loss resilience was suggested to contribute to the improvement of depressive symptoms before and after bereavement. On the other hand, it was suggested that it had no effect on complex grieving or posttraumatic growth after bereavement.

Free Research Field

緩和ケア看護

Academic Significance and Societal Importance of the Research Achievements

死別後に家族介護者の10％～20％が大うつ病や複雑性悲嘆のリスクが高い状態となることが知られている。死別に伴い医療機関にかかる機会が減ることで、抑うつの遷延や複雑性悲嘆のリスクが高い家族に対して支援につなげることができていないことが問題となっている。本研究によりレジリエンスが低い家族介護者は死別後にうつ症状が遷延する可能性が高いことが明らかになったため、死別前のレジリエンスの高さは支援が必要な家族介護者を死別前に同定する際に有用な情報であることが分かった。これにより支援が必要な家族介護者に適切な支援を届けることにつながる可能性がある。