Depression and complicated grief in bereaved caregivers in cardiovascular diseases: prevalence and determinants

被引:8
作者
Shinada, Keitaro [1 ]
Kohno, Takashi [1 ,2 ]
Fukuda, Keiichi [1 ]
Higashitani, Michiaki [3 ]
Kawamatsu, Naoto [4 ]
Kitai, Takeshi [5 ,6 ,7 ]
Shibata, Tatsuhiro [8 ]
Takei, Makoto [9 ]
Nochioka, Kotaro [10 ]
Nakazawa, Gaku [11 ,12 ]
Shiomi, Hiroki [13 ]
Miyashita, Mitsunori [14 ]
Mizuno, Atsushi [15 ,16 ]
机构
[1] Keio Univ, Sch Med, Div Cardiol, Tokyo, Japan
[2] Kyorin Univ, Dept Cardiovasc Med, Fac Med, Tokyo, Japan
[3] Tokyo Med Univ, Dept Cardiol, Ibaraki Med Ctr, Ibaraki, Japan
[4] Mito Saiseikai Gen Hosp, Dept Cardiol, Ibaraki, Japan
[5] Kobe City Med Ctr Gen Hosp, Dept Cardiovasc Med, Kobe, Hyogo, Japan
[6] Kobe City Med Ctr Gen Hosp, Dept Clin Res Support, Kobe, Hyogo, Japan
[7] Natl Cerebral & Cardiovasc Ctr, Dept Cardiovasc Med, Osaka, Japan
[8] Kurume Univ, Dept Internal Med, Div Cardiovasc Med, Sch Med, Fukuoka, Japan
[9] Saiseikai Cent Hosp, Dept Cardiol, Tokyo, Japan
[10] Tohoku Univ, Dept Cardiovasc Med, Grad Sch Med, Sendai, Miyagi, Japan
[11] Tokai Univ, Sch Med, Dept Cardiol, Hiratsuka, Kanagawa, Japan
[12] Kindai Univ, Dept Cardiol, Fac Med, Osaka, Japan
[13] Kyoto Univ, Dept Cardiol, Grad Sch Med, Kyoto, Japan
[14] Tohoku Univ, Dept Palliat Nursing, Hlth Sci, Grad Sch Med, Sendai, Miyagi, Japan
[15] Univ Penn, Penn Med Nudge Unit, Philadelphia, PA USA
[16] St Lukes Int Univ, Dept Cardiovasc Med, Chuo Ku, Tokyo, Japan
关键词
depression; terminal care; bereavement; end of life care; family management; heart failure; OF-LIFE CARE; FAMILY-MEMBERS; PALLIATIVE CARE; QUALITY; HEALTH; PREDICTORS; NATIONWIDE; DEATH; COMMUNICATION; INVENTORY;
D O I
10.1136/bmjspcare-2021-002998
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objectives Despite the recommendation that patients with cardiovascular disease (CVD) receive bereavement care, few studies have examined the psychological disturbances in bereaved caregivers. We examined the prevalence and determinants of depression and complicated grief among bereaved caregivers of patients with CVD. Methods We conducted a cross-sectional survey using a self-administered questionnaire for bereaved caregivers of patients with CVD who had died in the cardiology departments of nine Japanese tertiary care centres. We assessed caregiver depression and grief using the Patient Health Questionnaire-9 (PHQ-9) and Brief Grief Questionnaire (BGQ), respectively. The questionnaire also covered caregivers' perspectives toward end-of-life care and the quality of the deceased patient's death. Results A total of 269 bereaved caregivers (mean age: 66 (57-73) years; 37.5% male) of patients with CVD were enrolled. Overall, 13.4% of the bereaved caregivers had depression (PHQ-9 >= 10) and 14.1% had complicated grief (BGQ >= 8). Depression and complicated grief's determinants were similar (ie, spousal relationship, unpreparedness for the death, financial and decision-making burden and poor communication among medical staff). Patients and caregivers' positive attitudes toward life-prolonging treatment were associated with complicated grief. Notably, in caregivers with complicated grief, there was less discussion with physicians about end-of-life care. Caregivers who felt that the patients did not receive sufficient treatment suffered more frequently from depression and complicated grief. Conclusions Approximately 15% of bereaved caregivers of patients with CVD suffered from depression and complicated grief. Cardiologists should pay particular attention to caregivers with high-risk factors to identify those likely to develop depression or complicated grief.
引用
收藏
页码:e990 / e1000
页数:11
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