title: Psychological states and coping strategies after bereavement among spouses of cancer patients: a quantitative study in Japan.
abstract: OBJECTIVE
  The purposes of this study were (1) to characterize psychological states and coping strategies after bereavement among spouses of cancer patients in Japan and (2) to explore the factors associated with psychological states in oncology settings.
  
  
  METHODS
  In March 2009, questionnaires to assess spouses' psychological states, coping strategies, and mental health states (GHQ-28) were sent after patients died at the National Cancer Center of Japan. To address the first purpose, exploratory factor analysis, gender comparison, and calculation of correlation with age, time since bereavement, and mental health states were conducted. Hierarchical regression analysis was conducted to address the second purpose.
  
  
  RESULTS
  A total of 821 spouses experiencing bereavement for 7 months to 7 years participated in the study. Psychological states revealed three factor structures: "Anxiety/Depression/Anger", "Yearning", and "Acceptance/Future-Oriented Feelings". Coping strategies also revealed three factor structures: "Distraction", "Continuing Bonds", and "Social Sharing/Reconstruction". Coping strategies represented 18 % to 34 % of each factor associated with psychological states, whereas the characteristics of bereaved spouses and deceased patients represented 6 % and less than 6 %, respectively. More "Distraction and Social Sharing/Reconstruction" and less "Continuing Bonds" were significantly associated coping strategies for achieving "Acceptance/Future-Oriented Feelings" (p < 0.01).
  
  
  CONCLUSIONS
  Both psychological states and coping strategies after bereavement revealed three factor structures. Coping strategies was the primary, bereaved spouses' characteristics was the secondary, and deceased patients' characteristics was the tertiary factor associated with psychological states. Enhancing "Distraction" and "Social Sharing/Reconstruction", and reducing "Continuing Bonds" might be promising strategies for achieving positive psychological states of the bereaved.
authors.affiliation: Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan. m.asai@thu.ac.jp
authors.forename: Mariko
authors.initials: M
authors.lastname: Asai
authors.forename: Nobuya
authors.initials: N
authors.lastname: Akizuki
authors.forename: Maiko
authors.initials: M
authors.lastname: Fujimori
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Matsui
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Itoh
authors.forename: Masafumi
authors.initials: M
authors.lastname: Ikeda
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Hayashi
authors.forename: Taira
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ohtsu
authors.forename: Kanji
authors.initials: K
authors.lastname: Nagai
authors.forename: Hiroya
authors.initials: H
authors.lastname: Kinoshita
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Uchitomi
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000786:Anger; D001007:Anxiety / Q000523:psychology; D001601:Bereavement; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D012044:Regression Analysis; D012944:Social Support; D018454:Spouses / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires