title: Association between quality of end-of-life care and possible complicated grief among bereaved family members.
abstract: BACKGROUND
  Little is known about the association between quality of end-of-life care of a patient and complicated grief among bereaved family members.
  
  
  OBJECTIVE
  This study aims to examine the impact of quality of end-of-life care on complicated grief among bereaved family members in a Japanese general population sample.
  
  
  METHODS
  A mail-based cross-sectional questionnaire survey was used. A total of 641 individuals aged 40 to 79 years in the general population who lost their loved one within the period between 6 months and 10 years were enrolled. Complicated grief was assessed using the Brief Grief Questionnaire, and the bereaved family members' perceptions on quality of end-of-life care were assessed using the Care Evaluation Scale and the Good Death Inventory. Logistic regression analysis was used to identify the variables that associated with possible complicated grief.
  
  
  RESULTS
  Possible complicated grief was observed in 24.5% of the participants. Three components of quality of end-of-life care, namely, dissatisfaction with the explanation to the family about the patient's expected outcome, unreasonable cost of care, and family's perception that the deceased person had not achieved a sense of completion about his or her life, were significantly associated with possible complicated grief. Spousal relationship, primary caregiver, and high psychological distress also had significant association.
  
  
  CONCLUSIONS
  Perceptions on quality of end-of-life care were significantly associated with complicated grief. Providing sufficient information to patients' family about expected outcome and enhancing patients' sense of completion about their life may prevent bereaved family members from developing complicated grief.
authors: 1 Department of Neuropsychiatry, Keio University School of Medicine , Tokyo, Japan .
authors: Kaya
authors: K
authors: Miyajima
authors: Daisuke
authors: D
authors: Fujisawa
authors: Kimio
authors: K
authors: Yoshimura
authors: Masaya
authors: M
authors: Ito
authors: Satomi
authors: S
authors: Nakajima
authors: Joichiro
authors: J
authors: Shirahase
authors: Masaru
authors: M
authors: Mimura
authors: Mitsunori
authors: M
authors: Miyashita
mesh_terms: D000328:Adult; D000368:Aged; D001601:Bereavement; D003430:Cross-Sectional Studies; D005190:Family / Q000523:psychology*; D006801:Humans; D007564:Japan; D008875:Middle Aged; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000592:standards*