title: Association Between Bereaved Families' Sense of Security and Their Experience of Death in Cancer Patients: Cross-Sectional Population-Based Study.
abstract: The sense of security scale was developed to indicate care quality within the community. Bereaved families have perspective to evaluate the quality of the care system.
  
  
  
  The aim was to examine associations between end-of-life care and sense of security regarding regional cancer care among bereaved families.
  
  
  
  A cross-sectional population-based survey was conducted with families of cancer patients who died in regional areas of Japan.
  
  
  
  A total of 1046 family caregivers of patients responded to surveys (effective response rate of 65%). In multiple regression analyses, the families' higher age (P < 0.001), home death (P = 0.039), better health status of the family at patients' end of life (P = 0.016), lower caregiving burden (P < 0.001), and elements of perceived good patient death, including being free from physical distress (P < 0.001), trusting the physician (P < 0.001), living in calm circumstances (P = 0.042), and feeling that one's life was fulfilling (P = 0.035), were associated with a higher sense of security.
  
  
  
  Quality of death and lower burden on family caregivers were associated with families' sense of security. This suggests strategies for improving care quality for each patient to improve the sense of security.
authors.affiliation: Division of Health Sciences & Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. Electronic address: igarashi-a@umin.ac.jp.
authors.forename: Ayumi
authors.initials: A
authors.lastname: Igarashi
authors.affiliation: Department of Palliative Nursing, Health Sciences, Graduate School of Tohoku University, Sendai, Japan.
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Miyashita
authors.affiliation: Department of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Morita
authors.affiliation: Psycho-Oncology Division, Chiba Cancer Center, Chiba, Japan.
authors.forename: Nobuya
authors.initials: N
authors.lastname: Akizuki
authors.affiliation: Faculty of Environment and Information Studies, Keio University, Tokyo, Japan.
authors.forename: Miki
authors.initials: M
authors.lastname: Akiyama
authors.affiliation: Shirahige Clinic, Nagasaki, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Shirahige
authors.affiliation: Department of Palliative Nursing, Health Sciences, Graduate School of Tohoku University, Sendai, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Sato
authors.affiliation: Division of Health Sciences & Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Yamamoto-Mitani
authors.affiliation: Department of Internal Medicine and Medical Oncology, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Eguchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D001601:Bereavement; D003430:Cross-Sectional Studies; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality* / Q000628:therapy*; D010166:Palliative Care / Q000523:psychology; D011787:Quality of Health Care; D012044:Regression Analysis; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000523:psychology*; D055815:Young Adult
keywords: Sense of security; end-of-life care; experience of bereaved family; quality of care; regional health care system