Bereavement Outcomes of Family Caregivers of Terminally Ill Cancer Patients

Project: National Science and Technology CouncilNational Science and Technology Council Academic Grants

Project Details


The trend toward shortened hospital stays and home care implies that the burden of caregiving for terminally ill patients is increasingly falling on their families. Caregiving responsibilities generate competing demands that make family caregivers vulnerable to physical disease and psychological distress, hinder their social engagement, and extend into bereavement with increasing morbidity and mortality. Little is known about Taiwanese caregiver's responses to the death of cancer patients and there has been scant research into the impact of caregiving on bereavement outcome. Although in general, family members who are heavily involved in caregiving before death show remarkable resilience in adapting to the death of their relatives, recently, researchers characterize delayed and prolonged bereavement as complicated grief. In addition, literature provides inconsistent support for the trajectory of bereavement. Therefore, it is urgent to conduct systematic analysis of the trajectory of bereavement and factors contributing to bereavement outcome for Taiwanese family caregivers of terminally ill cancer patients. The specific aims of this study are to: (1) examine the emotional adjustment and grief intensity of bereaved caregivers from pre-bereavement through the first two years after the death to explore the pattern of changes in grief intensity and mental health over time; (2) compare the effects of caregiving and other factors that may influence bereavement outcome between caregivers with and without complicated grief to identify predictors of complicated grief; and (3) investigate the impact of complicated grief on subsequent mental health. A 3-year prospective, longitudinal and descriptive study will be conducted. 222 family caregivers of terminally ill cancer patients will be recruited by a convenience sampling strategy. Several well-established instruments, including CRA, MOS Social Support Survey, CES-D, Sense of Coherence Scale, Inventory of Complicated Grief, and Mental Health Inventory will be used to measure potential predictors of bereavement outcome, emotional adjustment, and grief intensity. Family caregivers will be interviewed at a two-week interval until the death of the patient. Bereavement assessments will be made at 1, 3, 6, 13, 18, and 24 months after the death. Generalized estimating equation model will be conducted to examine the pattern of changes of grief intensity and mental health over time. Multivariate logistic regression will be conducted to identify predictors of complicated grief among bereaved family caregivers. Hierarchical multiple regression analysis will be used to explore the contribution of complicated grief experienced at the sixth month after the death of care-recipient on mental health at subsequent time points after controlling for the other potential predictors of bereavement outcome. Results from this study may enlighten health care professionals about the longitudinal challenges or difficulties inherent in adjusting the loss of a loved one for family caregivers of terminally ill cancer patients. Findings from this study also shed light on factors that may facilitate or impede bereavement adjustment. These insights may lay the groundwork for tailoring effective clinical interventions to help family caregivers of terminally ill cancer patients retain control, find meaning in bereavement, minimize short and long-term negative impact of bereavement, and achieve the highest quality of life.

Project IDs

Project ID:PC9706-0964
External Project ID:NSC96-2314-B182-029-MY2
Effective start/end date01/08/0831/07/09


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