Objectives/purpose
Preparing for death in families of patients with cancer is important for better psychological health after bereavement. However, reasons why families evaluate their preparedness as sufficient or insufficient remain unclear. This study aimed to determine how families of patients with cancer perceive their preparedness for the death of a loved one.
Sample and setting
An exploratory sequential mixed-methods study was conducted. In Phase 1, ten medical staffs (physicians, nurses, and psycologists) engaged in cancer treatment and 20 bereaved family members were interviewed. In Phase 2, a web-based survey was conducted with 610 bereaved families across Japan.
Procedures
Phase 1 involved semi-structured interviews analyzed using qualitative content analysis. Insights from these interviews informed the development of a questionnaire for Phase 2. Quantitative validation included exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) based on the factors identified from Phase 1.
Results
Six key categories of perceived preparedness emerged: 1) Understanding and accepting imminent death, 2) Imagining life after the loved one’s death, 3) Acting in anticipation of death, 4) Realizing the sadness and pain of loss, 5) Experiencing feelings that cannot be realized beforehand, 6) Emotional fluctuation based on the patient’s and family’s conditions. A confirmatory factor analysis, based on the qualitative findings, showed acceptable model fit: Goodness-of-Fit Index (GFI) = 0.88 and Adjusted Goodness-of-Fit Index (AGFI) = 0.89.
Conclusion and clinical implications
Families perceive preparedness as involving both cognitive acceptance and emotional struggle. Healthcare providers should assess preparedness across these dimensions and offer support that addresses emotional, informational, and practical needs to facilitate grieving process.