Prevalence and Associated Factors of Anxiety and Depressive Symptoms Among Bereaved Family Members of Cancer Patients in Korea

Abstract

Bereaved family members of cancer patient are at risk of having psychological problems such as anxiety and depression. However, prevalence and associated factors of anxiety and depressive symptoms among this population have not been explored in Korea.We conducted a nation-wide cross-sectional questionnaire survey of 3522 bereaved family members of cancer patients who died at 44 hospice palliative care unit (HPCU) in Korea in 2012. The questionnaire comprised the Hospital Anxiety and Depression Scale (HADS) and Good Death Inventory (GDI). Deceased patient's age, sex, primary site of cancer, duration of stay at HPCU, awareness of terminal status, bereaved family member's age, sex, and relation to the deceased were collected from Korean Terminal Cancer Patients Information System.1121 returned questionnaires were analyzed (response rate, 31.8%). Using a cut-off value of 8 for HADS subscale, the prevalence of anxiety and depressive symptoms was 48.0% and 57.6%, respectively. Mean scores for HADS-A and HADS-D were 7.88 ± 4.87 and 8.91 ± 4.82, respectively. Among the bereaved, older age, being a spouse to the deceased, family members of younger patient, and negative score for a few GDI items were significantly associated with an increased risk of having anxiety or depressive symptoms in the multivariate logistic analysis.In conclusion, we noted the high prevalence of anxiety and depressive symptoms among the bereaved of cancer patients and identified associated factors for these psychological morbidities. Systematic efforts are needed to improve the mental health of the bereaved family members of cancer patients.

Bereavement stressors and psychosocial well-being of young adults following the loss of a parent – A cross-sectional survey

“…[24][25][26] Symptoms of anxiety and depression 2 to 6 months after the loss among family members have been widely recognized in the research. 24,27,28 For example, a literature review of bereavement needs after cancer, covering the years 2003 to 2013, demonstrated high levels of complicated grief, anxiety and depression; however, it was also shown that there could be meaning in loss, 25 such as a rewarding feeling of having done everything for their relative. 29 Furthermore, a meta-summary involving family members in bereavement revealed that they may experience positive feelings related to serenity, that is to say, feeling acceptance and relief, in bereavement.…”

“…118 Less symptoms of anxiety have, in addition, been demonstrated in several studies with bereaved adults. 27,28,119,120 This indicates that the experience of losing a parent to cancer in young adulthood may constitute a particular vulnerability to anxiety. In addition, the young adults' depression levels were lower compared to samples of bereaved adults.…”

“…In addition, the young adults' depression levels were lower compared to samples of bereaved adults. 27,28 It could be argued that this may be because young adults with more symptoms of depression might be less likely to attend support groups, however, in comparison with bereaved adults who participated in support groups, the depression levels in the young adults were also lower. 120 Although the depression levels were lower compared to the anxiety levels, the prevalence of depression was higher in comparison to normative scores of symptoms of depression among Swedish young adults.…”

Stress and mood of adults with moyamoya disease: A cross‐sectional study

“…A cut‐off score of >7 was used in stroke populations in Korea (Kim et al, 2011). The K‐HADS has been used for various Korean populations, such as patients with strokes (Jeong et al, 2012; Kim et al, 2011), patients newly diagnosed with gastrointestinal cancer (Chung et al, 2018), and bereaved family members of patients who died of cancer in 44 hospice palliative care units (Jho et al, 2016). Cronbach's α for the K‐HADS was determined at 0.89 and 0.86 for anxiety and depression, respectively, in a previous study (Oh et al, 1999).…”

Increased risk for hip fracture after death of a spouse—further support for bereavement frailty?

“…Bereavement, in the form of becoming a widow or widower, is a major life event associated with an increased risk for compromised physical and mental health, as well as mortality [1]. Health problems as results of bereavement may include depression, anxiety, illness, sleep disturbance, and increased intake of medications [1][2][3][4][5].…”