Association between Bereaved Families' Sense of Security and Their Experience of Death in Cancer Patients: Cross-Sectional Population-Based Study

Context 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. Objectives The aim was to examine associations between end-of-life care and sense of security regarding regional cancer care among bereaved families. Methods A cross-sectional population-based survey was conducted with families of cancer patients who died in regional areas of Japan. Results 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. Conclusion 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.