Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Terminal delirium related distress is associated with bereaved prolonged grief disorder. (#491)

Megumi Uchida 1 2 , Tatsuo Akechi 1 2 , Tatsuya Morita 3 , Naoko Igarashi 4 , Yasuo Shima 5 , Mitsunori Miyashita 4
  1. Division of Palliative Care and Psycho-oncology, Nagoya City University Hospital, Nagoya, Aichi, Japan
  2. Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
  3. Department of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, Japan
  4. Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
  5. Department of Palliative Medicine, Tsukuba Medical Center Hospital, Tsukuba, Ibaragi, Japan

 

Aim: This study aimed to investigate the association between terminal delirium related distress assessed by bereaved family and bereaved family's depression and prolonged grief disorder.
Methods: A self-administered questionnaire was mailed to the bereaved families of cancer patients who were admitted to a hospice/palliative care ward. The questionnaire asked about age, relationship with the patient, education, physical and mental health status during the patient's last hospitalization, depression (PHQ-9), prolonged grief disorder (BGQ), terminal delirium related distress (Terminal Delirium related Distress Scale: TDDS) , whether they had accompanied the patient in the week before death, whether there was a substitute attendant, whether there was someone who listened to them, whether there was someone who care them, whether they had religion, and whether the patient became delirium. 
Results:513 bereaved returned their questionnaire (response rate: 65%). Of these, 281 bereaved (55%) reported their family member had terminal delirium. The mean (+-SD) and median age of the respondent was 59(+-12) and 59 years,
respectively. Chi-square test indicated that 1) age (59 /60), relationship (spouse or child), physical and mental health status during the patient's last hospitalization were significantly associated with bereaved depression (PHQ-9:11/10) and 2) relationship (spouse or child), physical and mental health status during the patient's last hospitalization and terminal delirium related distress (TDDS:75/76) were significantly associated with bereaved prolonged grief disorder (BGQ:9/8). A logistic regression analysis revealed that 1) relationship (spouse) and physical health state during the patient's last hospitalization were significantly associated with bereaved depression and 2) relationship (spouse or child) and terminal delirium related distress were significantly associated with bereaved prolonged grief disorder.
Conclusion: Assessing and improving the quality of treatment and care for terminal delirium may reduce prolonged grief disorder of bereaved family.