Depression and Complicated Grief, and Associated Factors, of Bereaved Family Members of Patients Who Died of Malignant Pleural Mesothelioma in Japan

Abstract

Objectives: we investigated the prevalence and associated factors of depression and complicated grief (CG) among bereaved family members of malignant pleural mesothelioma (MPM) patients in Japan. Methods: Bereaved family members of MPM patients (n = 72) were surveyed. The Japanese version of the Patient Health Questionnaire-9 (PHQ-9) and the Japanese version of the Brief Grief Questionnaire (BGQ) were used to assess depression and complicated grief (CG), respectively. Socio-economic factors, anger toward asbestos, care satisfaction, achievement of good death, and quality of end-of-life care were assessed in relation to depression and CG. Results: In the family members of MPM patients, the frequencies of depression and CG were 19.4% and 15.3%, respectively. The bereaved family members who were not compensated by the asbestos-related health-damage relief system (p = 0.018) and who felt the financial impacts of the patient’s MPM on the family (p = 0.006) had a higher likelihood of depression. The bereaved family members who were not satisfied with the care given when the patient became critical (p = 0.034), who were not compensated by the asbestos-related health-damage relief system (p = 0.020), who felt the financial impact of the patient’s MPM on the family (p = 0.016), and whose deceased relative underwent surgery (p = 0.030) had a higher likelihood of CG. Conclusions: For bereaved family members of MPM patients, routine screening for depression and CG and the provision of grief care are suggested. In addition, for family members of MPM patients, financial support, including the promotion of the asbestos-related health-damage relief system, and improved care for patients who undergo surgery and when patients become critical, are recommended.

67 The mental health and well-being implications of a mesothelioma diagnosis: a mixed methods study

“…This should cover exploring barriers to access and the type/effectiveness of interventions, including whether these are trauma-informed. The need for further multi-site research on complicated grief after the death of a loved one from mesothelioma has been recommended (Nagamatsu et al, 2022), and we echo this in the European context. Lastly, the issue of scanxiety in mesothelioma has not yet been explored, despite being a key concern of patients and carers.…”

“…Our finding that carers had worse depression than patients chimes with Moore et al's (2023) study, which indicated 74% of carers for mesothelioma patients were at risk of depression, linked to the burden of caregiving plus impacts on their own physical health and employment. A recent study of depression and complicated grief in family members of mesothelioma patients, Nagamatsu et al (2022) reported that 19% of participants had depression, with higher scores for those who had not received financial compensation. Complicated grief (intense grief lasting longer than usual and causing impairment in daily functioning) was more likely in those who did not receive compensation, who's relative had surgery, and who were dissatisfied with their care when critically ill.…”

“…The devastation and shock often experienced from receiving this diagnosis have been emphasised (Lond et al, 2022;Taylor et al, 2019). Depression has been reported across cultures (Demirjian et al, 2024;Nagamatsu et al, 2022). Traumatic stress symptoms (TSS) have also been reported by participants living with mesothelioma (Dooley et al, 2010;Bonafede et al, 2020).…”

Psychological interventions for mesothelioma patients and their caregivers

“…In terms of the experience of MM specifically, the poor prognosis, reduced effectiveness of treatments, occupational etiology, poor quality of life for those in the latter stages of the disease, and advanced age at diagnosis exacerbate the psychological impact and make the experiences of individuals and family members even more problematic (Bonafede et al, 2020;Demirjian et al, 2024;Nagamatsu et al, 2022;Warby et al, 2019). Both patients and their families may experience somatic and psychosomatic symptoms, impaired quality of life, anxiety, depression, fear, and mistrust as well as post-traumatic symptoms (Bonafede et al, 2022;Demirjian et al, 2024;Gonzalez-Ling et al, 2023;Nagamatsu et al, 2022).…”

“…In terms of the experience of MM specifically, the poor prognosis, reduced effectiveness of treatments, occupational etiology, poor quality of life for those in the latter stages of the disease, and advanced age at diagnosis exacerbate the psychological impact and make the experiences of individuals and family members even more problematic (Bonafede et al, 2020;Demirjian et al, 2024;Nagamatsu et al, 2022;Warby et al, 2019). Both patients and their families may experience somatic and psychosomatic symptoms, impaired quality of life, anxiety, depression, fear, and mistrust as well as post-traumatic symptoms (Bonafede et al, 2022;Demirjian et al, 2024;Gonzalez-Ling et al, 2023;Nagamatsu et al, 2022). We strongly believe that an interdisciplinary approach to the treatment of MM is fundamental to restore and promote in both patients and caregivers the ability to tolerate, symbolize, mentalize and narrate the traumatic effects of the disease, but also the vital aspects that live on in them and in their relationships (Granieri et al, 2018).…”