Regional Differences in Quality of Care at Palliative Care Units (PCUs), and Complicated Grief and Depression of Bereaved Family Members: Results from a Nationwide Bereavement Survey in Japan

Abstract

Our aim of this study was to explore regional differences in the quality of end-of-life care, and complicated grief and depression among bereaved family members. This study was a secondary analysis of combined data from two previous nationwide bereaved family surveys. We used following data for analysis; demographic characteristics, scales to evaluate the quality of perceived care (Care Evaluation Scales: CES), patient’s achievement of a good death (Good Death Inventory: GDI), bereaved family member’s grief (Brief Grief Questionnaire: BGQ), and depression (Patient Health Questionnaire: PHQ-9). We compared the total score adjusted with demographic characteristics of each scale by region (reference=Kanto region). The Kyusyu-Okinawa region was significantly higher compared to the Kanto region for CES, and GDI (both p<0.05). The Chubu region, the Kinki region, the Chugoku region and Kyusyu-Okinawa region were significantly lower compared to the Kanto region for BGQ (all p<.005). Significant difference in region was not observed for PHQ-9 after adjustment. Despite the significant difference observed among regions, that effect size was small. The present study reports that there were few regional differences in the quality of perceived palliative care.