Determinants of complicated grief in caregivers who cared for terminal cancer patients

There is little research on determinants and the grief that caregivers experience after their relatives die of cancer. This study evaluated factors which influence complicated grief among caregivers who cared for patients who died of cancer in Taiwan. This prospective study recruited 668 caregivers who cared for terminally ill cancer patients in the hospice ward or who received shared-care consultation. Caregivers were interviewed on the telephone an average 8.9 months after the cancer patients passed away. The Inventory of Complicated Grief (ICG), modified for use in a Chinese population, was used to assess the grief status of caregivers. ICG > 25 was defined as complicated grief. Our study found that female gender (odds ratio (OR), 2.27; 95% confidence interval (CI), 1.75-2.82), spouse relationship (OR, 1.20; 1.01-1.40), parents-children relationship (OR, 1.70; 1.11-2.31), lack of religious belief (OR, 1.47; 1.19-1.75), unavailable family support (OR, 1.42; 1.03-1.83), and history of mood co-morbidity (OR, 1.41; 1.02-1.83) were risk factors that would predispose towards complicated grief; whereas, longer duration of caring (months, OR, 0.79; 0.69-0.91), medical disease history in the carer (OR, 0.77; 0.57-0.99), and patients being cared for on the hospice ward (OR, 0.60; 0.44-0.77) were factors that would mitigate against complicated grief. These results suggest that clinical professionals who care for terminal cancer patients and their caregivers should pay particular attention to caregivers with these predisposing factors.