Journal of adolescent and young adult oncology · 2026
Quality of End-of-Life Care for Adolescent and Young Adult Patients with Cancer and Depression and Grief in Bereaved Families: A Secondary Analysis.
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Miyashita Mitsunori, Fu Anni, Ito Satomi, Dong Lei, Nakazawa Yoko, Mori Masanori, Shimizu Chikako
Аннотация
BACKGROUND: Adolescent and young adult (AYA) patients with cancer face numerous challenges, particularly at the end-of-life. However, little is known about how the patients and their families experience end-of-life care.
OBJECTIVE: We aimed to compare the quality of end-of-life palliative care and the levels of depression and grief among bereaved families of AYAs and middle-aged patients with cancer, and to identify associated factors.
METHODS: We conducted a secondary analysis of a nationwide mortality follow-back survey based on death certificates of patients who died from cancer in 2017 and 2018. Subjects were classified into two groups AYA (aged 20-39 years) and the middle-aged (aged 40-64 years). End-of-life quality was evaluated using the Care Evaluation Scale, Good Death Inventory, and Memorial Symptom Assessment Scale. Depression and grief levels among bereaved family members were also evaluated.
RESULTS: We analyzed 261 and 5790 bereaved families from the AYA and middle-aged groups, respectively. While the quality of end-of-life palliative care did not differ clinically significantly between the AYA and middle-aged group, the levels of grief and depression were significantly higher in the AYA compared with the middle-aged group (Effect Size [ES] = 0.57, p < 0.0001; ES = 0.22, p = 0.001, respectively).
CONCLUSION: Although end-of-life care quality was comparable between AYAs and middle-aged patients, bereaved families of AYA patients experienced significantly greater grief and depression. These findings underscore the need for tailored bereavement support for AYA families.
OBJECTIVE: We aimed to compare the quality of end-of-life palliative care and the levels of depression and grief among bereaved families of AYAs and middle-aged patients with cancer, and to identify associated factors.
METHODS: We conducted a secondary analysis of a nationwide mortality follow-back survey based on death certificates of patients who died from cancer in 2017 and 2018. Subjects were classified into two groups AYA (aged 20-39 years) and the middle-aged (aged 40-64 years). End-of-life quality was evaluated using the Care Evaluation Scale, Good Death Inventory, and Memorial Symptom Assessment Scale. Depression and grief levels among bereaved family members were also evaluated.
RESULTS: We analyzed 261 and 5790 bereaved families from the AYA and middle-aged groups, respectively. While the quality of end-of-life palliative care did not differ clinically significantly between the AYA and middle-aged group, the levels of grief and depression were significantly higher in the AYA compared with the middle-aged group (Effect Size [ES] = 0.57, p < 0.0001; ES = 0.22, p = 0.001, respectively).
CONCLUSION: Although end-of-life care quality was comparable between AYAs and middle-aged patients, bereaved families of AYA patients experienced significantly greater grief and depression. These findings underscore the need for tailored bereavement support for AYA families.