PURPOSE We investigated relationships between domains of quality of dying and death in patients with advanced cancer and their caregivers' bereavement outcomes and the moderating effect of patient age at death. METHODS Bereaved caregivers of deceased patients with advanced cancer who had participated in an early palliative care trial completed measures of grief (Texas Revised Inventory of Grief [TRIG]), complicated grief (Prolonged Grief Inventory [PG-13]), and depression (Center for Epidemiologic Studies-Depression [CESD-10]). They also completed the Quality of Dying and Death measure (QODD), which assesses patients' symptom control, preparation for death, connectedness with loved ones, and sense of peace with death. RESULTS A total of 157 bereaved caregivers completed the study. When patient age × QODD subscale interactions were included, greater death preparation was related to less grief at patient death (past TRIG: β =  - .25, p = .04), less current grief (present TRIG: β =  - .26, p = .03), less complicated grief (PG-13: β =  - .37, p = .001), and less depression (CESD-10: β =  - .35, p = .005). Greater symptom control was related to less current grief (present TRIG: β =  - .27, p = .02), less complicated grief (PG-13: β =  - .24, p = .03), and less depression (CESD-10: β =  - .29, p = .01). Significant patient age × connectedness interaction effects for current grief (present TRIG: β = .30, p = .02) and complicated grief (PG-13: β = .29, p = .007) indicated that, with less connectedness, younger patient age at death was associated with greater caregiver grief. CONCLUSION Better end-of-life death preparation and symptom control for patients with cancer may attenuate later caregiver grief and depression. Less connectedness between younger patients and their families may adversely affect caregiver grief.

中文翻译：

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晚期癌症的照顾者丧亲结局：与死亡质量和患者年龄的关联。

目的 我们调查了晚期癌症患者的死亡质量和死亡领域与其照顾者的丧亲结局之间的关系，以及患者死亡年龄的调节作用。方法 参与早期姑息治疗试验的已故晚期癌症患者的遗属照顾者完成了悲伤（德克萨斯修订的悲伤清单 [TRIG]）、复杂悲伤（延长悲伤清单 [PG-13]）和抑郁（中心用于流行病学研究-抑郁症 [CESD-10]）。他们还完成了死亡质量和死亡测量 (QODD)，该测量评估患者的症状控制、死亡准备、与亲人的联系以及对死亡的平静感。结果 共有 157 名失去亲人的照顾者完成了这项研究。当包括患者年龄 × QODD 子量表交互作用时，更多的死亡准备与患者死亡时的悲伤更少（过去的 TRIG：β = - .25，p = .04）、当前的悲伤更少（现在的 TRIG：β = - .26， p = .03），不那么复杂的悲伤（PG-13：β = - .37，p = .001）和更少的抑郁（CESD-10：β = - .35，p = .005）。更好的症状控制与更少的当前悲伤（目前的 TRIG：β = - .27，p = .02）、不太复杂的悲伤（PG-13：β = - .24，p = .03）和更少的抑郁（CESD -10：β = - .29，p = .01）。当前悲伤（目前的 TRIG：β = .30，p = .02）和复杂悲伤（PG-13：β = .29，p = .007）的显着患者年龄 × 连通性交互作用表明，连通性越小，越年轻患者死亡年龄与更大的照顾者悲伤有关。结论 癌症患者更好的临终死亡准备和症状控制可能会减轻照顾者后期的悲伤和抑郁。年轻患者与其家人之间的联系较少可能会对照顾者的悲伤产生不利影响。