• Yoichi Shimizu, Kento Masukawa, Maho Aoyama, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, and Mitsunori Miyashita.
• Department of Adult Nursing (Y.S.), National College of Nursing Japan, Tokyo, Japan; Department of Palliative Nursing (Y.S., K.M., M.A., M.M.), Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan; (former) Department of Nursing (Y.S.), National Cancer Center Hospital, Tokyo, Japan. Electronic address: yo-shimiz@umin.ac.jp.
• J Pain Symptom Manage. 2023 Apr 1; 65 (4): 273284273-284.

ContextBereaved family members sometimes experience distress due to stressful life events. However, the effects of this distress on depression and grief remain unclear.ObjectivesTo clarify the degree of distress due to postbereavement stressful life events, its associated factors, especially social isolation, and its effects on major depressive disorder (MDD) and complicated grief (CG) risks among bereaved family members of patients with cancer.MethodsThis cross-sectional questionnaire survey was conducted in 2018 as part of the J-HOPE4 study. We recruited 1740 bereaved family members of patients with cancer who died from July to August of 2018. We assessed distress due to postbereavement stressful life events with the Bereavement Secondary Stressor Scale, social isolation with the Lubben Social Network Scale Short-Form, and the MDD and CG risk with the Patient Health Questionnaire-9 and Brief Grief Questionnaire, respectively.ResultsAmong the 913 (52.5%) respondents, 88%, 57%, 46%, 28%, and 19% experienced distress due to incidental tasks, daily life difficulties, financial problems, problems with other people, and deterioration of family relationships, respectively. More distress was associated with higher risks of MDD (odds ratio [OR] = 2.5, P < 0.01) and CG (OR = 2.5, P < 0.01). Social isolation and specific backgrounds were associated with more distress in response to stressful life events.ConclusionMost family members experienced distress due to stressful life events, which were risk factors for MDD and CG. Assessing risk factors for maladaptation to post-bereavement life changes and enhancing readiness to adapt to them is important.Copyright © 2022 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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