• Ayumi Igarashi, Mitsunori Miyashita, Tatsuya Morita, Nobuya Akizuki, Miki Akiyama, Yutaka Shirahige, Kazuki Sato, Noriko Yamamoto-Mitani, and Kenji Eguchi.
• Division of Health Sciences & Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. Electronic address: igarashi-a@umin.ac.jp.
• J Pain Symptom Manage. 2016 May 1; 51 (5): 926-32.

ContextThe sense of security scale was developed to indicate care quality within the community. Bereaved families have perspective to evaluate the quality of the care system.ObjectivesThe aim was to examine associations between end-of-life care and sense of security regarding regional cancer care among bereaved families.MethodsA cross-sectional population-based survey was conducted with families of cancer patients who died in regional areas of Japan.ResultsA total of 1046 family caregivers of patients responded to surveys (effective response rate of 65%). In multiple regression analyses, the families' higher age (P < 0.001), home death (P = 0.039), better health status of the family at patients' end of life (P = 0.016), lower caregiving burden (P < 0.001), and elements of perceived good patient death, including being free from physical distress (P < 0.001), trusting the physician (P < 0.001), living in calm circumstances (P = 0.042), and feeling that one's life was fulfilling (P = 0.035), were associated with a higher sense of security.ConclusionQuality of death and lower burden on family caregivers were associated with families' sense of security. This suggests strategies for improving care quality for each patient to improve the sense of security.Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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