Objectives: This study aimed to describe the experiences of bereaved family members of cancer patients in terms of regret in relation to ending terminal treatment for the patient. Methods: We conducted a semi-structured qualitative interview of 37 bereaved family members regarding their decision-making and their psychological adjustment from the time they made the decision to terminate treatment. Interviews were analyzed using qualitative content analysis. Results: Approximately 40% of bereaved family members reported that they had some regrets about their decision. Regret contents were classified into 8 categories and diversified from 4 categories at the time of decision-making to 7 categories after the death. The reasons for regret were classified into 43 categories. Common factors that minimized regret included situations at the time when they made the decision, such as patient- and family-specific factors and relationship with the medical staff. In comparison, the common reasons for regret centered on factors related to the approach for decision-making, such as the process, options, as well as psychological coping and relationships with medical staff. Conclusion: The results suggest that regret in the bereaved could be modified by understanding the relationship between regret characteristics and psychological coping.

Objective: To clarify family members’ behaviors toward terminally ill cancer patients with communication difficulties and the related support provided by medical professionals. Method: Participants included 15 medical professionals engaged in palliative care (physicians, nurses, and psychologists) and 5 bereaved family members who had cared for terminally ill cancer patients at a hospital. Semi-structured interviews were conducted on the following: (1) family members’ behaviors toward the patient and (2) related support provided by medical professionals to family members. The interviews were qualitatively analyzed using category analysis. Results: We identified three categories of family members’ behaviors toward the patient such as behaviors that continue to communicate with the patient as usual, behaviors that assist patients to feel secure and relaxed, We also identified nine categories of the related support provided by medical professionals such as advising family members on how to behave with the patient and providing encouraging feedback to family members on their behaviors toward the patient. Discussion: Our results suggest that medical professionals encouraged family members to continue their behaviors to patients confidently. Support to family members included suggesting behaviors to make it easier for them to put into practice, encouraging the patient and family interaction, and giving feedback on the family member’s behaviors.

The purpose of this study was to clarify feasibility of a booklet for families of children dying with incurable cancer. Of 267 pediatric oncology specialists, 76 (28%) participated in this cross-sectional survey. Ninety-three percent of participants answered that they were “likely to use” the booklet, and 86% percent answered that they believed the booklet was “helpful” for families. Some participants described various advantages of its use as follows: “able to communicate something that is difficult to put into words,” “easy to understand for families,” “families can read whenever they choose to,” and “able to grasp the direction of dying.” In contrast, other participants described points of attention of use as follows: “optimal timing to bring out,” “acceptance of families,” “direction as interdisciplinary team,” “confidential relationship between families and interdisciplinary team,” “disinclination among health care providers,” and “information volume of the booklet.” Thus, our results validated feasibility of the booklet. In conclusion, pediatric oncology specialists should provide their support of utilizing the booklet for families and assessing each family condition and advantage/attention of using the booklet.