Structure of the spiritual pain of bereaved caregivers of cancer patients: A preliminary scale development

BACKGROUND: Although spiritual pain in cancer patients has been extensively studied, little is known about the spiritual pain experienced by bereaved caregivers in Japan. OBJECTIVES: This preliminary scale development aimed to clarify the structure of spiritual pain experienced by bereaved caregivers of cancer patients. METHODS: This preliminary scale development was conducted as a secondary analysis of the nationwide J-HOPE4 survey, a cross-sectional questionnaire study of bereaved family members of cancer patients. Thirty-five items related to spiritual pain were analyzed using exploratory factor analysis (EFA). RESULTS: Responses were obtained from 930 bereaved caregivers in general hospitals and palliative care units. Seven constructs were obtained through the EFA: Loneliness, Life's heartlessness, A sense of unfinished business, Distress over patient deterioration, Remorse, Regret, and A sense of loss. CONCLUSION: This preliminary scale development provides insights into the structure of spiritual pain experienced by bereaved caregivers of cancer patients. Further validation using independent samples is required. SIGNIFICANCE OF RESULTS: Seven factors of spiritual pain were identified among bereaved caregivers of cancer patients, and understanding this multidimensional experience may inform supportive care.