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Bereavement risk assessment of family caregivers of patients with cancer: Japanese version of the Bereavement Risk Assessment Tool

  • Tomohiro Uchida (a1), Noriaki Satake (a2), Toshimichi Nakaho (a3), Akira Inoue (a4) and Hidemitsu Saito (a5) (a6)...



The Bereavement Risk Assessment Tool (BRAT) seems to be useful in identifying those who are likely to suffer from the more severe consequences of bereavement. To date, however, only a few studies have examined bereavement risk using the BRAT. This study investigated bereavement risk in family caregivers of patients with cancer using the Japanese version of the Bereavement Risk Assessment Tool (BRAT-J). We also investigated the relationship of bereavement risk with psychological distress and resilience among caregivers to determine the validity of the BRAT-J.


We conducted family psychoeducation in the palliative care unit of Tohoku University Hospital with participants who were recruited in this study. Among the participants, 50 family caregivers provided their written informed consent and were included in this study. Participants were assessed using the BRAT-J and completed the Japanese version of the Kessler Psychological Distress Scale (K6) and the Tachikawa Resilience Scale (TRS).


According to the BRAT-J, five individuals (10%) were in the high category of bereavement risk (level 4 or 5). We also found that family caregivers of patients experienced many different pressures, such as facing the unknown; their own work; and insufficient financial, practical, or physical resources. These issues are associated with various mental problems. Additionally, the level of bereavement risk was significantly correlated with K6 scores (ρ = 0.30, p = 0.032), and the TRS score (ρ = –0.44, p = 0.001). These correlations confirmed previous findings and that the BRAT-J can be an efficient screening tool for the bereavement risk of family caregivers of patients with cancer.

Significance of results

It appears that the BRAT-J is useful in predicting the likelihood of difficulties or complications in bereavement for family caregivers and could help to provide support with these issues when needed.


Corresponding author

Author for correspondence: Tomohiro Uchida, PH.D., Division of Human Psychology, Shokei Gakuin University, 4-10-1 Yurigaoka, Natori, Miyagi 981-1295, Japan. E-mail:


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Ajdacic-Gross, V, Ring, M, Gadola, E, et al. (2008) Suicide after bereavement: An overlooked problem. Psychological Medicine 38(5), 673676.
Boelen, PA (2013) Symptoms of prolonged grief, depression, and adult separation anxiety: Distinctiveness and correlates. Psychiatry Research 207(1–2), 6872.
Bonanno, GA, Wortman, CB, Lehman, DR, et al. (2002) Resilience to loss and chronic grief: A prospective study from preloss to 18-months postloss. Journal of Personality and Social Psychology 83, 11501164.
Currow, DC, Alien, K, Plummer, J, et al. (2008) Bereavement help-seeking following an ‘expected’ death: A cross-sectional randomised face-to-face population survey. BMC Palliative Care 7, 19.
Furukawa, T A, Kawakami, N, Saitoh, M, et al. (2008) The performance of the Japanese version of the K6 and K10 in the World Mental Health Survey Japan. International Journal of Methods in Psychiatric Research 17(3), 152158.
Ghesquiere, A, Haidar, YMM, and Shear, MK (2011) Risk for complicated grief in family caregivers. Journal of Social Work in End-of-Life & Palliative Care 7(2–3), 216240.
Haley, WE, LaMonde, LA, Han, B, et al. (2001) Family caregiving in hospice: Effects on psychological and health functioning among spousal caregivers of hospice patients with lung cancer or dementia. Hospice Journal 15(4), 118.
Hirooka, K, Sakaguchi, Y, & Iwamoto, K (2016) Development of the Japanese Version Bereavement Risk Assessment Tool: A pilot survey for family members of cancer patients. Palliative Care Research 11(3), 225233 [in Japanese].
Hudson, PL, Thomas, K, Trauer, T, et al. (2011) Psychological and social profile of family caregivers on commencement of palliative care. Journal of Pain and Symptom Management 41(3), 522534.
Kessler, RC, Barker, PR, Colpe, LJ, et al. (2003) Screening for serious mental illness in the general population. Archives of General Psychiatry 60(2), 184189.
Nishi, D, Uehara, R, Yoshikawa, E, et al. (2013) Culturally sensitive and universal measure of resilience for Japanese populations: Tachikawa Resilience Scale in comparison with Resilience Scale 14-item version. Psychiatry and Clinical Neurosciences 67(3), 174181.
Prigerson, HG, Frank, E, Kasl, SV, et al. (1995) Complicated grief and bereavement-related depression as distinct disorders: Preliminary empirical validation in elderly bereaved spouses. American Journal of Psychiatry 152, 2230.
Prigerson, H, Horowitz, MJ, Jacobs, SC, et al. (2009) Prolonged grief disorder: Psychometric validation of criteria proposed for DSM-V and ICD-11. PLoS Med 6(8), e1000121.
Rose, C, Wainwright, W, Downing, M, et al. (2011) Inter-rater reliability of the Bereavement Risk Assessment Tool. Palliative and Supportive Care 9, 153164.
Schut, H and Stroebe, MS (2005) Interventions to enhance adaptation to bereavement. Journal of Palliative Medicine 8(Suppl 1), S140S147.
Saito, H, Tominaga, M, Takamatsu, K, et al. (2012) Family support in the palliative care center. Seishin-igaku 54, 419426 [in Japanese].
Stroebe, MS, Folkman, S, Hansson, RO, et al. (2006) The prediction of bereavement outcome: Development of an integrative risk factor framework. Social Science & Medicine 63(9), 24402451.
Suzuki, Y, Fukasawa, M, Obara, A, et al. (2014) Mental health distress and related factors among prefectural public servants seven months after the great East Japan Earthquake. Journal of Epidemiology 24, 287294.
Sone, T, Nakaya, N, Sugawara, Y, et al. (2016) Longitudinal association between time-varying social isolation and psychological distress after the Great East Japan Earthquake. Social Science & Medicine 152, 96101.
Thomas, K, Hudson, P, Trauer, T, et al. (2014) Risk factors for developing prolonged grief during bereavement in family carers of cancer patients in palliative care: A longitudinal study. Journal of Pain and Symptom Management 47(3), 531541.


Bereavement risk assessment of family caregivers of patients with cancer: Japanese version of the Bereavement Risk Assessment Tool

  • Tomohiro Uchida (a1), Noriaki Satake (a2), Toshimichi Nakaho (a3), Akira Inoue (a4) and Hidemitsu Saito (a5) (a6)...


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