{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T18:38:06Z","timestamp":1767724686178,"version":"build-2238731810"},"reference-count":23,"publisher":"Wiley","issue":"17","license":[{"start":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T00:00:00Z","timestamp":1756512000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Family conflict is a common problem in palliative care and has been identified as a potential barrier to providing appropriate care. Several demographic factors associated with family conflict have been reported; however, associated clinical factors, including symptoms, treatments, and communication, remain to be elucidated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The aim of this study was to identify symptoms, treatments, and communication factors associated with family conflict in palliative care units (PCUs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used matched data for deceased patients from a prospective cohort study conducted between January 2017 and December 2017 of cancer patients admitted to PCUs and their bereaved families from a nationwide cross\u2010sectional questionnaire survey in Japan. We assessed family conflict using the Outcome\u2010Family Conflict Scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We sent out 667 questionnaires, of which 443 (66.4%) were returned. We excluded 81 family members who refused to participate; therefore, we analyzed 362 (81.7%) responses. The mean age of the patients who died of cancer was 73.9\u2009\u00b1\u200911.3\u2009years, and 51.9% were men. Multivariate logistic regression revealed a significant association between rapid deterioration of the patient's condition, resulting in death within 1\u20132\u2009days, and family conflict about what is meant by \u201ca good death\u201d (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.044, odds ratio: 2.66), and the presence of family members who insulted or yelled at other family members (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005, OR: 3.22). In addition, a significant association was found between the confirmation of the family's wishes regarding CPR during hospitalization and family conflicts about healthcare decisions for their relative (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013, OR: 0.46), about the way a member was treating their relative (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014, OR: 0.43), and about what is meant by \u201ca good death\u201d (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.028, OR: 0.38).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings suggest that abrupt clinical deterioration is associated with family conflict. Confirming patients' and families' wishes regarding CPR during hospitalization may help reduce family conflict in PCUs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71192","type":"journal-article","created":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T07:56:46Z","timestamp":1756540606000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical and Communication Factors Associated With Family Conflict in Palliative Care Units: A Survey of Bereaved Families in Japan"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0304-9881","authenticated-orcid":false,"given":"Jun","family":"Hamano","sequence":"first","affiliation":[{"name":"Department of Palliative and Supportive Care, Institute of Medicine University of Tsukuba  Ibaraki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kento","family":"Masukawa","sequence":"additional","affiliation":[{"name":"Department of Palliative Nursing, Health Sciences Tohoku University Graduate School of Medicine  Sendai Miyagi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5489-9395","authenticated-orcid":false,"given":"Masanori","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Palliative and Supportive Care Seirei Mikatahara General Hospital  Hamamatsu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3060-0245","authenticated-orcid":false,"given":"Takashi","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Otani","sequence":"additional","affiliation":[{"name":"Department of Palliative Care Team, and Palliative and Supportive Care National Hospital Organization Kyushu Cancer Center  Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroto","family":"Ishiki","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine National Cancer Center Hospital  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yutaka","family":"Hatano","sequence":"additional","affiliation":[{"name":"Department of Palliative Care Daini Kyoritsu Hospital  Kawanishi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0018-3359","authenticated-orcid":false,"given":"Isseki","family":"Maeda","sequence":"additional","affiliation":[{"name":"Department of Palliative Care Senri Chuo Hospital  Suita Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoru","family":"Tsuneto","sequence":"additional","affiliation":[{"name":"Graduate School of Medicine Kyoto University  Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuo","family":"Shima","sequence":"additional","affiliation":[{"name":"Hospice Palliative Care Japan  Ashigarakami Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7257-7429","authenticated-orcid":false,"given":"Tatsuya","family":"Morita","sequence":"additional","affiliation":[{"name":"Department of Palliative and Supportive Care Seirei Mikatahara General Hospital  Hamamatsu Japan"},{"name":"Research Association for Community Health  Hamamatsu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiyuki","family":"Kizawa","sequence":"additional","affiliation":[{"name":"Department of Palliative and Supportive Care, Institute of Medicine 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