{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:27:49Z","timestamp":1788348469530,"version":"build-2803163510"},"reference-count":19,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"unspecified","delay-in-days":174,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Pall Supp Care"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1478951526102776_sec1a\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although spiritual pain in cancer patients has been extensively studied, little is known about the spiritual pain experienced by bereaved caregivers in Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951526102776_sec2b\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This preliminary scale development aimed to clarify the structure of spiritual pain experienced by bereaved caregivers of cancer patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951526102776_sec3c\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951526102776_sec4d\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Responses were obtained from 930 bereaved caregivers in general hospitals and palliative care units. Seven constructs were obtained through the EFA: Loneliness, Life\u2019s heartlessness, A sense of unfinished business, Distress over patient deterioration, Remorse, Regret, and A sense of loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951526102776_sec5e\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951526102776_sec6f\">\n                    <jats:title>Significance of results<\/jats:title>\n                    <jats:p>Seven factors of spiritual pain were identified among bereaved caregivers of cancer patients, and understanding this multidimensional experience may inform supportive care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1478951526102776","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T13:43:57Z","timestamp":1782308637000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Structure of the spiritual pain of bereaved caregivers of cancer patients: A preliminary scale development"],"prefix":"10.1017","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0109-1870","authenticated-orcid":false,"given":"Hiroko","family":"Sumi","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04k6gr834","id-type":"ROR","asserted-by":"publisher"}],"name":"Kyoto University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3825-9443","authenticated-orcid":false,"given":"Shuji","family":"Hiramoto","sequence":"additional","affiliation":[{"name":"Peace Homecare Clinic"},{"id":[{"id":"https:\/\/ror.org\/00d8gp927","id-type":"ROR","asserted-by":"publisher"}],"name":"Shiga University of Medical Science"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kento","family":"Masukawa","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01dq60k83","id-type":"ROR","asserted-by":"publisher"}],"name":"Tohoku University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Morita","sequence":"additional","affiliation":[{"name":"Seirei Mikatahara General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiyuki","family":"Kizawa","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02956yf07","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Tsukuba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoru","family":"Tsuneto","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02kpeqv85","id-type":"ROR","asserted-by":"publisher"}],"name":"Kyoto University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuo","family":"Shima","sequence":"additional","affiliation":[{"name":"Tsukuba Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsunori","family":"Miyashita","sequence":"additional","affiliation":[{"name":"Health 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Published by Cambridge University Press.","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0), which permits non-commercial re-use, distribution, and reproduction in any medium, provided that no alterations are made and the original article is properly cited. The written permission of Cambridge University Press or the rights holder(s) must be obtained prior to any commercial use and\/or adaptation of the article.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e178"}}