{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T10:59:28Z","timestamp":1780829968423,"version":"3.54.1"},"reference-count":35,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Sudden unexpected death can occur even among patients with advanced cancer receiving hospice and palliative care. How bereaved families perceive this remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To investigate the prevalence of sudden unexpected death from bereaved family perspectives, the level of agreement with physician perspectives, and their association with bereaved families\u2019 mental health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design\/Setting\/Subjects:<\/jats:title>\n                    <jats:p>We analyzed longitudinally linked data from a prospective cohort of advanced cancer patients in 23 palliative care units in Japan and a nationwide survey of bereaved families.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements:<\/jats:title>\n                    <jats:p>Sudden unexpected death was assessed using previously reported definitions: (1) \u201csurprise death\u201d and (2) \u201crapid decline death,\u201d evaluated from both physician and bereaved family perspectives, and (3) \u201cperformance status-defined sudden death,\u201d evaluated only by physicians. Agreement among definitions was analyzed using kappa statistics. Bereaved families\u2019 mental health was evaluated using the Patient Health Questionnaire-9.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 611 cases, \u201csurprise death\u201d and \u201crapid decline death\u201d were more frequent from bereaved family (46.5% and 51.2%, respectively) than physician (8.2% and 16.5%, respectively) perspectives. Agreement between family and physician perspectives was low (\u03ba = 0.04\u20130.14). The bereaved family-perceived \u201crapid decline death\u201d was significantly correlated with depression (adjusted odds ratio = 1.75,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.028), whereas physician-perceived sudden unexpected death showed no significant correlation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Compared with physicians\u2019 perspectives, bereaved family members perceive death to be sudden or unexpected more frequently and differently, and their perceptions are associated with postbereavement mental health. Further research is needed to explore strategies to improve communication and support families\u2019 psychological preparedness when a patient\u2019s death may be sudden and unexpected.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10966218261425445","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T14:30:25Z","timestamp":1773239425000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Half of Hospice and Palliative Care Unit Inpatients\u2019 Family Members Are Surprised by Death"],"prefix":"10.1177","author":[{"given":"Satoko","family":"Ito","sequence":"first","affiliation":[{"name":"Hospice, The Japan Baptist Hospital, Kyoto, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Morita","sequence":"additional","affiliation":[{"name":"Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Hamamatsu, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanori","family":"Mori","sequence":"additional","affiliation":[{"name":"Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Hamamatsu, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isseki","family":"Maeda","sequence":"additional","affiliation":[{"name":"Department of Palliative Care, Senri\u2010chuo Hospital, Toyonaka, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Hatano","sequence":"additional","affiliation":[{"name":"Department of Palliative Care, Yoshida Hospital, Nara, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Japan."},{"name":"Department of Palliative Care, Konan Medical Center, Kobe, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Yamagiwa","sequence":"additional","affiliation":[{"name":"Hospice, The Japan Baptist Hospital, Kyoto, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiyuki","family":"Kizawa","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoru","family":"Tsuneto","sequence":"additional","affiliation":[{"name":"Graduate School of Medicine, Kyoto University, Kyoto, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuo","family":"Shima","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kento","family":"Masukawa","sequence":"additional","affiliation":[{"name":"Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsunori","family":"Miyashita","sequence":"additional","affiliation":[{"name":"Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,10]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2014.13081132"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2010.06.008"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2023.102375"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(25)00354-X"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.30.7173"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.4030"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/SPC.0000000000000174"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2343"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/pon.4610"},{"issue":"1","key":"e_1_3_3_11_2","first-page":"131","article-title":"[Accuracy of clinical prediction of survival for terminally ill cancer patients]","volume":"26","author":"Morita T","year":"1999","unstructured":"Morita T, , Tsunoda J, , Inoue S, et al. 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