Factors Associated With Good Death Perception Among Primary Caregivers of Terminally Ill Patients: The Role of Filial Piety and Caregiving Burden

Objective In East Asian societies, end-of-life care is deeply rooted in family-centered values. This study aimed to examine the relationships among filial piety values, caregiving burden, and perceptions of a good death among primary caregivers of terminally ill patients in Taiwan. Methods Between December 6, 2022 and April 30, 2023, a cross-sectional survey using purposive sampling was conducted at a medical center in Southern Taiwan. Primary caregivers ( N = 256) of terminally ill patients completed the Chinese Filial Piety Scale, Caregiver Burden Inventory, and the Good Death Inventory-Short Version. Data were analyzed using multiple linear regression to identify independent predictors of good death perceptions. Results Caregivers reported high levels of filial piety (Mean = 4.46, SD = 0.50) and moderate perceptions of a good death (Mean = 5.42, SD = 0.87). Pearson's correlation revealed that filial piety was positively associated with good death perceptions ( r = 0.277, p < .001), whereas caregiving burden showed a significant negative association ( r = −0.361, p < .001). Multiple regression analysis ( R 2 = 28.18%) revealed that caregiving burden (β = −0.48, p < .001) and being employed (β = −0.39, p = .009) were negative predictors of good death perceptions. In contrast, filial piety (β = 0.33, p = .001), religious belief (β = 0.35, p = .012), and older age (41-55 years: β = 0.29, p = .015; >55 years: β = 0.32, p = .013) were significant positive predictors. Conclusion Filial piety serves as a cultural resource that enhances caregivers’ understanding of a dignified death, while caregiving burden remains a primary barrier to positive end-of-life perceptions. Palliative care interventions should be culturally sensitive, focusing on alleviating the emotional and physical strain of caregivers while integrating traditional filial values to facilitate meaningful and dignified dying experiences.