ABSTRACT
Objectives: Spiritual pain is not formally defined. The aim of this study was to clarify the beliefs about spiritual pain among Japanese palliative care physicians and liaison psychiatrists and to compare their beliefs. Methods: A nationwide questionnaire survey was conducted by mail August, 2019 on certified palliative care physicians and liaison psychiatrists. We asked 9 questions about spiritual pain (i.e. current status, definition, and the delivery of care) using a 5-Likert scale. Result: 387 palliative care physicians (response rate, 53%) and 374 psychiatrists (45%) responded. 72% (76% of the palliative care physicians/69% of the psychiatrists) reported that spiritual pain was distinct from depression, but 69% (66/71) reported that it was not defined adequately; and 59% (59/60) perceived the risks of using the words ambiguously. Only 43% (40/47) recommended the universal definition of spiritual pain, and opinions about how spiritual pain should be defined (i.e, higher being, meaning/value, or specific terms) differed among physicians. Perception about spiritual pain of the physicians were significantly associated with their religion, while beliefs about spiritual pain were essentially similar between palliative care physicians and psychiatrists. Conclusion: Although physicians regarded the definition of spiritual pain as being inadequate, the opinions about preferable definition differed among physicians. Discussion about the value of developing a consensus of spiritual pain is needed.
ABSTRACT
<b>Purpose</b>: To clarify the effect of a palliative care team intervention for nausea of cancer patients. <b>Methods</b>: The study participants were all cancer patients who were referred to a palliative care team in Yodogawa Christian Hospital in 2010, and had nausea with score 2 or over of the Support Team Assessment Schedule Japanese version (STAS－J). The causes of nausea were classified into 4 categories. Etiology－based antiemetic medications were recommended, and the intensities of nausea were assessed using the STAS－J on the day of referral, and 7 days after. <b>Result</b>: Among 27 patients were recruited for this study, 24 were assessed 7 days after. Nine patients had chemically induced nausea, eight had impaired gastric emptying, four had vestibular and central nervous system disturbance, and three had bowel obstruction. The mean STAS－J score significantly decreased from 3.0 (SD, 0.55) on the day of referral to 1.1 (0.80) after 7 days (<i>p</i>＜0.001). Two patients had mild drowsiness. <b>Conclusion</b>: The recommendations of etiology－based antiemetics by the palliative care team may be effective for managing nausea in cancer patients.
ABSTRACT
<b>Purpose</b>: The Liverpool Care Pathway is a clinical path for the dying patient. In this study, a pilot study of a Japanese language version of the Liverpool Care Pathway Powered by Editorial Manager® and Preprint Manager® from Aries Systems Corporation (henceforth, “LCP”) was carried out in order to investigate the significance of using LCP and the possibility of its introduction. <b>Method</b>: 1. LCP was used on inpatients in the palliative care wards, and the status of the achieved care goal was evaluated. 2. A questionnaire survey regarding the usefulness of LCP was conducted on the nursing staff of the study facility. <b>Results</b>: The care goal indicated by LCP were achieved in 80% or more of the patients and families. The nursing staff members were asked to evaluate of LCP was evaluated the usefulness of LCP in confirming that the patient is in the dying phase, reviewing end-of-life care, continuous integrated care giving, and education for nurses with limited experience with end-of-life care. <b>Conclusion</b>: The high degree of achievement of the care goal in LCP shows concordance between LCP and end-of-life care at the study facility, and shows that it is possible for LCP to be introduced as an index of clinical pathway for end-of-life care giving. In addition, the nurses' evaluations imply the significance of LCP in reinforcement and education with regard to end-of-life care giving.