The level of the information and understanding state of patients and family members before and after palliative care unit admission: evaluation of the nurses

<b>Purpose and Method</b>: It is known that people have insufficient recognition about hospital-based palliative care units (PCUs). Patients with cancer and their families are probably not well informed about PCUs on its admission. To understand the situation of patients and their families before and after PCU admission, a questionnaire survey was performed and evaluated by PCU nurses. <b>Result</b>: As a result, two points regarding PCU admission have become clear. First, about 55％ of the nurses reported that prior to PCU admission, patients and family members lacked proper information about PCUs; about 62% of the nurses felt that PCUs had not been appropriately explained to the patients; and about 37% of the nurses felt that family members had not received an appropriate explanation of PCUs at the time of PCU admission. Second, before PCU admission, the main concern of patients and their families was proper utilization of PCUs. After admission, their main concerns were the extent of treatment provided in the PCU and the progress of the disease. <b>Conclution</b>: These results suggest that appropriate information on PCUs, including the scope of treatment provided to patients and the requirements for PCU admission, is necessary for general ward staff as well as for the patients and their families prior to PCU admission.

Patient and family perceptions of palliative care units in Japan

<b>Objectives</b>: The purpose of this study was to examine common experiences among patients and primary family caregivers as they transition to hospice and palliative care units (PCU), with focus on the perspectives of cancer patients and their primary family caregivers. <b>Methods</b>: We conducted semi-structured interviews using a questionnaire with a purposive sample of 5 terminal cancer patients and 9 primary family members of patients who were admitted to the PCU from November 2005 to December 2006. The questionnaires consisted of questions about the PCU, and semi-structured interviews inquired about perceptions of the PCU. We analyzed interview contents from 14 participants (mean age ±SD; patients, 77.2±4.0 years; family members, 53.7±14.6) by summarizing content analysis. The Aiwa Hospital Institutional Review Board approved the present study. <b>Results</b>: Content analysis identified common perceptions about the PCU. Perceptions prior to the transition were summarized into 2 categories for patients and 5 categories for families, including general impressions of the PCU, PCU environment and equipment, treatment, cost, and other patients. After being admitted to the PCU, perceptions were summarized into 3 categories for patients and 7 categories for families, including general impressions of the PCU, PCU environment and equipment, treatment, staff, cost, other patients, and religion. <b>Conclusion</b>: Identification of these themes from patient and family perspectives suggested that patients transitioned to hospice with no particular impressions about the PCU, while families perceived the PCU as both “a place to relax” and “a place where one only waits to die” before entering the PCU. These results may aid in designing interventions that consider patient and family needs and desires during the transition to the PCU.

Roles of clinical psychologists desired by palliative care team members: Focus group interviews

The objective of this study was to identify the roles of clinical psychologists in palliative care teams by conducting focus group interviews. The participants were 7 physicians and nurses of highly active palliative care teams. Results from the qualitative analysis of interview content revealed that the most important knowledges needed by psychologists in palliative care is fundamental and specialized psychological knowledges and skills. The second most important was general and psychiatric medical knowledges regarding cancer. Otherwise, psychologists were expected to understand the roles of other staff members and the medical system, and provide mental and emotional support to medical staff. Our results clarified that psychologists require a broad understanding of medical care for cancer, good communication skills for interacting with other staff members, and the ability to actively utilize their psychiatric specialty to provide psychological support to patients, families and medical workers. Palliat Care Res 2009; 4(2): 228-234