Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 56
Filter
Add filters








Year range
1.
Article in Japanese | WPRIM | ID: wpr-873947

ABSTRACT

This study sought to evaluate how a training program on spiritual care affected physicians’ confidence, self-reported practice, and attitudes in caring for terminally ill cancer patients who express meaninglessness in living. Questionnaires were distributed to participating physicians before and after the training program. A total of 30 physicians completed the program. Confidence and self-reported practice regarding communication with terminally ill cancer patients who express meaninglessness significantly improved after the training: effect size, 1.3 (P=0.0001) and 1.2 (P=0.0001), respectively. Moreover, physician-reported helplessness significantly decreased (effect size, 0.8; P=0.0001) and positive appraisal and willingness to participate in caring for terminally ill cancer patients experiencing meaninglessness significantly improved (effect size, 0.8, P=0.0001; effect size, 0.4, P=0.0001, respectively). Overall, 96–100% of the participating physicians reported the program was useful for understanding the concept of spiritual care and for learning a practical approach for caring for such patients.

2.
Palliative Care Research ; : 135-146, 2020.
Article in Japanese | WPRIM | ID: wpr-826278

ABSTRACT

To decide the policy to promote palliative care properly, a new questionnaire has been added to Patient’s behavior survey to assess Quality of Life (QOL) of inpatients and outpatients in Japan. The aim of this study was to survey QOL score of general population in Japan by using a questionnaire of patient’s behavior survey. A large nationwide postal survey was conducted from January through February 2013 in Japan. A total of 2400 subjects were selected randomly from among members of the general population who were 20 to 79 years of age and lived in Japan. A total of 978 (41.1%) questionnaires were analyzed, and reference data of QOL score weighted by the national standard value of sex-age group population were calculated. Correlation coefficients were calculated between QOL score and SF-8TM, Patient Health Questionnaire-9 (PHQ-9), Eastern Cooperative Oncology Group Performance Status (ECOG), Memorial Symptom Assessment Scale (MSAS) score. In addition, sociodemographic factors related to QOL score were evaluated. From the perspectives of public health and administrative policy, the results of this survey will provide important basic data to evaluate patient’s behavior survey broadly and continuously with the goal of establishing a palliative care system in Japan.

3.
Article in Japanese | WPRIM | ID: wpr-822065

ABSTRACT

Objectives: The study purpose was to examine quality-of-life (QOL) of pediatric cancer patients at end-of-life and related factors using a QOL proxy rating scale from the nurse’s perspective. Methods: We conducted a survey in October 2015−February 2016. The subjects to be surveyed were nurses who were primarily in charge of patients with childhood cancer at end-of-life. We investigated 22 items of the Good Death Inventory for Pediatrics (GDI-P) and their related factors. Results: In total, 53 proxy evaluate questionnaires were completed from 18 centers. Among the eight factors of GDI-P, “Relief from physical and psychological suffering” was the lowest. The total score of GDI-P was positively correlated with the structure and process of care (r=0.58). Although there was a bias in the number of cases, in the case of the place of death was the intensive care unit, the total score of GDI-P was lower than home and the general ward. Conclusions: It was suggested that the top priority in improving QOL was relief from suffering and the structure and process of care were related to QOL.

4.
Palliative Care Research ; : 265-276, 2020.
Article in Japanese | WPRIM | ID: wpr-829829

ABSTRACT

Purpose: To determine how nurses perceive the need for advance care planning (ACP) for chronic heart failure with patients and their families. Methods: A questionnaire survey was administered with 427 nurses who were affiliated with implantable cardioverter-defibrillators and resynchronization therapy. The survey included 13 items related to the need for ACP for simulated advanced heart failure cases with patients and their families. Results: Valid Responses were obtained from 207 nurses. On out of all items, the least proprtion of participants (51%) responded “giving predictions about functional prognosis and life expectancy” should be performed with patients. The participants’ perceptions regarding 8 items, which included the items on communication about prognosis, reflected their belief that ACP should be performed with family members rather than the patient. It was found that participants with certification in chronic heart failure nursing were more likely to respond in favor of ACP being performed with the patients in relation to 7 items, which included “ask about what has been important in one’s life”, and being performed with the family in relation to 10 items that included “ask the family what kind of life you want the patient to have hereafter”, as compared to other nurses. Conclusion: Regarding ACP, it is suggested that nurses are careful in discussing prognosis with patients, and certified nurses tend to attach importance to the individualities and values of patients and their families.

5.
Palliative Care Research ; : 259-267, 2019.
Article in Japanese | WPRIM | ID: wpr-758331

ABSTRACT

The purposes of this study were to compare the response distribution of the result of using “nurse’s difficulty scale with cancer care” to nurses engaged in cancer nursing with 2010 survey at Tohoku University Hospital. Self-reported questionnaires were distributed to 512 nurses in 2010 and to 524 nurses in 2016. Responses from 356 (70%) nurses in 2010 and from 332 (63%) nurses in 2016 were analyzed. As a result of comparing the surveys of 2010 and 2016, the rate of correct answer in each items of the knowledge scale rose significantly (all p<0.05). From the items regarding their own knowledge and skills, difficulty in collaboration with the community, and end-of-life care decreased (both p<0.05). Despite the increase in the correct answer rate of the knowledge scale, the difficulty has become high. This may reflect the complexity in cancer care due to development of treatment.

6.
Palliative Care Research ; : 177-185, 2019.
Article in Japanese | WPRIM | ID: wpr-758190

ABSTRACT

Objectives: To assess the perception of care and outcomes of end-of-life palliative care by bereaved family members to determine differences in care provided to patients with and without cancer. Methods: This cross-sectional, anonymous survey using a self-reporting questionnaire for bereaved family members was conducted online. Care was assessed using overall satisfaction score and the care evaluation scale (CES) and outcomes were assessed using good death inventory (GDI). Results: The present study included data from 118 patients with cancer and 299 patients without cancer (103, heart failure; 71, stroke; and 125, pneumonia). The overall satisfaction score was not significantly different between patients with and without cancer. Conversely, physical care score in the CES and autonomy score in the GDI were significantly lower in patients without cancer than in patients with cancer (p<0.05). Conclusion: The satisfaction with end-of-life care was comparable between the bereaved family members of patients without cancer and those of patients with cancer. However, results related to some items of CES and GDI suggest that some components of end-of-life care for patients without cancer might require attention. Not only treatment of the underlying disease but also relief of suffering is important to improve end-of-life care.

7.
Palliative Care Research ; : 121-128, 2018.
Article in Japanese | WPRIM | ID: wpr-688870

ABSTRACT

We conducted a questionnaire survey of nurses to develop a scale for the Japanese version of the Quality of Dying and Death in the Intensive Care Unit (ICU-QODD) instrument for use by nurses. The questionnaire was based on “patient’s experience at the end of life” in ICU-QODD for health professionals in the United States. We assessed whether it could be used as a comprehensive evaluation tool. Respondents included 1,372 nurses for factor validity and internal consistency, and 39 nurses for test-retest reliability. Two factors, “physical symptoms” and “dignity” that comprised 6 items were identified. Cronbach’s alpha values were 0.89 and 0.75, respectively. Intraclass correlation coefficients were 0.62 and 0.72, respectively. Sufficient reliability and validity were confirmed. It was suggested that 6 out of 15 items could be used as for comprehensive evaluation of the ICU-QODD.

8.
Article in Japanese | WPRIM | ID: wpr-688868

ABSTRACT

Objective: The purpose of this study was to clarify the job types and related factors that physicians and nurses feel easy to consult about pediatric cancer patients’ and their families’ end of life care. Design and methods: We conducted a self-reported questionnaire survey for physicians and nurses who have experienced at least one case of end of life care of childhood cancer. In the survey, we asked participants about whether they feel easy to consult about 15 job types such as palliative care team, certified nurse specialist in child health nursing, physicians and nurses of the same team. Results: A total of 427 physicians and nurses participated in this study. More than 70% of the respondents felt that it felt easy to consult with three job types such as “Nurses of the same team” and “Physicians of the same team”. Job types of the respondents were the main related factors in the most job types. Physicians felt easier to consult with person in each job type than nurses. Consideration: It was suggested that it would be necessary to consider the systems that allow individual professionals to feel easy to consult with persons in each job type, such as specifying consultation methods and procedures for each job type, and introducing inter-professional education.

9.
Palliative Care Research ; : 383-391, 2018.
Article in Japanese | WPRIM | ID: wpr-688581

ABSTRACT

The purpose of this study was to clarify feasibility of a booklet for families of children dying with incurable cancer. Of 267 pediatric oncology specialists, 76 (28%) participated in this cross-sectional survey. Ninety-three percent of participants answered that they were “likely to use” the booklet, and 86% percent answered that they believed the booklet was “helpful” for families. Some participants described various advantages of its use as follows: “able to communicate something that is difficult to put into words,” “easy to understand for families,” “families can read whenever they choose to,” and “able to grasp the direction of dying.” In contrast, other participants described points of attention of use as follows: “optimal timing to bring out,” “acceptance of families,” “direction as interdisciplinary team,” “confidential relationship between families and interdisciplinary team,” “disinclination among health care providers,” and “information volume of the booklet.” Thus, our results validated feasibility of the booklet. In conclusion, pediatric oncology specialists should provide their support of utilizing the booklet for families and assessing each family condition and advantage/attention of using the booklet.

10.
Palliative Care Research ; : 313-327, 2018.
Article in Japanese | WPRIM | ID: wpr-688574

ABSTRACT

Purpose: Integrated care pathway (ICP) is structured multidisciplinary care plan that aim to improve the quality of care. ICP could be effective in providing quality End-of-Life (EOL) care in long-term care facilities (LTCFs). However, the outcomes and components of ICP for EOL care in LTCFs are not clear. Methods: We conducted a scoping review to identify the outcomes and components. We searched electronic databases (PubMed, CINAHL, Cochrane Library, PsycINFO, Ichushi) and conducted an additional hand search for relevant journal articles related to EOL care. We searched intervention and implementation studies for ICP in EOL care in LTCFs. Results: Thirteen papers met the inclusion criteria. We identified the following components of ICP: documents, education regarding EOL care and ICP, support by experts, and regular conferences among care providers. The effects of ICP were reported as reductions in transfers to hospitals and improvement in staff confidence regarding EOL care. Conclusion: With reference to the components of ICP identified in this study, ICP should be developed based on the characteristics of LTCFs, and the effects of intervention or implementation studies using a more robust design should be examined.

11.
Palliative Care Research ; : 761-770, 2017.
Article in Japanese | WPRIM | ID: wpr-379454

ABSTRACT

<p>Understanding the symptoms of the general population has an important role in assessing and improving the quality of palliative care systems. However, there are no reliable epidemiological data on the symptoms of the general population in Japan. The aim of this study was to survey the actual status of the symptoms experienced by the general population in Japan. A large nationwide postal survey was conducted from January through February 2013 in Japan. A total of 2400 subjects were selected randomly from among members of the general population who were 20 to 79 years of age and lived in Japan. The Memorial Symptom Assessment Scale (MSAS) was used to multi-dimensionally evaluate symptoms experienced within the past week, and the Short Form 8™ (SF-8™) was used to assess the health-related quality of life (QOL). A total of 978 (41.1%) self-completed questionnaires were analyzed. The prevalences, severity rates, and distress rates of 35 physical and psychological symptoms were analyzed according to sex and age group. In addition, the relation between symptom severity and the health-related QOL score was evaluated. From the perspectives of public health and administrative policy, the results of this survey will most likely provide important basic data, with the ultimate goal of establishing a palliative care system in Japan. </p>

12.
Palliative Care Research ; : 753-760, 2017.
Article in Japanese | WPRIM | ID: wpr-379453

ABSTRACT

<p>Objectives: This study aimed to describe the experiences of bereaved family members of cancer patients in terms of regret in relation to ending terminal treatment for the patient. Methods: We conducted a semi-structured qualitative interview of 37 bereaved family members regarding their decision-making and their psychological adjustment from the time they made the decision to terminate treatment. Interviews were analyzed using qualitative content analysis. Results: Approximately 40% of bereaved family members reported that they had some regrets about their decision. Regret contents were classified into 8 categories and diversified from 4 categories at the time of decision-making to 7 categories after the death. The reasons for regret were classified into 43 categories. Common factors that minimized regret included situations at the time when they made the decision, such as patient- and family-specific factors and relationship with the medical staff. In comparison, the common reasons for regret centered on factors related to the approach for decision-making, such as the process, options, as well as psychological coping and relationships with medical staff. Conclusion: The results suggest that regret in the bereaved could be modified by understanding the relationship between regret characteristics and psychological coping.</p>

13.
Palliative Care Research ; : 731-737, 2017.
Article in Japanese | WPRIM | ID: wpr-379447

ABSTRACT

<p>The aim of this study was to understand the use of complementary and alternative medicine (CAM) in cancer patients in Japan. This study was part of the Japan Hospice and Palliative care Evaluation 2016 (J-HOPE2016) Study. A multicenter questionnaire survey was conducted on a sample of bereaved family members of cancer patients who died at palliative care units. Data suggest that 54% of cancer patients use CAM. In comparison with a previous study in 2005 in Japan, categories of CAM vary widely; CAM previously included supplements mostly, but now exercise and mind and body therapy are also used. Most cancer patients use CAM without any harmful influence on their household economy and cancer treatment; however, in some patients, CAM incurs a large expense and a delay in starting cancer treatment. Therefore, it is important for medical staff and patients to have an opportunity to discuss CAM use. Multiple logistic regression analysis shows that CAM use is significantly associated with younger patients and highly educated families; moreover, there is a possibility that family members who use CAM have a high level of psychological distress. We must pay attention to the physical and the psychological aspects of cancer patients who use CAM and their families. Further studies are needed to investigate the use of each category of CAM, and to understand patients who use CAM and who die at home or in hospitals other than palliative care units.</p>

14.
Palliative Care Research ; : 271-276, 2017.
Article in Japanese | WPRIM | ID: wpr-379439

ABSTRACT

<p>Aim: To clarify the predictive risk factors for bedsores of terminal cancer patients receiving home-based care. Methods: A retrospective study was conducted involving 95 terminal cancer patients receiving home-based care, including people using services provided by home-visit care providers until death. Results: The numbers of patients with and without bedsores were 31 and 64, respectively. Bivariate analyses revealed that significant variables were the Ohura-Hotta scale (P=0.02), hyperactive delirium (P=0.005), contracture (P=0.008), and anemia (P=0.02). According to multivariable logistic analysis, significant variables were contracture (OR=16.55, P=0.0002) and hyperactive delirium (OR=4.22, P=0.008) as independent risk factors for bedsores. Discussion: For terminal cancer patients receiving home-based care, hyperactive delirium should also be considered as a predictive risk factor for bedsores.</p>

15.
Palliative Care Research ; : 259-269, 2017.
Article in Japanese | WPRIM | ID: wpr-379438

ABSTRACT

<p>Purpose: To clarify the factors that affect the family caregiver’s quality of life (QOL) of cancer patients. Methods: We conducted an internet survey including 21 items of the Japanese version CQOLC for 400 families of cancer patients in March 2012. Results: Factors that increased psychological burden were that caregivers were women, other family needed long-term care, and the patient had higher need for care. Factors that increased the family caregiver’s difficulty in their daily activities due to long-term care were caregivers are women, other family needed long-term care, caregivers did not think they had a good relationship with the patient, and the patient had higher need for care. Factors that increased financial burden were that the age of caregivers was less than 60 years, decreased of income after the patient’s diagnosis, and patients were men. Factors that increase the positive feeling for caregiving were that caregivers thought they had good relationship with the patient, and the patient’s need for care was higher. Conclusions: To reduce the burden in family caregiver of cancer patients without losing the positive feeling for caregiving would be important for both improving the family caregiver’s QOL, and to continue the care for patient in long term. </p>

16.
Palliative Care Research ; : 211-220, 2017.
Article in Japanese | WPRIM | ID: wpr-378913

ABSTRACT

<p>Previous study reported that patients of institutions with religious background are more likely to achieve ‘good death’ than patients in non-religious institutions, although the reasons are unclear. This study aims to examine the reasons for this difference using a national survey of religious and non-religious institutions. We sent a self-administered questionnaire to 10,715 bereaved family caregiver and 133 hospice and palliative care units which cared for their family members prior to death. The questionnaire for bereaved families included the Good Death Inventory (GDI). The questionnaire for institutions included their religious affiliation and their subjective and objective provided care. In total, 7,286 bereaved families (68%) and 127 (95%) institutions including 23 religious end-of-life care institutions responded. We performed t-test and χ-square test to compare the GDI scores and provided care for religious and non-religious end-of-life care institutions. The GDI total score was significantly higher (p=0.01) in religious institutions compared to non-religious institutions. Items such as “providing many activities for seasonal events to the patients”, “providing more bereavement care”, “having facilities to practice their religion”, and “having regular visits from religious leaders”, were all reported more frequently in the religious institutions, and significantly associated with achievement of ‘good death’ (p<0.05 for all items). This study suggests that factors for achieving ‘good death’ are not only limited to providing religious care but also providing other forms of care, services, and activities that can enhance the patients’ ‘good death’.</p>

17.
Palliative Care Research ; : 149-158, 2017.
Article in Japanese | WPRIM | ID: wpr-378901

ABSTRACT

<p>Objectives: This study aimed to evaluate good death (end-of-life quality of life) from the perspective of bereaved family members. Methods: We conducted a cross-sectional, anonymous, self-report questionnaire survey for bereaved family members by web survey. Outcomes were achievement of a good death (Good Death Inventory, GDI). We compared the outcomes between with and without dementia. Results: 163 and 224 dying elderly patients with and without comorbid dementia were analyzed from bereaved family members’ responses. The achievement of good death were significantly different (GDI scores, 4.2±1.0, 4.4±0.9, Adj P=0.053) as regards “maintaining hope and pleasure,” “good relationship with family,” and “independence.” Conclusion: The achievement of good death was not significantly different between the dying elderly patients with and without comorbid dementia. Psychosocial care for informal caregivers would be important for better quality of dying in the terminally ill elderly patients with dementia.</p>

18.
Palliative Care Research ; : 159-168, 2017.
Article in Japanese | WPRIM | ID: wpr-378900

ABSTRACT

<p>Objectives: This study aimed to evaluate the consequences of caring for end-of-life elderly patients from the bereaved family’s perspective. Methods: We conducted a cross-sectional, anonymous, self-report questionnaire survey for bereaved family members by web survey. Outcomes were caregiving consequences (Caregiving Consequences Inventory). We compared the outcomes between with and without dementia. Results: 163 and 224 dying elderly patients with and without comorbid dementia were analyzed from bereaved family members’ responses. The outcomes were not significantly different (burden, 5.24±1.12, 5.32±1.24, p=0.487; fulfillment, 4.53±1.06, 4.59±1.29, p=0.627; growth, 4.94±0.93, 5.00±1.04, p=0.523). Fulfillment was significantly associated with spouse, family visitation, and mental health. Growth was significantly associated with age, spouse, end-of-life discussion, and family preference of treatments. Conclusion: The evaluation of the consequences of caring for end-of-life elderly patients from the bereaved family’s perspective were not significantly between the informal caregivers of those with and without comorbid dementia.</p>

19.
Palliative Care Research ; : 131-139, 2017.
Article in Japanese | WPRIM | ID: wpr-378740

ABSTRACT

<p>Aims: The aim of this study was to clarify practical use of feedback report in each institution participated the nationwide bereavement survey (J-HOPE3). Methods: After a nationwide bereavement survey (J-HOPE3) conducted in 2014, we sent a feedback report to each participated institution (20 general wards, 133 inpatient palliative care units, and 22 home hospice services). The feedback report included the results from quality of care, bereaved family’s mental status, and free comments from the participant of their own institution. We sent a questionnaire 4 month following to the feedback report for all institutions regarding the practical use of results from the feedback report. Results: The analysis included 129 (response rate 74%) returned questionnaires. The institutions that they passed around the report was 90%, discussed about their results at a staff meeting was 54%, and reported the results to manager/chief of the institution was 65%. Around 80% of the institutions responded positively to receive the feedback report of their own institution such as “It was good that they could understand the strengths and weakness of their own institutions” which reported that they worked on to improve care were 48%. Conclusions: Current study had shown data about practical use of the feedback report of bereavement study. It is important to feedback the results and encourage the institution to make use of the results in their daily practice, especially to discuss the results in staff meetings.</p>

20.
Palliative Care Research ; : 116-124, 2017.
Article in Japanese | WPRIM | ID: wpr-378738

ABSTRACT

<p>The aim of this study was to investigate the dementia provision for elderly cancer patients in designated regional cancer centers. A survey was mailed to 389 designated regional cancer centers from February to June, 2015. A total of 188 facilities responded (response rate: 48.3%). 5.3% of the respondents used two manuals (on basic dementia care and the behavioral and psychological symptoms of dementia) to check whether these centers were following appropriate measures. About 50% of the respondents performed dementia assessments by the primary care team. 29.3% of the respondents maintained the system of the education and training of dementia care. Therefore, dementia provision for elderly cancer patients in designated regional cancer centers needs to improve the education of dementia care.</p>

SELECTION OF CITATIONS
SEARCH DETAIL