[A newly opened palliative care ward and the nursing of terminal patients with gynecological cancer at our Department of Obstetrics and Gynecology in Tokyo Women's Medical University Hospital].

Seventy-nine terminal patients with gynecological cancer treated in the past 5 years in our hospital or their families were interviewed on where those patients died and the reason why they chose to die in the place. Fifty-two patients (65.8%) were died at our hospital, 18 patients (22.8%) at other hospitals, 5 (6.3%) at other hospice and 4 (5.1%) at home. The 52 patients who died at our hospital were asked why they chose to die there. 42 of them (80.8%) wanted care at our hospital to the death. 10 (20.2%) had no time to think of home care or other institutions because of the sudden change of the condition. The 18 patients who died at other institutions were also asked about the reason. 9 of them (50%) wanted to die in their hometown or close to their home. 5 of them (27.8%) were referred to other hospitals due to brain metastasis or the necessity of undergoing dialysis. 2 of them (11.1%) were referred to the institutions which provide long-term care. 2 of them (11.1%) were brought into a nearby emergent care hospital and died after the sudden change of the condition. The palliative care ward in our university hospital can provide continued relationship with cancer patients. We had time to talk enough with carcinoma patients and their family in the ward, which widened choices of their death place, including home death.

[A newly opened palliative care ward and the nursing of terminal patients with gynecological cancer at our Department of Obstetrics and Gynecology in Tokyo Women's Medical University Hospital].

Seventy-nine terminal patients with gynecological cancer treated in the past 5 years in our hospital or their families were interviewed on where those patients died and the reason why they chose to die in the place. Fifty-two patients (65.8%) died at our hospital, 18 patients (22.8%) at other hospitals, 5 (6.3%) at other hospice and 4 (5.1%) at home. The 52 patients who died at our hospital were asked why they chose to die there. 42 of them (80.8%) wanted care at our hospital to the death. 10 (20.2%) had no time to think of home care or other institutions because of the sudden change of the condition. The 18 patients who died at other institutions were also asked about the reason. 9 of them (50%) wanted to die in their hometown or close to their home. 5 of them (27.8%) were referred to other hospitals due to brain metastasis or the necessity of undergoing dialysis. 2 of them (11.1%) were referred to the institutions which provide long-term care. 2 of them (11.1%) were brought into a nearby emergent care hospital and died after the sudden change of the condition. The palliative care ward in our university hospital can provide continued relationship with cancer patients. We had time to talk enough with carcinoma patients and their family in the ward, which widened choices of their death place, including home death.

[Present situation of home care and roles of nurses at Tokyo Women's Medical University Hospital--through the 5-year home care support activities].

Diseases, details of interventions, medical cares provided and the condition of use and services of local medical institutions were investigated in the home care support activities during the period from November 1997 to March 2003. We intervened in 1,309 patients. 70% of them were terminal patients with malignant tumor. Interventions were mostly consultations about the life under medical care, guidance about HPN/tube feeding, consultations about nursing and coordination with local medical institutions. 422 of them were under care of family doctors. 502 of them used visiting nursing. 70% of the patients under care of the hospital required high-tech home care and home hospice care. The 5-year activities indicate that nurses who support home care at the hospitals providing acute medical care are expected to (1) serve as the consultation contact for patients and families, (2) support the life under medical care in consultation with internal and external related professionals, (3) use social resources, (4) serve as the contact for providing the logistic support under an emergent situation or under the lack of care-giving capabilities, (5) provide guidance for the safe use of high-tech home medical care by patients/families at the discharge, (6) communicate or coordinate with local medical institutions for continued care/nursing and (7) develop/support the flexible and convenient distribution system of medical equipment and medical materials/drugs or the 24 hour healthcare support system jointly with private enterprises.

[Present situation of home care and roles of nurses at Tokyo Women's Medical University Hospital--through the 5-year home care support activities].

Diseases, details of interventions, medical cares provided and the condition of use and services of local medical institutions were investigated in the home care support activities during the period from November 1997 to March 2003. We intervened in 1,309 patients. 70% of them were terminal patients with malignant tumor. Interventions were mostly consultations about the life under medical care, guidance about HPN/tube feeding, consultations about nursing and coordination with local medical institutions. 422 of them were under care of family doctors. 502 of them used visiting nursing. 70% of the patients under care of the hospital required high-tech home care and home hospice care. The 5-year activities indicate that nurses who support home care at the hospitals providing acute medical care are expected to 1. serve as the consultation contact for patients and families, 2. support the life under medical care in consultation with internal and external related professionals, 3. use social resources, 4. serve as the contact for providing the logistic support under an emergent situation or under the lack of care-giving capabilities, 5. provide guidance for the safe use of high-tech home medical care by patients/families at the discharge, 6. communicate or coordinate with local medical institutions for continued care/nursing and 7. develop/support the flexible and convenient distribution system of medical equipment and medical materials/drugs or the 24-hour healthcare support system jointly with private enterprises.