M Sanjo1, M Miyashita, T Morita, K Hirai, M Kawa, T Akechi, Y Uchitomi. 1. Department of Adult Nursing/Palliative Care Nursing, Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan. shibagaki-tky@umin.ac.jp
Abstract
BACKGROUND: The aims of this study were to clarify end-of-life cancer care preferences and associations with good-death concepts. METHODS: The general population was sampled using a stratified random sampling method (N = 2548; response rate = 51%) and bereaved families from 12 certified palliative care units ('PCU-bereaved families') were surveyed (N = 513; response rate = 70%). The respondents reported their end-of-life care preferences and good-death concepts. RESULTS: Regarding place of end-of-life care, approximately 50% of the general population preferred 'Home', while 73% of PCU-bereaved families preferred 'PCU'. The concepts of 'Maintaining hope and pleasure' and 'Dying in a favorite place' were associated with the preference for 'Home'. Regarding prognostic disclosure, approximately 50% of the participants preferred some level of negotiation with the physician. The concept of 'Control over the future' was associated with this preference. Regarding treatment of severe refractory physical distress, 75% of the general population and 85% of the PCU-bereaved families preferred palliative sedation therapy. The concepts of 'Physical and psychological comfort' and 'Unawareness of death' were associated with this preference. CONCLUSIONS: End-of-life care preferences were associated with good-death concepts. It would be useful for health-care workers to discuss patients' good-death concepts to support subsequent treatment decisions.
BACKGROUND: The aims of this study were to clarify end-of-life cancer care preferences and associations with good-death concepts. METHODS: The general population was sampled using a stratified random sampling method (N = 2548; response rate = 51%) and bereaved families from 12 certified palliative care units ('PCU-bereaved families') were surveyed (N = 513; response rate = 70%). The respondents reported their end-of-life care preferences and good-death concepts. RESULTS: Regarding place of end-of-life care, approximately 50% of the general population preferred 'Home', while 73% of PCU-bereaved families preferred 'PCU'. The concepts of 'Maintaining hope and pleasure' and 'Dying in a favorite place' were associated with the preference for 'Home'. Regarding prognostic disclosure, approximately 50% of the participants preferred some level of negotiation with the physician. The concept of 'Control over the future' was associated with this preference. Regarding treatment of severe refractory physical distress, 75% of the general population and 85% of the PCU-bereaved families preferred palliative sedation therapy. The concepts of 'Physical and psychological comfort' and 'Unawareness of death' were associated with this preference. CONCLUSIONS: End-of-life care preferences were associated with good-death concepts. It would be useful for health-care workers to discuss patients' good-death concepts to support subsequent treatment decisions.