Takuya Shinjo1, Tatsuya Morita2, Kei Hirai3, Mitsunori Miyashita4, Megumi Shimizu4, Satoru Tsuneto5, Yasuo Shima6. 1. Shinjo Clinic, Kobe, Japan. Electronic address: shinjo@doctor.email.ne.jp. 2. Department of Palliative and Supportive Care, Palliative Care Team and Seirei Hospice, Seirei Mikatahara Hospital, Hamamatsu, Japan. 3. Department of Complementary and Alternative Medicine, Osaka University Graduate School of Medicine, Osaka, Japan. 4. Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan. 5. Department of Multidisciplinary Cancer Treatment Graduate School of Medicine, Kyoto University, Kyoto, Japan. 6. Department of Palliative Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan.
Abstract
CONTEXT: Many surveys have evaluated patient-related barriers to pain management. OBJECTIVES: To explore associations between a preference for opioids and general attitudes toward drugs, the experience and information received as a bereaved family, and beliefs regarding a good death. METHODS: A cross-sectional survey, performed in 2010, of bereaved families of patients with cancer in palliative care units across Japan. Questionnaires were sent to 997 families. RESULTS: A total of 66% of families responded. Of these, 224 responses were excluded because the family declined to participate in the study (n = 38), the patient was not receiving any opioid analgesics, and there were missing data (n = 164), or data were missing for the primary end points (n = 22). Thus, 432 responses were finally analyzed (43%). In total, 26%, 41%, and 31% of family members stated that they strongly want to receive, want to receive, or slightly want to receive opioids if needed in the future, respectively. Determinants associated with a preference for receiving opioid treatment were the following: a general appreciation of the drugs (P = 0.005), witnessing an improvement in the patient's quality of life as a result of pain relief (P = 0.003), information provided by medical professionals that the opioid could be discontinued if side effects developed (P = 0.042), and the belief that a good death was one that was free from pain and physical distress (P < 0.001). CONCLUSION: More than 90% of bereaved families whose relatives were treated with opioid analgesics reported a preference to receive opioid analgesics for the treatment of cancer pain, if necessary, in the future.
CONTEXT: Many surveys have evaluated patient-related barriers to pain management. OBJECTIVES: To explore associations between a preference for opioids and general attitudes toward drugs, the experience and information received as a bereaved family, and beliefs regarding a good death. METHODS: A cross-sectional survey, performed in 2010, of bereaved families of patients with cancer in palliative care units across Japan. Questionnaires were sent to 997 families. RESULTS: A total of 66% of families responded. Of these, 224 responses were excluded because the family declined to participate in the study (n = 38), the patient was not receiving any opioid analgesics, and there were missing data (n = 164), or data were missing for the primary end points (n = 22). Thus, 432 responses were finally analyzed (43%). In total, 26%, 41%, and 31% of family members stated that they strongly want to receive, want to receive, or slightly want to receive opioids if needed in the future, respectively. Determinants associated with a preference for receiving opioid treatment were the following: a general appreciation of the drugs (P = 0.005), witnessing an improvement in the patient's quality of life as a result of pain relief (P = 0.003), information provided by medical professionals that the opioid could be discontinued if side effects developed (P = 0.042), and the belief that a good death was one that was free from pain and physical distress (P < 0.001). CONCLUSION: More than 90% of bereaved families whose relatives were treated with opioid analgesics reported a preference to receive opioid analgesics for the treatment of cancer pain, if necessary, in the future.