Masanori Mori 1 , Tatsuya Morita 2 , Naoko Igarashi 3 , Yasuo Shima 4 , Mitsunori Miyashita 3 Show Affiliations »
Abstract
OBJECTIVES: Explanation about the impending death of imminently dying patients with cancer is important for their families. However, little is known about how clinicians explain impending death and how families perceive the explanation. We aimed to clarify bereaved families' perception of the need for improvements in the explanation about impending death and to explore the factors contributing to the need. METHODS: In a nationwide survey of 818 bereaved families of patients with cancer admitted to inpatient hospices in Japan, we evaluated family-perceived need for improvements in the explanation about impending death and families' experiences of the explanation. RESULTS: Among all the participants (n=516, 63%), 35 (6.8%), 123 (24%) and 297 (58%) families felt that much/considerable, some and no improvements were needed, respectively. Independent determinants of the need were a younger patient age (OR=0.97; 95% CI 0.95 to 0.99; P=0.009); not receiving an 'explicit explanation about physical signs of impending death' (OR=0.67; 95% CI 0.51 to 0.88; P=0.004); not receiving an 'explanation of how long the patient and family could talk' (OR=0.67; 95% CI 0.51 to 0.88; P<0.001); receiving an 'excessive warning of impending death' (OR=1.45; 95% CI 1.03 to 2.03; P=0.033) and having a feeling of 'uncertainty caused by vague explanations about future changes' (OR=1.77; 95% CI 1.38 to 2.27; P<0.001). CONCLUSIONS: Nearly a third of the bereaved families perceived some need to improve the explanation about impending death. To better help patients/families prepare for their end-of-life, clinicians should recognise and explain various impending death signs; find a balance between detailed explanation and excessive warning and address how long they could talk in the remaining time. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
OBJECTIVES: Explanation about the impending death of imminently dying patients with cancer is important for their families. However, little is known about how clinicians explain impending death and how families perceive the explanation. We aimed to clarify bereaved families' perception of the need for improvements in the explanation about impending death and to explore the factors contributing to the need. METHODS: In a nationwide survey of 818 bereaved families of patients with cancer admitted to inpatient hospices in Japan, we evaluated family-perceived need for improvements in the explanation about impending death and families' experiences of the explanation. RESULTS: Among all the participants (n=516, 63%), 35 (6.8%), 123 (24%) and 297 (58%) families felt that much/considerable, some and no improvements were needed, respectively. Independent determinants of the need were a younger patient age (OR=0.97; 95% CI 0.95 to 0.99; P=0.009); not receiving an 'explicit explanation about physical signs of impending death' (OR=0.67; 95% CI 0.51 to 0.88; P=0.004); not receiving an 'explanation of how long the patient and family could talk' (OR=0.67; 95% CI 0.51 to 0.88; P<0.001); receiving an 'excessive warning of impending death' (OR=1.45; 95% CI 1.03 to 2.03; P=0.033) and having a feeling of 'uncertainty caused by vague explanations about future changes' (OR=1.77; 95% CI 1.38 to 2.27; P<0.001). CONCLUSIONS: Nearly a third of the bereaved families perceived some need to improve the explanation about impending death. To better help patients /families prepare for their end-of-life, clinicians should recognise and explain various impending death signs; find a balance between detailed explanation and excessive warning and address how long they could talk in the remaining time. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Entities: Disease
Species
Keywords:
cancer; explanation; family; hospice care; impending death
Mesh： See more »
Year: 2018
PMID： 29363549 DOI： 10.1136/bmjspcare-2017-001460
Source DB: PubMed Journal: BMJ Support Palliat Care ISSN： 2045-435X Impact factor: 3.568