Yu Uneno1, Maki Iwai2, Naoto Morikawa3, Keita Tagami4, Yoko Matsumoto5, Junko Nozato6, Takaomi Kessoku7,8, Tatsunori Shimoi9, Miyuki Yoshida10, Aya Miyoshi11, Ikuko Sugiyama12, Kazuhiro Mantani13, Mai Itagaki14, Akemi Yamagishi15, Tatsuya Morita16, Akira Inoue17, Manabu Muto1. 1. Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan. 2. Former Non-Profit Organization, Cancer Policy Summit, Tokyo, 155-0032, Japan. 3. Department of Clinical Oncology, Tohoku Rosai Hospital, Sendai, 981-8563, Japan. 4. Department of Palliative Medicine, Tohoku University Graduate School of Medicine, Sendai, 980-8575, Japan. 5. Specified Non-Profit Organization, Ehime Cancer Support Association Orange, Matsuyama, 790-0023, Japan. 6. Department of Internal Medicine, Palliative Care, Tokyo Medical and Dental University Hospital, Tokyo, 113-8519, Japan. 7. Department of Palliative Medicine, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. 8. Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. 9. Department of Medical Oncology, National Cancer Center Hospital, Tokyo, 104-0045, Japan. 10. Program for Nursing and Health Sciences, Graduate School of Medicine, Ehime University, Ehime, 791-0295, Japan. 11. Specified Non-Profit Organization, Cancer Support Kagoshima, Kagoshima, 890-8511, Japan. 12. Division of Nursing, Tohoku University Hospital, Sendai, 980-8574, Japan. 13. Cancer Support Centre, National Hospital Organization, Osaka-Minami Medical Center, Osaka, 586-8521, Japan. 14. Section of Research Administration, National Cancer Center Hospital East, Chiba, 277-8577, Japan. 15. Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, 160-8582, Japan. 16. Department of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, 433-8558, Japan. 17. Department of Palliative Medicine, Tohoku University Graduate School of Medicine, Sendai, 980-8575, Japan. akira.inoue.b2@tohoku.ac.jp.
Abstract
BACKGROUND: Despite recommendations to deliver palliative care to cancer patients and their caregivers, their distress has not been alleviated satisfactorily. National health policies play a pivotal role in achieving a comprehensive range of quality palliative care delivery for the public. However, there is no standardised logic model to appraise the efficacy of these policies. This study aimed to develop a logic model of a national health policy to deliver cancer palliative care and to reach consensus towards specific policy proposals. METHODS: A draft version of the logic model and specific policy proposals were formulated by the research team and the internal expert panel, and the independent external expert panel evaluated the policy proposals based on the Delphi survey to reach consensus. RESULTS: The logic model was divided into three major conceptual categories: 'care-delivery at cancer hospitals', 'community care coordination', and 'social awareness of palliative care'. There were 18 and 45 major and minor policy proposals, which were categorised into four groups: requirement of government-designated cancer hospitals; financial support; Basic Plan to Promote Cancer Control Programs; and others. These policy proposals were independently evaluated by 64 external experts and the first to third Delphi round response rates were 96.9-98.4%. Finally, 47 policy proposals reached consensus. The priority of each proposal was evaluated within the four policy groups. CONCLUSIONS: A national health policy logic model was developed to accelerate the provision of cancer palliative care. Further research is warranted to verify the study design to investigate the efficacy of the logic model.
BACKGROUND: Despite recommendations to deliver palliative care to cancer patients and their caregivers, their distress has not been alleviated satisfactorily. National health policies play a pivotal role in achieving a comprehensive range of quality palliative care delivery for the public. However, there is no standardised logic model to appraise the efficacy of these policies. This study aimed to develop a logic model of a national health policy to deliver cancer palliative care and to reach consensus towards specific policy proposals. METHODS: A draft version of the logic model and specific policy proposals were formulated by the research team and the internal expert panel, and the independent external expert panel evaluated the policy proposals based on the Delphi survey to reach consensus. RESULTS: The logic model was divided into three major conceptual categories: 'care-delivery at cancer hospitals', 'community care coordination', and 'social awareness of palliative care'. There were 18 and 45 major and minor policy proposals, which were categorised into four groups: requirement of government-designated cancer hospitals; financial support; Basic Plan to Promote Cancer Control Programs; and others. These policy proposals were independently evaluated by 64 external experts and the first to third Delphi round response rates were 96.9-98.4%. Finally, 47 policy proposals reached consensus. The priority of each proposal was evaluated within the four policy groups. CONCLUSIONS: A national health policy logic model was developed to accelerate the provision of cancer palliative care. Further research is warranted to verify the study design to investigate the efficacy of the logic model.
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