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Annals of Oncology Advance Access originally published online on July 28, 2007
Annals of Oncology 2007 18(9):1539-1547; doi:10.1093/annonc/mdm199
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© 2007 European Society for Medical Oncology

palliative care

Preferences regarding end-of-life cancer care and associations with good-death concepts: a population-based survey in Japan

M Sanjo1,*, M Miyashita1, T Morita2, K Hirai3, M Kawa1, T Akechi4 and Y Uchitomi5

1 Department of Adult Nursing/Palliative Care Nursing, Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo
2 Department of Palliative and supportive care, Palliative Care Team and Seirei Hospice, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka
3 Center of the Study for Communication Design, Osaka University, Osaka
4 Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya
5 Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Chiba, Japan

* Correspondence to: M. Sanjo, Department of Adult Nursing/Palliative Care Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Bunkyo-ku, Tokyo 113-0033, Japan. Tel: +81-3-5841-3508; Fax: +81-3-5841-3502; E-mail: shibagaki-tky{at}umin.ac.jp

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.

Key words: attitude towards death, palliative care, neoplasm, cross-sectional studies

Received for publication January 5, 2007. Revision received April 4, 2007. Accepted for publication April 11, 2007.


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