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
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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