Annals of Oncology Advance Access published online on March 12, 2007
Annals of Oncology, doi:10.1093/annonc/mdm068
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© 2007 European Society for Medical Oncology
Good death in cancer care: a nationwide quantitative study
1 Department of Adult Nursing/Palliative Care Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo
2 Department of Palliative and Supportive Care, Palliative Care Team and Seirei Hospice, Seirei Mikatahara Hospital, Shizuoka
3 Center of the Study for Communication Design, Psychology and Behavioral Sciences, Graduate School of Human Science, Department of Complementary and Alternative Medicine, Graduate School of Medicine, Osaka University, Osaka
4 Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Chiba, Japan
* Correspondence to: Dr M. Miyashita, Department of Adult Nursing/Palliative Care Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. Tel: +81-3-5841-3507; Fax: +81-3-5841-3502; E-mail: miyasita-tky{at}umin.net
Background: The aims of this study were to (i) conceptualize dimensions of a good death in Japanese cancer care, (ii) clarify the relative importance of each component of a good death and (iii) explore factors related to an individual's perception of the domains of a good death.
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 were surveyed as well (n = 513; 70%). We asked the subjects about the relative importance of 57 components of a good death.
Results: Explanatory factor analysis demonstrated 18 domains contributing to a good death. Ten domains were classified as ‘consistently important domains’, including ‘physical and psychological comfort’, ‘dying in a favorite place’, ‘good relationship with medical staff’, ‘maintaining hope and pleasure’, ‘not being a burden to others’, ‘good relationship with family’, ‘physical and cognitive control’, ‘environmental comfort’, ‘being respected as an individual’ and ‘life completion’.
Conclusions: We quantitatively identified 18 important domains that contribute to a good death in Japanese cancer care. The next step of our work should be to conduct a national survey to identify what is required to achieve a good death.
attitude to death, good death, hospice, neoplasms, palliative care, public opinion
Received for publication September 28, 2006. Revision received December 19, 2006. Accepted for publication January 29, 2007.
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