Factors contributing to evaluation of a good death from the bereaved family member's perspective

Psycho-Oncology - Tập 17 Số 6 - Trang 612-620 - 2008
Mitsunori Miyashita1, Tatsuya Morita2, Kazuki Sato1, Kei Hirai3,4, Yasuo Shima5, Yosuke Uchitomi6
1Department of Adult Nursing/Palliative Care Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
2Department of Palliative and Supportive Care, Palliative Care Team and Seirei Hospice, Seirei Mikatahara Hospital, Shizuoka, Japan
3Center of the Study for Communication Design, Psychology and Behavioral Sciences, Graduate School of Human Sciences, Osaka University, Osaka, Japan
4Department of Complementary and Alternative Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
5Department of Palliative Medicine, Tsukuba Medical Center Hospital, Ibaraki, Japan
6Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Chiba, Japan

Tóm tắt

Abstract

Background: Although it is important to achieve a good death in Japan, there have been no studies to explore factors associated with a good death. The aim of this study was to explore factors contributing to a good death from the bereaved family members' perspectives, including patient and family demographics and medical variables.

Methods: A cross‐sectional anonymous questionnaire survey for bereaved family members of cancer patients who had died in a regional cancer center and a medical chart review were conducted. We measured the results from the Good Death Inventory and family demographics. In addition, we extracted patient demographics, medical variables, and medical interventions in the last 48 h before death from a medical chart review.

Results: Of the 344 questionnaires sent to bereaved family members, 165 responses were analyzed (48%). We found, first, that death in the palliative care unit was more likely to be described as a good death compared with death on a general ward. Some significant characteristics were ‘environmental comfort,’ ‘physical and psychological comfort,’ ‘being respected as an individual,’ and ‘natural death.’ Second, we found that a patient's and family member's age and other demographic factors significantly correlated with an evaluation of a good death. In addition, life prolongation treatment and aggressive treatment such as chemotherapy in the last 2 weeks of life were barriers to attainment of a good death. Moreover, appropriate opioid medication contributed to a good death.

Conclusion: Withholding aggressive treatment and life‐prolonging treatment for dying patients and appropriate opioid use may be associated with achievement of a good death in Japan. Copyright © 2007 John Wiley & Sons, Ltd.

Từ khóa


Tài liệu tham khảo

10.1001/jama.281.2.163

10.7326/0003-4819-132-10-200005160-00011

10.1016/S0885-3924(01)00333-5

10.1016/S0885-3924(01)00335-9

10.1001/jama.284.19.2476

10.1016/S0885-3924(01)00334-7

10.1089/10966210260499014

10.1017/S1478951504040027

10.1016/j.ejca.2006.04.010

10.1016/0277-9536(95)00198-0

10.1191/0269216302pm524oa

10.1001/jama.291.1.88

10.1378/chest.128.1.280

10.1378/chest.127.5.1775

10.1016/S0885-3924(01)00331-1

10.1016/S0885-3924(02)00419-0

10.1016/j.jpainsymman.2003.10.014

10.5630/jans1981.19.1_49

10.1016/j.socscimed.2003.10.037

10.1016/j.jpainsymman.2005.06.012

10.1093/annonc/mdm068

Miyashita M, Good Death Inventory: a measure for evaluating good death from the bereaved family member's perspective, J Pain Symptom Manage

10.1191/0269216302pm514oa

Sato K, Quality of end‐of‐life care for patients with cancer in general wards and palliative care unit at a Japanese regional cancer center, Support Care Cancer

10.1093/annonc/mdm199

10.1016/j.jpainsymman.2004.07.013

Miyashita M, 1999, Attitudes towards terminal care among the general population and medical practitioners in Japan, Jpn J Public Health, 46, 391

10.1200/JCO.2003.03.059

10.1200/JCO.2004.08.136

10.1177/0269216306072553

10.1053/eujp.2001.0285

10.1016/j.jpainsymman.2005.09.004

10.1016/j.jpainsymman.2004.03.004

10.1007/s00520-004-0678-2

10.1089/jpm.2005.8.716

10.1093/annonc/mdh386