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Abstract
OBJECTIVE China is home to one-fifth of the world's population. In the setting of a growing and aging population as well as the designation of palliative care access as a human right in 2013, the implementation of palliative care in China gains special importance. Palliative care education is an important precondition to ensure a nationwide access to palliative care. This systematic review details the status of under- and postgraduate palliative care education in China, examining both the students' and physicians' perception, knowledge, and skills in palliative care, and the available educational interventions and programs. METHOD Four databases were searched in September 2018, using considered search terms. Titles, abstracts, and, if necessary, full texts were scanned to identify publications matching the inclusion criteria. RESULTS Nine publications were included. They revealed six findings: palliative care education is lacking in both under- and postgraduate medical education, only a few programs exist. Palliative care as a concept is well known, detailed knowledge, and practical skills are less developed. Chinese physicians consider palliative care an important field to be developed in cancer care, yet the majority of healthcare professionals are not willing to work in palliative care services. Communication should be a main emphasis in palliative care education, especially in undergraduate training. Finally, there is no highly qualified research on under- or postgraduate palliative care education in Mainland China. SIGNIFICANCE OF RESULTS These findings suggest that palliative care education in China is in demand and should be systematically integrated into medical education. Further research on the topic is urgently needed.
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Uneno Y, Sato K, Morita T, Nishimura M, Ito S, Mori M, Shimizu C, Horie Y, Hirakawa M, Nakajima TE, Tsuneto S, Muto M. Current status of integrating oncology and palliative care in Japan: a nationwide survey. BMC Palliat Care 2020; 19:12. [PMID: 31980015 PMCID: PMC6982384 DOI: 10.1186/s12904-020-0515-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 01/13/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Palliative care (PC) is increasingly recognized as essential for oncology care, and several academic societies strongly recommend integrating oncology and palliative care (IOP) in daily practice. Similarly, the Japanese government encouraged the implementation of IOP through the Cancer Control Act of 2007; however, its detailed progress remains unclear. Therefore, this cross-sectional nationwide survey was conducted to investigate the current status and hospital executive physicians' perception of IOP. METHODS The questionnaire was developed based on IOP indicators with international consensus. It was distributed to executive physicians at all government-designated cancer hospitals (DCHs, n = 399) and matched non-DCHs (n = 478) in November 2017 and the results were compared. RESULTS In total, 269 (67.4%) DCHs and 259 (54.2%) non-DCHs responded. The number of PC resources in DCHs was significantly higher than those in non-DCHs (e.g., full-time PC physicians and nurses, 52.8% vs. 14.0%, p < 0.001; availability of outpatient PC service ≥3 days per week, 47.6% vs. 20.7%, p < 0.001). Routine symptom screening was more frequently performed in DCHs than in non-DCHs (65.1% vs. 34.7%, p < 0.001). Automatic trigger for PC referral availability was limited (e.g., referral using time trigger, 14.9% vs. 15.3%, p = 0.700). Education and research opportunities were seriously limited in both types of hospitals. Most executive physicians regarded IOP as beneficial for their patients (95.9% vs. 94.7%, p = 0.163) and were willing to facilitate an early referral to PC services (54.7% vs. 60.0%, p < 0.569); however, the majority faced challenges to increase the number of full-time PC staff, and < 30% were planning to increase the staff members. CONCLUSIONS This survey highlighted a considerable number of IOP indicators met, particularly in DCHs probably due to the government policy. Further efforts are needed to address the serious research/educational gaps.
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Affiliation(s)
- Y Uneno
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho Shogoin Sakyo-ku, Kyoto, 606-8507, Japan. .,Seirei Hospice, Seirei Mikatahara General Hospital, Hamamatsu, Japan.
| | - K Sato
- Department of Nursing, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - T Morita
- Division of Supportive and Palliative Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - M Nishimura
- Geriatric Health Service Facility, You-You no Sono, Hiroshima, Japan.,Department of Health Informatics, Kyoto University Graduate School of Medicine/ School of Public Health, Kyoto, Japan
| | - S Ito
- Department of Health Informatics, Kyoto University Graduate School of Medicine/ School of Public Health, Kyoto, Japan
| | - M Mori
- Palliative Care Team, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - C Shimizu
- Department of Breast Medical Oncology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Y Horie
- Department of Clinical Oncology, St Marianna University School of Medicine, Kawasaki, Japan
| | - M Hirakawa
- Department of Clinical Oncology, St Marianna University School of Medicine, Kawasaki, Japan
| | - T E Nakajima
- Department of Clinical Oncology, St Marianna University School of Medicine, Kawasaki, Japan
| | - S Tsuneto
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - M Muto
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho Shogoin Sakyo-ku, Kyoto, 606-8507, Japan
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Manirakiza A, Irakoze L, Manirakiza S, Bizimana P. Efficacy and Safety of Fentanyl Compared With Morphine among Adult Patients with Cancer: A Meta-Analysis. East Afr Health Res J 2020; 4:8-16. [PMID: 34308214 PMCID: PMC8279272 DOI: 10.24248/eahrj.v4i1.617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 04/29/2020] [Indexed: 11/25/2022] Open
Abstract
Background: Cancer pain is experienced by numerous patients; thus, the main pain-relieving opioid analgesics, fentanyl and morphine, are of great importance. However, their analgesic efficacy and safety are different among individuals and are still controversial. The aim of this study was to compare the safety and efficacy of fentanyl and morphine among patients with cancer. Methods: We performed a meta-analysis by searching PubMed and the Cochrane Library up to 01 April 2019. The search terms were fentanyl, morphine, opioids and cancer pain. All randomised controlled trials comparing fentanyl and morphine were included in the analysis. Results: Overall, the initial search identified 2970 published studies; among them, 9 studies were included in the efficacy analysis and 8 studies were included in the safety analysis. The oral morphine versus oral transmucosal fentanyl subgroup analysis showed a mean difference(MD)=0.47[Confidence interval(CI):0.35-0.58] with an overall effect, Z=8.10, P<.00001. The outcome of the oral morphine versus nasal/transdermal fentanyl subgroup indicated a MD=0.20[CI:0.3-0.37] with an overall effect, Z=2.24 and P=.02. For the oral morphine versus buccal/sublingual fentanyl subgroup, the analysis revealed a MD=1.80[CI:1.35-2.25] with an overall effect, Z=7.87 and P<.00001. The oral morphine versus other forms of fentanyl subgroup showed a MD=0.70[95%CI:0.34-1.06] with the test for the overall effect, Z=3.81 and P=.0001. Constipation, drowsiness, confusion and dry mouth were more common in the morphine group than in the fentanyl group, with a risk ratio=0.60[CI:0.37-0.97]; 0.93[CI:0.69-1.25]; 0.85[CI:0.23-3.13] and 0.54[CI:0.05-6.43], respectively. Conclusions: Compared with oral morphine, fentanyl is safer and more effective. Moreover, fentanyl presents fewer side effects than morphine, especially constipation, drowsiness, confusion and dry mouth.
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Inoue A, Yamaguchi T, Tanaka K, Sakashita A, Aoe K, Seki N, Hagiwara K. Benefits of a Nationwide Palliative Care Education Program on Lung Cancer Physicians. Intern Med 2019; 58:1399-1403. [PMID: 30713293 PMCID: PMC6548920 DOI: 10.2169/internalmedicine.0872-18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 07/16/2018] [Indexed: 01/22/2023] Open
Abstract
Objective The early integration of palliative care into standard cancer treatment has become a global standard. The Palliative care Emphasis program on symptom management and Assessment for Continuous medical Education (PEACE) has been conducted in Japan, and previous studies have reported that the PEACE workshop was able to improve various palliative care skills of participants. However, whether or not the effects of the program are long-lasting and if the program consequently changed physicians' practice with regard to lung cancer patients have been unclear. Methods Web-based surveys, including the palliative care knowledge test (PEACE-Q), the Palliative Care self-reported Practice Scale (PCPS), and the Palliative Care Difficulties Scale (PCDS), were conducted among lung cancer physicians in Japan. The differences in the survey results between participants and non-participants of the PEACE workshop were examined. Results Among 923 respondents (455 respiratory physicians, 345 pulmonary surgeons, and 123 others), 519 had participated in the PEACE workshop. The total PEACE-Q score was significantly higher in the PEACE workshop participants than in non-participants (28.0 versus 24.5, p<0.0001). The score was significantly higher in respiratory physicians than in pulmonary surgeons (27.4 versus 25.5). The total PCPS and PCDS scores were also significantly better in workshop participants than in non-participants (71.8 versus 67.1 and 34.3 versus 36.9, respectively), although some domains of PCDS were similar between the groups. Conclusion The PEACE program improved the knowledge and practices with regard to palliative care and resolved difficulties associated therewith among lung cancer physicians. In regions where palliative care specialists are insufficient, such educational programs may be effective.
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Affiliation(s)
- Akira Inoue
- Department of Palliative Medicine, Tohoku University School of Medicine, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Japan
| | - Keiko Tanaka
- Department of Palliative Care, Tokyo Metropolitan Cancer & Infectious Diseases Center Komagome Hospital, Japan
| | - Akihiro Sakashita
- Department of Palliative Medicine, Kobe University Graduate School of Medicine, Japan
| | - Keisuke Aoe
- Department of Medical Oncology, Yamaguchi-Ube Medical Center, Japan
| | - Nobuhiko Seki
- Division of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Japan
| | - Koichi Hagiwara
- Division of Pulmonary Medicine, Department of Internal Medicine, Jichi Medical University, Japan
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Ahmedzai SH, Bautista MJ, Bouzid K, Gibson R, Gumara Y, Hassan AAI, Hattori S, Keefe D, Kraychete DC, Lee DH, Tamura K, Wang JJ. Optimizing cancer pain management in resource-limited settings. Support Care Cancer 2018; 27:2113-2124. [PMID: 30242544 PMCID: PMC6499735 DOI: 10.1007/s00520-018-4471-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 09/10/2018] [Indexed: 12/11/2022]
Abstract
Purpose Adequate cancer pain management (CPM) is challenging in resource-limited settings, where current international guideline recommendations are difficult to implement owing to constraints such as inadequate availability and accessibility of opioids, limited awareness of appropriate opioid use among patients and clinicians, and lack of guidance on how to translate the best evidence into clinical practice. The multinational and multidisciplinary CAncer Pain managEment in Resource-limited settings (CAPER) Working Group proposes a two-step initiative to bridge clinical practice gaps in CPM in resource-limited settings. Methods A thorough review of the literature, a steering committee meeting in February 2017, and post-meeting teleconference discussions contributed to the development of this initiative. As a first step, we developed practical evidence-based CPM algorithms to support healthcare providers (HCPs) in tailoring treatment according to availability of and access to resources. The second part of the initiative proposes a framework to support an effective implementation of the CPM algorithms that includes an educational program, a pilot implementation, and an advocacy plan. Results We developed CPM algorithms for first-line use, breakthrough cancer pain, opioid rotation, and refractory cancer pain based on the National Comprehensive Cancer Network guidelines and expert consensus. Our proposed educational program emphasizes the practical elements and illustrates how HCPs can provide optimal CPM according to evidence-based guidelines despite varied resource limitations. Pilot studies are proposed to demonstrate the effectiveness of the algorithms and the educational program, as well as for providing evidence to support a draft advocacy document, to lobby policymakers to improve availability and accessibility of analgesics in resource-limited settings. Conclusions These practical evidence-informed algorithms and the implementation framework represent the first multinational step towards achieving optimal CPM in resource-limited settings. Electronic supplementary material The online version of this article (10.1007/s00520-018-4471-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sam H Ahmedzai
- National Institute of Health Research Clinical Research Network for Cancer, Leeds, UK
| | | | - Kamel Bouzid
- Medical Oncology Department, Pierre & Marie Curie Center, Algiers, Algeria
| | - Rachel Gibson
- Division of Health Sciences, University of South Australia, Adelaide, Australia
| | - Yuddi Gumara
- National Cancer Center Dharmais Hospital, Jakarta, Indonesia
| | - Azza Adel Ibrahim Hassan
- Supportive & Palliative Care Section, Medical Oncology Department, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar.,Cancer Management & Research, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Seiji Hattori
- Department of Cancer Pain Management, The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - Dorothy Keefe
- Department of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, Australia
| | | | - Dae Ho Lee
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Kazuo Tamura
- General Medical Research Center, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Jie Jun Wang
- Department of Oncology, Shanghai Changzheng Hospital, Second Military Medical University, No. 64 He Tian Road, Shanghai, 200070, People's Republic of China.
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Yoshimoto T, Ryu E, Tomiyasu S, Hojo M, Kokubun H, Matoba M. Efficacy and Safety of Oxycodone Injection for Relieving Cancer Pain: A Study in Japan Consisting of Two Open Trials for Intravenous and Subcutaneous Administration. Biol Pharm Bull 2018. [PMID: 29526884 DOI: 10.1248/bpb.b17-00728] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Pure oxycodone injection became increasingly necessary after oral oxycodone was launched in Japan in 2003. However, trials clarifying the efficacy and safety of injection are rare. Therefore, a multicenter open study on injection was designed and carried out in 2010, resulting in the launch of injection therapy in 2012. As published domestic case reports on efficacy already show widespread prescription, this study aimed to provide useful information for cancer pain relief in Japan and other countries. Our oxycodone injection study consisted of two trials, one of intravenous (S#9131) and the other of subcutaneous (S#9132) administration. The minimum required number of enrolled patients suffering cancer pain was determined to be 70 in S#9131 and 20 in S#9132. These studies had the same dose-titration protocol as the main endpoint, i.e., pain relief rate (PRR) defined as the rate of achieving adequate pain control (APC), as in prior oral oxycodone trials in Japan. In S#9131, PRR was 81.4% (95% confidence interval: 70.3-89.7%), therefore, the null hypothesis of PRR<70% was rejected using the binominal one-sided test (p=0.0217). In S#9132, PRR was 73.7% also surpassing 70%. Safety was also assessed in the same way as in prior trials. The majority of adverse effects were moderate or mild and recovered with no sequelae. As shown above, the injection was considered to be effective and safe in cancer pain treatment. The details of these trials, particularly the dose-titration protocol for achieving APC and route switching information, are expected to enhance injection convenience for prescribers.
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Affiliation(s)
| | - Emi Ryu
- Department of Hospital Pharmacy, Nagasaki University Hospital
| | - Shiro Tomiyasu
- Department of Palliative Care, Sasebo City General Hospital
| | | | - Hideya Kokubun
- Department of Pharmacy, Tokyo University of Pharmacy and Life Sciences
| | - Motohiro Matoba
- Department of Palliative Care, Japanese Red Cross Medical Center
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Murakami N, Tanabe K, Morita T, Fujikawa Y, Koseki S, Kajiura S, Nakajima K, Hayashi R. Impact of a Six-Year Project to Enhance the Awareness of Community-Based Palliative Care on the Place of Death. J Palliat Med 2018; 21:1494-1498. [PMID: 29723109 PMCID: PMC6200065 DOI: 10.1089/jpm.2017.0696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Object: To examine the clinical outcomes of a project to enhance the awareness of community-based palliative care (awareness-enhancing project), focusing on home death and care rates in communities. Methods: A single-center study on community-based intervention was conducted. The awareness-enhancing project, consisting of three intervention approaches (outreach, palliative care education for community-based medical professionals, and information-sharing tool use), was executed, and changes in the home death rate in the community were examined. Results: The home death rate markedly exceeded the national mean from 2010. In 2012–2013, it was as high as 19.9%, greater than the previous 5.9% (p = 0.001). Through multivariate analysis, the participation of home care physicians and visiting nurses in a palliative care education program, and patients' Palliative Prognostic Index values were identified as factors significantly influencing the home death rate. Conclusion: The three intervention approaches time dependently increased the home death rate as a clinical outcome in the community, although they targeted limited areas. These approaches may aid in increasing the number of individuals who die in their homes.
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Affiliation(s)
- Nozomu Murakami
- 1 Department of Palliative Care Surgery, Kouseiren Takaoka Hospital , Takaoka, Toyama, Japan
| | - Kouichi Tanabe
- 2 Drug Informatics, Faculty of Pharmacy, Meijo University , Nagoya, Aichi, Japan
| | - Tatsuya Morita
- 3 Department of Palliative and Supportive Care, Seirei Mikatahara Hospital , Hamamatsu, Shizuoka, Japan
| | - Yasunaga Fujikawa
- 4 A Board of Palliative Care, Saiseikai Takaoka Hospital , Takaoka, Toyama, Japan
| | - Shiro Koseki
- 5 Home Palliative Care Committee, Takaoka Medical Service Region , Takaoka, Toyama, Japan
| | - Shinya Kajiura
- 6 Department of Medical Oncology, Toyama University Hospital , Toyama, Toyama, Japan
| | - Kazunori Nakajima
- 1 Department of Palliative Care Surgery, Kouseiren Takaoka Hospital , Takaoka, Toyama, Japan
| | - Ryuji Hayashi
- 6 Department of Medical Oncology, Toyama University Hospital , Toyama, Toyama, Japan
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Nakazawa Y, Yamamoto R, Kato M, Miyashita M, Kizawa Y, Morita T. Improved knowledge of and difficulties in palliative care among physicians during 2008 and 2015 in Japan: Association with a nationwide palliative care education program. Cancer 2017; 124:626-635. [DOI: 10.1002/cncr.31071] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 09/10/2017] [Accepted: 09/14/2017] [Indexed: 11/10/2022]
Affiliation(s)
- Yoko Nakazawa
- Division of Medical Support and Partnership; Center for Cancer Control and Information Services, National Cancer Center; Tokyo Japan
- Department of Palliative Nursing, Health Sciences; Tohoku University Graduate School of Medicine; Miyagi Japan
| | - Ryo Yamamoto
- Department of Palliative Medicine; Saku Central Hospital Advanced Care Center; Nagano Japan
| | - Masashi Kato
- Division of Medical Support and Partnership; Center for Cancer Control and Information Services, National Cancer Center; Tokyo Japan
| | - Mitsunori Miyashita
- Department of Palliative Nursing, Health Sciences; Tohoku University Graduate School of Medicine; Miyagi Japan
| | - Yoshiyuki Kizawa
- Division of Palliative Medicine; Kobe University Hospital, Kobe University School of Medicine; Hyogo Japan
| | - Tatsuya Morita
- Department of Palliative and Supportive Care; Palliative Care Team, and Seirei Hospice, Seirei Mikatahara General Hospital; Shizuoka Japan
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Yamaguchi T, Maeda I, Hatano Y, Mori M, Shima Y, Tsuneto S, Kizawa Y, Morita T, Yamaguchi T, Aoyama M, Miyashita M. Effects of End-of-Life Discussions on the Mental Health of Bereaved Family Members and Quality of Patient Death and Care. J Pain Symptom Manage 2017; 54:17-26.e1. [PMID: 28450216 DOI: 10.1016/j.jpainsymman.2017.03.008] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 03/02/2017] [Accepted: 03/17/2017] [Indexed: 11/24/2022]
Abstract
CONTEXT End-of-life discussions are crucial for providing appropriate care to patients with advanced cancer at the end of their lives. OBJECTIVES The objective of this study was to explore associations between end-of-life discussions and bereaved families' depression and complicated grief and the quality of patient death and end-of-life care. METHODS A nationwide questionnaire survey of bereaved family members was conducted between May and July 2014. A total of 13,711 bereaved family members of cancer patients who were cared for by specialist palliative care services at 75 institutions throughout Japan and died before January 2014 participated. We evaluated the prevalence of depression (defined as the Patient Health Questionnaire-9 ≥ 10) and complicated grief (defined as the Brief Grief Questionnaire ≥ 8) in bereaved family members. Moreover, we evaluated the quality of death and end-of-life care with the Good Death Inventory and the Care Evaluation Scale, respectively. RESULTS A total of 9123 questionnaires were returned (response rate 67%), and 80.6% of the respondents reported that they had end-of-life discussions. After propensity score-weighted adjustment, the results showed that bereaved family members who had end-of-life discussions had a lower frequently of depression (17.3% vs. 21.6%; P < 0.001) and complicated grief (13.7% vs. 15.9%; P = 0.03). End-of-life discussions were associated with better quality of death (the Good Death Inventory score, 47.2 ± 8.5 vs. 46.1 ± 9.4; P < 0.001) and end-of-life care (the Care Evaluation Scale score, 84.1 ± 11.4 vs. 78.9 ± 14.3; P < 0.001). CONCLUSION End-of-life discussions may contribute to reducing depression and complicated grief in bereaved family members and enable patients to experience quality end-of-life care and a good death.
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Affiliation(s)
- Takashi Yamaguchi
- Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Japan; Department of Palliative Care, Hyogo Prefectural Kakogawa Medical Center, Kakogawa, Japan.
| | - Isseki Maeda
- Gratia Hospice, Gratia Research and Clinical Education (GRACE) Center, Gratia Hospital, Minoh, Japan
| | - Yutaka Hatano
- Department of Psychosomatic Medicine, Kinki University Hospital, Osaka-Sayama, Japan
| | - Masanori Mori
- Department of Laboratory Medicine, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Yasuo Shima
- Department of Palliative Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan
| | - Satoru Tsuneto
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoshiyuki Kizawa
- Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tatsuya Morita
- Department of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Maho Aoyama
- Division of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mitsunori Miyashita
- Division of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
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Masaki H, Kawai N, Matsumoto K, Kuwata M, Yoshioka S, Nishiyama M, Uchino R, Nagae H, Teshima M, Sakai S, Endo K. Consensus development of quality indicators for end-of-life care for elders in Japan. Int J Nurs Pract 2017. [DOI: 10.1111/ijn.12562] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Harue Masaki
- Graduate School of Nursing; Chiba University; Chiba Japan
| | | | | | | | | | | | - Ryoko Uchino
- Takinoi Regional Comprehensive Support Center; Funabashi Japan
| | | | - Megumi Teshima
- Graduate School of Nursing; Chiba University; Chiba Japan
| | | | - Kazuko Endo
- Yamagata Prefectural University of Health Sciences; Yamagata Japan
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Yoshimoto T, Tomiyasu S, Saeki T, Tamaki T, Hashizume T, Murakami M, Matoba M. How Do Hospital Palliative Care Teams Use the WHO Guidelines to Manage Unrelieved Cancer Pain? A 1-Year, Multicenter Audit in Japan. Am J Hosp Palliat Care 2016; 34:92-99. [DOI: 10.1177/1049909115608810] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
It has been reported that pain relief for patients with cancer is suboptimal in Japan. This has been mainly attributed to inadequate dissemination of the World Health Organization (WHO) guidelines for cancer pain management. To better understand this problem, we reviewed how 6 hospital palliative care teams (HPCTs) used the WHO guidelines for unrelieved pain in a 1-year audit that included 534 patients. The HPCT interventions were classified according to the contents of the WHO guidelines. In our study, HPCT interventions involved opioid prescriptions in >80% of referred patients, and “For the Individual” and “Attention to Detail” were the 2 most important principles. Our study indicates which parts of the WHO guidelines should be most heavily emphasized, when disseminating them in Japan.
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Affiliation(s)
| | - Shiro Tomiyasu
- Department of Anesthesia and Palliative Care, Nishida Hospital, Saga, Japan
| | - Toshinari Saeki
- Department of Palliative Care Medicine, Municipal Miyoshi Central Hospital, Hiroshima, Japan
| | - Tomohiro Tamaki
- Department of Palliative Care, Cancer Center, Hokkaido University Hospital, Hokkaido, Japan
| | | | - Masahiko Murakami
- Department of Palliative Care Medicine, Iwate Prefectural Ofunato Hospital, Iwate, Japan
| | - Motohiro Matoba
- Department of Palliative Care Medicine, Japanese Red Cross Medical Center, Tokyo, Japan
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12
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Sakaguchi M, Maebayashi T, Aizawa T, Ishibashi N, Fukushima S, Saito T. Radiation Therapy and Palliative Care Prolongs the Survival of Hepatocellular Carcinoma Patients with Bone Metastases. Intern Med 2016; 55:1077-83. [PMID: 27150858 DOI: 10.2169/internalmedicine.55.6003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective In recent years, an increase has been observed in the incidence of bone metastases from hepatocellular carcinoma (HCC). In 2007, our institution established a team approach, which includes the provision of palliative care. In the present study we evaluate the effects of palliative care on the prognosis of HCC patients with bone metastases. Methods The subjects included 44 patients with bone metastases who were treated with radiotherapy between 2000 and 2014. The subjects were divided into groups that received radiotherapy from 2000 to 2006 and after 2007. The overall survival rates after radiotherapy were analyzed. Results The median survival time of the patients who received care between 2007 and 2014 was 6 months, which was significantly longer than that in the patients who received care between 2000 and 2006. Conclusion The present team approach in our hospital, which includes the provision of palliative care, started in 2007. This approach may have improved prognosis of patients with metastatic HCC.
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13
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Kinoshita S, Miyashita M, Morita T, Sato K, Miyazaki T, Shoji A, Chiba Y, Tsuneto S, Shima Y. Changes in Perceptions of Opioids Before and After Admission to Palliative Care Units in Japan: Results of a Nationwide Bereaved Family Member Survey. Am J Hosp Palliat Care 2015; 33:431-8. [PMID: 25862807 DOI: 10.1177/1049909115579407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aimed to clarify perspectives of bereaved family members regarding opioids and compare perceptions before admission and after bereavement. A cross-sectional questionnaire survey for bereaved family members in 100 inpatient palliative care units was administered. Participants were 297 bereaved family members of patients who used opioids. Many bereaved family members had misconceptions of opioids before admission. There was improvement after bereavement, but understanding remained low. Respondents less than 65 years old showed significantly greater decreases in misconceptions regarding opioids compared to older generations, after bereavement. Bereaved family members who were misinformed about opioids by physicians were significantly more likely to have misconceptions about opioids. Educational interventions for physicians are needed to ensure that they offer correct information to the general population.
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Affiliation(s)
- Satomi Kinoshita
- College of Nursing, Kanto Gakuin University, Yokohama, Kanagawa, Japan
| | - Mitsunori Miyashita
- Division of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan
| | - Tatsuya Morita
- Department of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, Japan
| | - Kazuki Sato
- Division of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan
| | - Tamana Miyazaki
- Division of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan
| | - Ayaka Shoji
- Division of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan
| | - Yurika Chiba
- Division of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan
| | - Satoru Tsuneto
- Department of Palliative Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yasuo Shima
- Department of Palliative Medicine, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan
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14
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Pergolizzi JV, Gharibo C, Ho KY. Treatment Considerations for Cancer Pain: A Global Perspective. Pain Pract 2014; 15:778-92. [DOI: 10.1111/papr.12253] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 07/11/2014] [Accepted: 08/26/2014] [Indexed: 12/13/2022]
Affiliation(s)
- Joseph V. Pergolizzi
- Department of Medicine; Johns Hopkins School of Medicine; Baltimore Maryland U.S.A
- Association of Chronic Pain Patients; Houston Texas U.S.A
- Department of Pharmacology; Temple University School of Medicine; Philadelphia Pennsylvania U.S.A
| | - Christopher Gharibo
- Department of Anesthesiology and Pain Medicine; New York University School of Medicine; New York City New York U.S.A
| | - Kok-Yuen Ho
- Raffles Pain Management Centre; Raffles Hospital; Singapore City Singapore
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15
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Yamamoto R, Kizawa Y, Nakazawa Y, Morita T. The Palliative Care Knowledge Questionnaire for PEACE: Reliability and Validity of an Instrument To Measure Palliative Care Knowledge among Physicians. J Palliat Med 2013; 16:1423-8. [DOI: 10.1089/jpm.2013.0112] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Ryo Yamamoto
- Palliative Care Team, Saku Central Hospital, Nagano, Japan
| | | | - Yoko Nakazawa
- Department of Palliative Care Nursing, University of Tokyo, Tokyo, Japan
| | - Tatsuya Morita
- Department of Palliative and Supportive Care, Palliative Care Team and Seirei Hospice, Seirei Mikatahara General Hospital, Shizuoka, Japan
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16
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Yamaguchi T, Shima Y, Morita T, Hosoya M, Matoba M. Clinical Guideline for Pharmacological Management of Cancer Pain: The Japanese Society of Palliative Medicine Recommendations. Jpn J Clin Oncol 2013; 43:896-909. [DOI: 10.1093/jjco/hyt099] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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