A Nationwide Survey of Quality of End-of-Life Cancer Care in Designated Cancer Centers, Inpatient Palliative Care Units, and Home Hospices in Japan: The J-HOPE Study
A Nationwide Survey of Quality of End-of-Life Cancer Care in Designated Cancer Centers, Inpatient Palliative Care Units, and Home Hospices in Japan: The J-HOPE Study
复制标题
DOI：
10.1016/j.jpainsymman.2015.01.007
复制
发表时间：
2015-07-01
影响因子：
4.7
通讯作者：
Shima, Yasuo
中科院分区：
文献类型：
--
作者：
Miyashita, Mitsunori;Morita, Tatsuya;Shima, Yasuo
语境。日本此前尚未对综合医院和家庭护理中的临终 (EOL) 癌症护理进行过评估。 目标。本研究旨在从日本全国指定癌症中心、住院姑息治疗中心 (PCU) 和家庭临终关怀中心的死者家属的角度评估 EOL 癌症护理。方法。我们于 2008 年 3 月对 56 个指定癌症中心和 2007 年 6 月对 100 个 PCU 和 14 个家庭临终关怀中心的癌症患者家属进行了横断面、匿名、自我报告的问卷调查。结果是总体护理满意度、护理结构和过程（护理评估量表）以及良好死亡的实现（良好死亡量表）。结果。在指定癌症中心、PCU 和家庭临终关怀中心，分别有 2794 名（回应率 59%）、5312 名（回应率 69%）和 292 名（回应率 67%）丧亲家属参加。所有死亡地点的总体护理满意度平均得分都很高，指定癌症中心为 4.3 +/- 1.2，PCU 为 5.0 +/- 1.2，家庭临终关怀中心为 5.0 +/- 1.0。指定癌症中心在护理结构和过程以及良好死亡实现方面的评分显着低于 PCU 和家庭临终关怀中心（各 P = 0.0001）。在实现良好死亡方面，家庭临终关怀中心的评级显着高于 PCU（P = 0.0001）。结论。本研究的主要结果是：1）总体而言，死者家属对所有三个死亡地点的临终关怀感到满意； 2）指定癌症中心不如PCU和家庭临终关怀中心，有更大的改进空间； 3) 尽管家庭临终关怀机构在日本并不常见，但在实现安乐死方面，家庭临终关怀机构的评级高于 PCU。 (C) 2015 年美国临终关怀和姑息医学学会。由爱思唯尔公司出版。保留所有权利。
Context. End-of-life (EOL) cancer care in general hospitals and home care has not previously been evaluated in Japan.Objectives. This study aimed to evaluate EOL cancer care from the perspective of bereaved family members in nationwide designated cancer centers, inpatient palliative care units (PCUs), and home hospices in Japan.Methods. We conducted a cross-sectional, anonymous, self-report questionnaire survey for bereaved family members of cancer patients in March 2008 for 56 designated cancer centers and in June 2007 for 100 PCUs and 14 home hospices. Outcomes were overall care satisfaction, structure and process of care (Care Evaluation Scale), and achievement of a good death (Good Death Inventory).Results. In designated cancer centers, PCUs, and home hospices, 2794 (response rate 59%), 5312 (response rate 69%), and 292 (response rate 67%) bereaved family members participated, respectively. Mean scores for overall care satisfaction were high for all places of death, at 4.3 +/- 1.2 for designated cancer centers, 5.0 +/- 1.2 for PCUs, and 5.0 +/- 1.0 for home hospices. Designated cancer centers showed significantly lower ratings than PCUs and home hospices for structure and process of care and achievement of a good death (P = 0.0001 each). Home hospices were rated significantly higher than PCUs for achievement of a good death (P = 0.0001).Conclusion. The main findings of this study were: 1) overall, bereaved family members were satisfied with end-of-life care in all three places of death; 2) designated cancer centers were inferior to PCUs and home hospices and had more room for improvement; and 3) home hospices were rated higher than PCUs for achieving a good death, although home hospices remain uncommon in Japan. (C) 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.