Good death in cancer care: a nationwide quantitative study

Abstract

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 Ôconsistently important domainsÕ, including Ôphysical and psychological comfortÕ, Ôdying in a favorite placeÕ, Ôgood relationship with medical staffÕ, Ômaintaining hope and pleasureÕ, Ônot being a burden to othersÕ, Ôgood relationship with familyÕ, Ôphysical and cognitive controlÕ, Ôenvironmental comfortÕ, Ôbeing respected as an individualÕ and Ôlife completionÕ. 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.

A National Survey to Systematically Identify Factors Associated With Oncologists’ Attitudes Toward End-of-Life Discussions: What Determines Timing of End-of-Life Discussions?

“…To explore physicians' perceptions of factors influencing a good death, we adopted a conceptual framework based on previous studies on good death [17][18][19]. We asked participants how important they perceived each element to be for terminally ill patients on a 6-point Likert-type scale from 1 (not important at all) to 6 (essential).…”

Patient Preferences versus Family Physicians' Perceptions Regarding the Place of End-of-Life Care and Death: A Nationwide Study in Taiwan

“…[1][2][3] Additionally, the World Health Organization recommends that planning for care at the end of life should be responsive to the patient's choices regarding the place of care and death. 4 Cancer patients who die in a hospital or an intensive care unit have worse quality of life than those who die at home, 5 and their bereaved caregivers are more likely to develop psychiatric illnesses.…”

What constitutes a good death?: implications for family nurse practitioners in rural British Columbia

“…Masson (2002), in his qualitative study of hospice patients, adds that death can in fact be a welcome release from prolonged hardships, declining health and function, or poor symptom control. Similarly, in their study of the general population in Japan, Miyashita et al (2007) (Hattori et al ). As internet access to global perspectives expands and immigration continues to diversify Canadian demographics, health practitioners will increasingly need to explore patients ' beliefs and preferences around EOL decision making control.…”

“…Likewise, our expectations for EOL are values-based and modifiable over time. They are dependent on our personal experience with illness and the health care system, as well as changes in health status and life context (Borreani & Miccinesi, 2008;Goldsteen et al , 2006;Hattori, McCubbin, & Ishida, 2006;Heyland et al , 2006;Hughes, Schumacher, Jacobs-Lawson, & Arnold, 2008;Jacques & Hasselkus, 2004;Kehl, 2006;Kelly & Minty, 2007;Masson, 2002;Miyashita, Sanjo, Morita, Hirai, & Uchitomi, 2007;Pierson, Curtis, & Patrick, 2002;Steinhauser et al , 2000b;Tong et al , 2003 ;Veillette, Fillion, Wilson, Thomas, & Dumont, 2010;Vig, Davenport, & Pearlman, 2002;Wilson et al , 2009a). Due to globalization and the diversity associated with multicultural societies, the concept of a good death and the factors influencing individual wishes related to a good death experience are becoming more complex and variable (Hattori et al).…”

“…While many studies referred to cultural groups based on race, ethnicity, or spiritual affiliation (Hirai et al, 2006;Kelly & Minty;Leung et al, 2009;Matsui & Braun, 2009;Miyashita et al , 2007;SmithStoner, 2007;Toscani et al , 2003), several also presented culture from the experiential paradigm of age, diagnosis, or place of residence (Gott et al, 2008;Hendrickson & McCorkle, 2008;Hirai et al 2006;Hughes et al , 2008;McGrath, 2007;Mjelde-Mossey & Chan, 2007;Pierson et al , 2002;Tang, 2003;Thomas, Morris, & Clark, 2004;Veillette et al, 2010;Vig et al , 2002;Vig & Pearlman, 2004;Wilson et al , 2009a). Hattori et al (2006) added the dimension of sociocultural norms to highlight the need for considering how one 's cultural, historical , political, and religious influences shape good death ideals and subsequent expectations for EOL care.…”