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Factors relating to terminally ill cancer patients' willingness to continue living at home during the early phase of home care after discharge from clinical cancer centers in Japan

Published online by Cambridge University Press:  27 February 2007

YUKA HIRABAYASHI ,
MITSUNORI MIYASHITA ,
MASAKO KAWA ,
KEIKO KAZUMA ,
KOHSUKE YAMASHITA  and
NAOYUKI OKAMOTO
YUKA HIRABAYASHI
Affiliation:
Statistics and Cancer Control Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan
MITSUNORI MIYASHITA
Affiliation:
Department of Adult Nursing/Palliative Care Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
MASAKO KAWA
Affiliation:
Department of Adult Nursing/Palliative Care Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
KEIKO KAZUMA
Affiliation:
Department of Adult Nursing/Palliative Care Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
KOHSUKE YAMASHITA
Affiliation:
Department of Radiotherapy, Kanagawa Cancer Center, Yokohama, Japan
NAOYUKI OKAMOTO
Affiliation:
Department of Epidemiology, Research Institute, Kanagawa Cancer Center, Yokohama, Japan
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Abstract

Objective: To assess the willingness of Japanese terminally ill cancer patients to continue living at home during the early phase of home care after discharge from a Clinical Cancer Center (CCC) in Japan, and to identify factors relating to their willingness to continue living at home.

Methods: A cross-sectional questionnaire survey of a convenient sample of both Japanese terminally ill cancer patients and their caregivers (PFCs) was conducted (n = 294, effective response rate 25.0%). Questionnaires were mailed and medical records were accessed for 73 pairs of respondents, comprising one terminally ill cancer patient and one PFC.

Results: At about 10 days after discharge, 64 patients (88%) wished to continue living at home. A hierarchical logistic regression analysis was performed on the data. It was found that the fewer the medical treatments undergone (OR = 0.20, 95% CI: 0.05–0.72), the higher the patients' perception that their condition was consistent with care at home (OR = 2.77, 95% CI: 1.08–8.62) and with their functional well-being (OR = 1.45, 95% CI: 1.08–2.17). In addition, the higher the caregivers' satisfaction with life (OR = 2.37, 95% CI: 1.15–5.77), the more willing patients tended to be to continue living at home.

Significant of results: The willingness of Japanese terminally ill cancer patients to continue living at home appears to be affected by caregiver status. This indicates a need for discharging facilities to monitor the state of home assistance and to investigate the nature of assistance required for continuing home care.

Keywords

End-of–life careTerminally ill cancerWillingness to continue living at homePalliative home careClinical Cancer Center
Type
Research Article
Information
Palliative & Supportive Care , Volume 5 , Issue 1 , March 2007 , pp. 19 - 30
Copyright
© 2007 Cambridge University Press

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References

REFERENCES

Cella, D.F. (1997). FACIT manual, Version 4. Evanston IL: Northwestern University.
European Organization for Research and Treatment of Cancer. (1996). European Organization for Research and Treatment of Cancer Evaluation Criteria Scoring Scales and Instruments. Performance Status: a Practical Guide to EORTC Studies. Brussels: EORTC Data Center.
Hakata, Y., Shima, Y., & Maruguchi, M. (2002). The psycho-social distress of families with terminally ill patient [in Japanese]. Symptom Control in Cancer Patients, 13, 51–57.Google Scholar
Ishigaki, Y. (1998). Development of rational home care system programme for cancer patients and their caregivers [in Japanese]. Japanese Foundation for Multidisciplinary Treatment of Cancer Report No. 22. Tokyo: Japanese Foundation for Multidisciplinary Treatment of Cancer.
Kaye, P. (1999). Home Care Decision Making in Palliative Care. Northampton, UK: EPL Publications.
Komoto, S. (2002). Inclusion of palliative care service within the medical insurance system [in Japanese]. Jpn J Hospice Palliat Care, 12, 333–337.Google Scholar
Ministry of Health, Labour and Welfare (2006). Percentage of prevalence and structure in place of death (Table 5) [in Japanese]. Statistic & Other Data. Available at: http://www.mhlw.go.jp/toukei/saikin/hw/jinkou/suii01/deth1.html.
Miyashita, M., Hashimoto, S., Kawa, M., et al. (1999). Attitudes towards terminal care among the general population and medical practitioners in Japan [in Japanese]. Nippon Kosyu Eisei Gakkaisi, 46, 391–401.Google Scholar
Nagae, H. (1998). Transitional care for terminally ill cancer patients involvement of patients' care as district nurses [in Japanese]. Japanese Journal of Clinical Nursing, 24, 18–28.Google Scholar
Nagae, H., Naruse, K., & Kawagoe, H. (2000). The structure of family support in home hospice care focusing on the support of the visiting nurse [in Japanese]. Bulletin of St. Luke's College of Nursing, 26, 31–43.Google Scholar
Naylor, M.D. (2000). Transitional care of older adults. Annual review of Nursing Research, 20, 127–147.Google Scholar
Naylor, M.D., Bowles, K.H., & Brooten, D. (2000). Patient problems and advanced practice nurse interventions during transitional care. Public Health Nursing, 17, 94–102.Google Scholar
Naylor, M.D., Brooten, D., & Campbell, R. (1999). The effects of a discharge planning and home follow-up intervention on elders hospitalized with common medical and surgical cardiac conditions. Journal of Cardiovascular Nursing, 14, 44–54.Google Scholar
Ogata, Y., Hashimoto, M., & Otosaka, K. (2000). Subjective burdens of family caring for “frail elderly” in their home [in Japanese]. Nippon Kosyu Eisei Gakkaisi, 47, 307–319.Google Scholar
Okamoto, N. (1998). Community Network System among Health Care and Welfare in Japan Home Care for Terminally Ill Cancer Patients [in Japanese]. Tokyo: Ministry and Labour Sciences Research Grants.
Okaya, K. (2000). Needs assessment of terminally ill cancer patients at home supports of dying at home by district nursing care. [in Japanese]. In Report of the End of Life Home Care in Japan, Okaya, K. (ed.), pp. 1–32. Tokyo: Japanese Nursing Association Nursing Education & Research Center.
Rinck, G.C., van den Bos, G.A.M., & Kleijnen, J. (1997). Methodologic issues in effectiveness research on palliative cancer care: A systematic review. Journal of Clinical Oncology, 15, 1697–1707.Google Scholar
Rossi Ferrario, S., Zotti, A.M., Massara, G., & Nuvolone, G. (2003). A comparative assessment of psychological and psychosocial characteristics of cancer patients and their caregivers. Psycho-Oncology, 12, 1–7.Google Scholar
Sakai, M. (2002). Home care nursing during the first month of care and a later month comparison of nursing problems, interventions and outcomes [in Japanese]. J St. Luke's Soc Nurs Res, 6, 1–8.Google Scholar
Sawada, K., Ogasawara, Y., Nagai, H., Shino, S., Inokuma, K., & Aruga, E. (2001). Relatives of medical treatment patients' quality of life and burdens of family caregivers at own their home [in Japanese]. Kenko Bunka Kenkyu Josei Ronbunsyu, 7, 35–40.Google Scholar
Schaapveld, K. & Cleton, F.J. (1989). Cancer in The Netherlands from scenarios to health policy. European Journal of Cancer & Clinical Oncology, 25, 767–771.Google Scholar
Suzuki, K., Egawa, K., Tanigame, M., et al. (2001). Available factors of patients' intention for home care care reports of ten terminally ill patients [in Japanese]. Home Care Services, 32, 39–43.Google Scholar
Tsuneto, S. (1999). Family care [in Japanese]. In The Palliative Medicine Up to Date, Tsuneto, S. (ed.), pp. 257–270. Osaka: Saishin-igakusya.
Umeda, M. & Iwasaki, K. (2001). Evaluating for Japanese medical service fee and end-of–life care [in Japanese]. Japanese Journal of Cancer Care, 6, 68–71.Google Scholar
World Health Organization. (1990). Report of a WHO Expert Committee: Cancer Pain Relief and Palliative Care. Geneva: World Health Organization.