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Publications (68)
Objective
This study aims to determine the frequency of falls and their serious complications in palliative care units (PCUs), as well as explore the complex interplay between falls, independence and quality of dying.
Design
A prospective cohort study.
Setting and participants
The dying process of patients with advanced cancer in 23 PCUs in Japan...
Introduction
Malignant wounds are lesions caused by metastasis from distant primary cancers or by direct invasion of the cutaneous structures of a primary cancer, and are most common in patients with breast or head and neck cancers. Malignant wounds not only cause physical symptoms, but also affect survival. Recognizing prognosis in terminal-stage...
Purpose
Advanced cancer patients have nutrition impact symptoms (NISs), while many of them have depressive moods. This study aimed to determine the associations of NISs with depression.
Methods
This study was a secondary analysis. The dietary intake and 19 NISs in patients receiving palliative care were evaluated using 10-point scales, and the pat...
Purpose
Determining whether patients’ unrealistic expectations of chemotherapy as a cure were associated with their perception of the disclosure of incurability.
Methods
This prospective study included consecutive patients with pretreated non-small cell lung cancer from four study sites. Patients and their oncologists were asked whether they perce...
This study comprehensively examines the medical needs and experiences of the lesbian, gay, bisexual, transgender/transsexual, and queer/questioning (LGBTQ) population—also referred to as sexual minorities—in Japan. It aims to bridge the existing gap in understanding the experiences of LGBTQ populations in accessing healthcare, and inform future hea...
Objective:
To determine the frequency of falls and their serious complications in palliative care units (PCUs), as well as explore the complex interplay between falls, independence, and quality of dying.
Methods:
A secondary analysis of a large prospective cohort study of 23 PCUs in Japan was conducted from January 2017 to June 2018. Palliative car...
Background
This study sought to investigate the symptoms and prognoses of patients with breast cancer and malignant wounds in the palliative care unit setting.
Methods
This study was a sub-group analysis of a multicenter, prospective, observational study. Patients admitted to 23 palliative care units in Japan between January and December 2017 were...
Objectives
To evaluate whether low serum creatinine levels are associated with poor outcomes in patients with advanced cancer.
Methods
This is a secondary analysis of a prospective cohort study. Patients were divided into three groups according to their baseline serum creatinine levels. We performed time-to-event analyses using the Kaplan-Meier me...
Background
End-of-life discussions for patients with advanced cancer are internationally recommended to ensure consistency of end-of-life care with patients’ values. This study examined the elements of end-of-life discussions associated with end-of-life care.
Materials and Methods
We performed a prospective observational study among consecutive pa...
Background: There is ongoing debate on whether continuous deep sedation (CDS) for psycho-existential suffering is appropriate. Objective: We aimed to (1) clarify clinical practice of CDS for psycho-existential suffering and (2) assess its impact on patients' survival. Methods: Advanced cancer patients admitted to 23 palliative care units in 2017 we...
Background:
Swallowing disorders including difficulty swallowing and food bolus obstruction, result in reduced dietary intake-a common occurrence that leads to cachexia in patients with advanced cancer. This study examined the effects of swallowing difficulty and food bolus obstruction on cachexia-related quality of life (QOL).
Methods:
This stu...
Purpose: We investigated the symptoms and prognoses of patients with fungating breast cancer in the palliative care unit setting.
Methods: This study was a sub-group analysis of a multicentre, prospective, observational study. Patients admitted to 23 palliative care units in Japan between January and December 2017 were enrolled. Data of patients wi...
PurposeTaste and smell are used to enjoy meals; however, impairments of these sensory perceptions seriously impact health and eating habits. This study is aimed at investigating the impact of taste and smell disturbances on dietary intakes and cachexia-related quality of life (QOL) in patients with advanced cancer.Methods
Using a self-report questi...
Purpose
There is ongoing debate on whether continuous deep sedation (CDS) for psycho-existential suffering is appropriate. We aimed to: 1) to clarify clinical practice of CDS for psycho-existential suffering, and 2) assess its impact on patients’ survival.
Methods
Advanced cancer patients admitted to 23 palliative care units in 2017 were consecuti...
Background:
Eating-related distress (ERD) is one type of psychosocial distress among advanced cancer patients and family caregivers. Its alleviation is a key issue in palliative care; however, there is no validated tool for measuring ERD.
Methods:
The purpose of this study was to validate tools for evaluating ERD among patients and family caregi...
Purpose
All five senses (i.e., sight, smell, hearing, taste, and touch) are used to enjoy meals; however, impairments in sensory perception, which are common among cancer patients, seriously impact health and cause eating-related distress.
Methods
Using a self-report questionnaire, we surveyed patients with advanced cancer undergoing treatment at...
Background
Although patients with advanced cancer often have poor prognostic awareness, the most effective communication approach for improving prognostic awareness is unclear. In addition, the association between prognostic awareness and preferences for future medical treatment remains unexplored.
Materials and Methods
We performed a prospective...
Background: The beliefs and perceptions of parenteral nutrition and hydration (PNH) by advanced cancer patients have not been elucidated.
Objectives: To clarify their beliefs and perceptions and to explore the relationships between their beliefs and perceptions and cachexia stages.
Design/setting/subjects: A questionnaire survey of advanced cancer...
Objective:
The objective of this survey was to identify areas where doctors have divergent practices in pharmacological treatment for hyperactive delirium in terminally ill patients with cancer.
Methods:
We conducted a survey of Japanese palliative care physicians and liaison psychiatrists. Inquiries were made regarding: (i) choice of drug class...
Background
The relationships between cachexia stages and the Functional Assessment of Anorexia/Cachexia Therapy Anorexia Cachexia Subscale (FAACT ACS) 12‐item, 5‐item anorexia symptoms, and 4‐item anorexia concerns have not been investigated in Asian patients with advanced cancer.
Methods
This is a multicentre questionnaire survey conducted in pal...
Purpose
Some patients experience intense symptoms refractory to intensive palliative care, and palliative sedation is sometimes used. Palliative sedation may be classified into proportional and continuous deep sedation (CDS). The primary aim of this study was to compare family experience between families of patients who received proportional or CDS...
Context
: The perspective toward hypoactive delirium in the last days of life could be different among physicians.
Objectives
To clarify the attitudes, beliefs, and opinions of palliative care physicians and liaison psychiatrists toward hypoactive delirium in the last days of life and to explore the association among these factors.
Methods
: A na...
Background
Where patients receive end-of-life care influences their quality of life.
Objectives
To clarify the effects of staying in a private or shared room in inpatient hospices.
Design
A part of a Japanese multicentre survey to evaluate the quality of end-of-life care.
Setting/participants
779 bereaved families whose relatives who died from c...
PurposeThe benefits of parenteral nutrition and hydration (PNH) in patients with advanced cancer remain unknown. Therefore, we conducted a prospective multicenter cohort study to assess the effects of PNH on survival in patients with malignant bowel obstruction (MBO).Methods
The present study was a secondary analysis. Data on primary nutritional ad...
Purpose
Objectives of this study are to clarify the beliefs and perceptions of parenteral nutrition and hydration (PNH) by patients with advanced cancer and to examine the relationships between their beliefs and perceptions and cachexia stages.
Methods
We conducted a questionnaire survey. We asked about patient characteristics and anthropometric me...
Background & Aims
The prevalence of artificially administered nutrition and hydration (AANH) in different age groups among patients with advanced cancer remains unknown. The present study investigated the current utilization of AANH according to age groups in palliative care units.
Methods
This was a secondary analysis of a prospective cohort stud...
PurposeTo examine the safety, effectiveness, and patient-perceived benefit of treatment with olanzapine for nausea and vomiting (N/V) in patients with advanced cancer.Methods
We conducted a multicenter prospective observational study in a tertiary care setting (Trial registration number: UMIN000020493, date of registration: 2016/1/12). We measured...
Objectives
The goal of palliative and supportive care is to improve patients’ quality of life (QoL). Patient-reported outcome measures (PROMs) are the gold standard for the assessment of QoL and symptoms; however, when self-reporting is complicated, PROMs are often substituted with proxy-reported outcome measures, such as clinician-reported outcome...
Objectives: Spiritual pain is not formally defined. The aim of this study was to clarify the beliefs about spiritual pain among Japanese palliative care physicians and liaison psychiatrists and to compare their beliefs. Methods: A nationwide questionnaire survey was conducted by mail August, 2019 on certified palliative care physicians and liaison...
Objective: The influence of depression, anxiety, and family function in breast cancer patients on the quality of life of their children was investigated from the perspective of the participants’ demographic characteristics after controlling for their attributes. Methods: The demographic characteristics and confounding factors were divided into two...
Background: During end-of-life care, the place in which the patients spend time influences their quality of life.
Objective: To clarify what it means to spend last days at home and in inpatient hospice.
Design: This study was a part of a nationwide multicenter questionnaire survey of bereaved family members of cancer patients evaluating the quality...
Context
Previous studies suggest that clinicians' prediction of survival (CPS) may have reduced the accuracy of objective indicators for prognostication in palliative care.
Objectives
We aimed to examine the accuracy of CPS alone, compared to the original Palliative Prognostic Score (PaP), and five clinical/laboratory variables of the PaP in patie...
Background & Aims
The benefits of artificial nutrition and hydration in patients with advanced cancer remain unknown. Therefore, we conducted a prospective study to evaluate effects of enteral nutrition (EN) and parenteral nutrition and hydration (PNH) on survival in palliative care units.
Methods
This study involved a secondary analysis of a mult...
Purpose
Duloxetine has some effect against cancer neuropathic pain (CNP); however, predictors of duloxetine response are unclear. This study sought to identify predictors of duloxetine response in patients with CNP.
Methods
Patients (N = 70) with CNP unresponsive to or intolerant of opioid–pregabalin combination therapy, with a brief pain inventor...
Recent evidence has shown the effectiveness of advance care planning (ACP). The Clinical Practice Guidelines for Pancreatic Cancer 2019 suggest that ACP be conducted for patients with pancreatic cancer. However, little is known about how best to practice ACP for patients with pancreatic and biliary tract cancer and their families. To help them init...
Context:
Although opioids and pregabalin are widely used for cancer-related neuropathic pain (CNP), no clinical trials exist to determine which medications are effective when an opioid-pregabalin combination therapy fails.
Objectives:
We investigated the efficacy of duloxetine for CNP nonresponsive or intolerant to opioid-pregabalin combination...
Background:
To improve palliative care practice, the need for patients-reported outcome measures is increasing globally. The Integrated Palliative care Outcome Scale (IPOS) is a streamlined outcome scale developed to comprehensively evaluate patients' distress. The goal of this study is to assess the reliability and validity of IPOS-Japanese versi...
Introduction:
Although various phrases to communicate prognoses based on a certain concept have been proposed, no study has systematically investigated preferences of patients with cancer for actual phrases. We investigated whether phrases with a wider range and additional "hope for the best, and prepare for the worst" (hope/prepare) statement wou...
Context:
When discussing end-of-life issues with cancer patients, the addition of reassurance statements is considered helpful. However, patients' preferences for such statements have not been systematically demonstrated.
Objectives:
The objectives of this study were to clarify if phrases with additional reassurance statements would be more pref...
Introduction:
There have been no reports about predicting survival of patients with advanced cancer constructed entirely with objective variables. We aimed to develop a prognostic model based on laboratory findings and vital signs using a fractional polynomial (FP) model.
Methods:
A multicentre prospective cohort study was conducted at 58 specia...
Background:
There are few studies on bereaved caregivers' perceptions of physician behavior toward death pronouncement. Although previous research indicates that most caregivers are satisfied with physician behavior toward death pronouncement at home hospices, bereaved caregivers' perceptions of death pronouncement in palliative care units (PCUs)...
Objectives:
The purpose of this study was (1) to describe the end-of-life experience of family caregivers of cancer patients, (2) to describe talking about death and dying of the patient to minor children, and (3) to examine the association of family caregivers' experiences by their characteristics and talking about death and dying of the patient....
Context
Few studies have explored the clinical significance of the family’s presence or absence at the moment of a patient’s death and meaningful communication (saying “goodbye”) in terms of post-bereavement outcomes.
Objectives
To explore the potential association between the family’s depression/complicated grief and their presence at the moment...
e21511
Background: End-of-life discussion (EOLd) including information about incurability, prognosis, the site of death, and do-not-resuscitate (DNR) status is considered indispensable for advanced care planning (ACP). However, the preference for EOLd in cancer patients has not been elucidated. Objective: To clarify the preferences of EOLd in Japan...
Background:
Survival prediction systems such as the Palliative Prognostic Index (PPI), which includes the Palliative Performance Scale (PPS), are used to estimate survival for terminally ill patients. Oncologists are, however, less familiar with the PPS in comparison with the Eastern Cooperative Oncology Group (ECOG) performance status (PS). This...
Background Few studies have been conducted on the experiences of children of terminally ill patients or hospital-based medical professionals supporting such children.
Aim This study explored distress among individuals whose parents died of cancer in childhood and among hospital-based medical professionals supporting such children.
Design A qualitat...
Context:
Plasma C-reactive protein (CRP) levels are elevated in patients with advanced cancer.
Objectives:
To investigate CRP as a prognostic marker in palliative settings.
Methods:
This multicenter prospective cohort study comprised 2426 patients. Laboratory data were obtained at baseline, and all patients were followed until death or six mon...
Background:
Continuous deep sedation (CDS) before death is a form of palliative sedation therapy that has become a focus of strong debate, especially with respect to whether it shortens survival. We aimed to examine whether CDS shortens patient survival using the propensity score-weighting method, and to explore the effect of artificial hydration...
Predicting the short-term survival in cancer patients is an important issue for patients, family, and oncologists. Although the prognostic accuracy of the surprise question has value in 1-year mortality for cancer patients, the prognostic value for short-term survival has not been formally assessed. The primary aim of the present study was to asses...
Objective:
We aimed to assess leaflet-based intervention effects on family-perceived distress, the need for improvements in professional care for delirium, and family knowledge of delirium causes.
Methods:
Leaflet-based intervention effects were assessed by comparing responses of family members given in the leaflet with those of a historical con...
Background and objective:
Delirium in terminally ill cancer patients causes considerable distress to family members. The aim was to determine the family-perceived usefulness of a leaflet about delirium in terminally ill cancer patients.
Methods:
Family members received a leaflet about delirium designed for this study as a part of routine practic...
Communicating the discontinuation of anticancer treatment to patients is a difficult task. The primary aim of this study was to clarify the level of oncologist-reported burden when communicating about discontinuation of an anticancer treatment. The secondary aims were (i) to identify the sources of burden contributing to their levels and (ii) to ex...
Oral administration of medication is often difficult in terminally ill cancer patients, and a subcutaneous route is traditionally one of the most preferred parenteral routes. Recent studies suggest, however, that some patients and families prefer the intravenous route, and peripherally inserted central venous catheters (PICCs) are actively used in...
Many breast cancer patients are troubled about telling their school-age children about their illness. However, little attention has been paid to the factors that encourage or discourage them from revealing the illness. This study explored decision-making by breast cancer patients about telling their children about their illness.
Participants were 3...
Delirium is frequently observed in terminally ill cancer patients, but complete remission is often difficult to achieve. Therefore, symptom palliation is of great importance to improve patients' quality of life. Although it has been suggested that psychostimulants would be beneficial to patients with hypoactive delirium, there have been very few em...