Publishing type：Research paper (scientific journal)   International / domestic magazine：International journal  

BACKGROUND: Consultation with palliative care specialists can be beneficial in addressing the numerous demands of patients with cancers and their families within communities. In settings lacking palliative care specialists, establishing a new community-based palliative care consultation system necessitates gathering evidence to support its development. This study aimed to identify the specific palliative care consultation needs and the consultation methods requested by Japanese physicians in settings without palliative care specialists. METHODS: A qualitative descriptive study utilizing semi-structured virtual interviews. From August 2023 to October 2023, we conducted interviews with 11 physicians providing cancer treatment in hospitals or clinics in a prefecture within the Kanto region of Japan without palliative care specialists. Participants were asked about the specific palliative care consultation needs they have and the need for consultation methods. RESULTS: Of the 11 physicians, nine had completed the nationwide basic primary palliative care education program. The survey revealed three themes regarding their consultation needs: 'receiving specialized insight', 'inspiring confidence', and 'improving care capacity', Two themes emerged regarding the need for consultation methods: 'enhancing care collaboration' and 'improving accessibility'. CONCLUSIONS: Physicians require consultation systems to empower them and enhance the community care capacity, in addition to providing specialized knowledge. These systems would include collaboration with specialists through outreach consultations, utilization of information and communications technology, and the establishment of nurse-led consultation teams to improve access to palliative care teams.

DOI： 10.1093/jjco/hyae157

PubMed

Authorship：Lead author   Publishing type：Research paper (scientific journal)   International / domestic magazine：Domestic journal  

<p> <b>Objective</b>: To identify effective strategies to provide high-quality palliative care in settings where palliative care specialists are scarce, particularly in Japan. <b>Methods</b>: A scoping review of literature (in English) was conducted using Arksey and O’Malley’s methodological framework. Electronic databases (MEDLINE, CINAHL, and the Cochrane Library) were searched and supplemented with a manual search of relevant journal articles. <b>Results</b>: Nine studies met our inclusion criteria. Four key strategies have emerged: (1) developing a video consultation system to improve the timeliness of care; (2) providing online consultations by specialists to support general practitioners; (3) training nurses to manage the palliative care process; and (4) transferring knowledge and information from experts to non-specialists. <b>Conclusion</b>: Based on these strategies, creating a system tailored to the specific needs and readiness of palliative care in Japan is necessary. The effectiveness of these strategies should be evaluated in future research.</p>

DOI： 10.2512/jspm.20.9

Authorship：Lead author   Publishing type：Research paper (scientific journal)   International / domestic magazine：International journal  

BACKGROUND: Patients with coexisting cancer and dementia often have complex health care needs and face challenges in achieving a good death. OBJECTIVES: To evaluate good death achievement and end-of-life (EOL) care in patients with coexisting cancer and dementia from the perspective of bereaved families. DESIGN: Cross-sectional nationwide postal survey. SETTING/SUBJECTS: Bereaved families of patients with cancer who died in hospice and palliative care units across Japan. MEASUREMENTS: Bereaved families completed an anonymous, self-reported questionnaire. Their perspective on achieving a good death was assessed using the Good Death Inventory (GDI) (total score: 18-126). The Revised Care Evaluation Scale-short version (CES2) was used to assess EOL care (total score: 10-60). We examined the Brief Grief Questionnaire (BGQ) (total score: 0-10) and Patient Health Questionnaire 9 (PHQ9) (total score: 0-27). RESULTS: Data from 670 participants were analyzed, including 83 (12.4%) bereaved families of patients with coexisting cancer and dementia. No statistical differences were observed in the total GDI score for 18 items (dementia comorbidity vs. nondementia comorbidity groups, mean ± standard deviation, respectively, 78.4 ± 17.7 vs. 80.0 ± 15.5, adjusted [adj] P = 0.186), CES2 score (49.70 ± 9.22 vs. 48.82 ± 8.40, adj P = 0.316), BGQ score (3.40 ± 2.41 vs. 4.36 ± 2.28, adj P = 0.060), and PHQ9 score (4.67 ± 4.71 vs. 5.50 ± 5.37, adj P = 0.788). CONCLUSIONS: GDI, CES2, BGQ, and PHQ9 scores did not differ significantly between groups, regardless of the presence of dementia in hospice and palliative care units. Patients with coexisting cancer and dementia can achieve a good death by high-quality EOL care.

DOI： 10.1089/pmr.2023.0083

PubMed

<p><b>Objectives</b>: This study aimed to describe the difficulties faced by physicians in providing palliative care to patients with cancer in facilities without palliative care specialists. <b>Methods</b>: Semi-structured interviews were conducted with 11 physicians involved in cancer treatment who were affiliated with facilities having no palliative care specialists such as Diplomate or Board Certification of the Specialty Board of Palliative Medicine of the Japanese Society for Palliative Medicine. The interview data were analyzed using qualitative content analysis. <b>Results</b>: The participants had “difficulties in palliative care consultation” because they could not consult with specialists or medical staff at their own facility, when immediate response to cancer symptoms was required. This was partly due to “difficulties in regional cooperation”. In addition, the participants had “difficulties in alleviation of symptoms” for highly complex symptoms of patients with cancer. Behind these difficulties, there was “difficulties in foundation of providing palliative care for individual physicians” including limited time available to the participants. <b>Conclusion</b>: These findings show that there is a necessity to establish a continuous external consultation system for specialists to respond to the immediacy of changes in symptoms and highly complex symptoms.</p>

DOI： 10.2512/jspm.19.307

J-GLOBAL

Total pages：vi, 299p  

CiNii Books

Total pages：vi, 247p  

CiNii Books

J-GLOBAL

Presentation type：Oral presentation (general)