Hirai Kei, Miyashita Mitsunori, Morita Tatsuya, Sanjo Makiko, Uchitomi Yosuke
Graduate School of Human Sciences, Osaka University, Japan.
J Pain Symptom Manage. 2006 Feb;31(2):140-7. doi: 10.1016/j.jpainsymman.2005.06.012.
One of the most important goals of palliative care is achieving a "good death" or a "good dying process." The primary aim of this study was to identify the components of a Japanese "good death" through qualitative interviews with cancer patients, their families, physicians, and nurses. Semistructured interviews were conducted. Thirteen advanced cancer patients, 10 family members of such patients, 20 physicians, and 20 nurses were recruited from five regional cancer institutions in Japan. Content analysis was applied to answers, and 58 attributes were extracted and classified into 17 categories as follows: Freedom from pain or physical/psychological symptoms, Having a good family relationship, Dying in one's favorite place/environment, Having a good relationship with medical staff, Not being a burden to others, Maintaining dignity, Completion of life, Maintaining a sense of control, Fighting against cancer, Maintaining hope, Not prolonging life, Contributing to others, Control of future, Not being aware of death, Appreciating others, Maintaining pride, and Having faith. The most frequently cited category was "Freedom from pain or physical/psychological symptoms" and the least common was "Having faith." This study identified important components of a good death in Japan. A future quantitative survey is planned to clarify the generalizability of these findings as the primary endpoint of palliative care in Japan.
姑息治疗的最重要目标之一是实现“善终”或“良好的死亡过程”。本研究的主要目的是通过对癌症患者、其家属、医生和护士进行定性访谈，确定日本“善终”的构成要素。进行了半结构化访谈。从日本五个地区癌症机构招募了13名晚期癌症患者、10名此类患者的家属、20名医生和20名护士。对回答进行了内容分析，提取了58个属性，并将其分为17类，如下所示：免于疼痛或身体/心理症状、拥有良好的家庭关系、在自己喜欢的地方/环境中离世、与医护人员关系良好、不给他人造成负担、维护尊严、生命的完整、保持掌控感、与癌症作斗争、保持希望、不延长生命、对他人有所贡献、掌控未来、未意识到死亡、感激他人、保持自尊、拥有信仰。被提及最多的类别是“免于疼痛或身体/心理症状”，最不常见的是“拥有信仰”。本研究确定了日本善终的重要构成要素。计划在未来进行定量调查，以阐明这些发现作为日本姑息治疗主要终点的普遍性。
