Miyashita M, Sanjo M, Morita T, Hirai K, Uchitomi Y
Department of Adult Nursing/Palliative Care Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Ann Oncol. 2007 Jun;18(6):1090-7. doi: 10.1093/annonc/mdm068. Epub 2007 Mar 12.
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.
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.
Explanatory factor analysis demonstrated 18 domains contributing to a good death. Ten domains were classified as 'consistently important domains', including 'physical and psychological comfort', 'dying in a favorite place', 'good relationship with medical staff', 'maintaining hope and pleasure', 'not being a burden to others', 'good relationship with family', 'physical and cognitive control', 'environmental comfort', 'being respected as an individual' and 'life completion'.
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.
本研究的目的是：（i）对日本癌症护理中善终的维度进行概念化；（ii）阐明善终各组成部分的相对重要性；（iii）探索与个人对善终领域认知相关的因素。
采用分层随机抽样方法对普通人群进行抽样（n = 2548；应答率为51%），并对来自12个认证姑息治疗单位的丧亲家庭进行了调查（n = 513；70%）。我们询问了受试者关于善终的57个组成部分的相对重要性。
解释性因素分析显示有18个领域有助于实现善终。其中10个领域被归类为“始终重要的领域”，包括“身体和心理舒适”、“在喜欢的地方离世”、“与医护人员关系良好”、“保持希望和愉悦”、“不给他人造成负担”、“与家人关系良好”、“身体和认知控制”、“环境舒适”、“作为个体受到尊重”以及“生命圆满”。
我们定量确定了18个在日本癌症护理中有助于实现善终的重要领域。我们下一步的工作应该是进行全国性调查，以确定实现善终需要什么。
