Kizawa Yoshiyuki, Tsuneto Satoru, Hamano Jun, Nagaoka Hiroka, Maeno Takami, Shima Yasuo
1Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Am J Hosp Palliat Care. 2013 Nov;30(7):664-9. doi: 10.1177/1049909112462860. Epub 2012 Oct 11.
To examine the current status of advance directives (ADs) and do-not-resuscitate (DNR) orders among patients with terminal cancer in palliative care units (PCUs) in Japan.
We conducted a retrospective chart review of the last 3 consecutive patients who died in 203 PCUs before November 30, 2010.
The percentages of patients who had ADs during the final hospitalization for cardiopulmonary resuscitation, mechanical ventilation, intravenous fluid administration, tube feeding, antibiotic administration, and who had appointed a health care proxy were 47%, 46%, 42%, 19%, 18%, and 48%, respectively. Seventy-six percent of the patients had a DNR order. Of the patients with decision-making capacity, 68% were involved in the DNR decision.
These findings may reflect positive changes in patients' attitudes toward ADs, in Japan.
调查日本姑息治疗病房（PCUs）中晚期癌症患者的预立医疗指示（ADs）和不进行心肺复苏（DNR）医嘱的现状。
我们对2010年11月30日前在203个PCUs中连续死亡的最后3例患者进行了回顾性病历审查。
在最后一次住院期间接受心肺复苏、机械通气、静脉输液、管饲、抗生素治疗时拥有ADs以及指定了医疗代理人的患者比例分别为47%、46%、42%、19%、18%和48%。76%的患者有DNR医嘱。在有决策能力的患者中，68%参与了DNR决策。
这些发现可能反映了日本患者对ADs态度的积极变化。
