Ikari Tomoo, Hiratsuka Yusuke, Oishi Takayuki, Miyashita Mitsunori, Morita Tatsuya, Mack Jennifer W, Okada Yoshinari, Chiba Natsuko, Ishioka Chikashi, Inoue Akira
Department of Palliative Medicine, Tohoku University School of Medicine, Sendai, United States.
Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, United States.
Indian J Palliat Care. 2024 Jul-Sep;30(3):268-274. doi: 10.25259/IJPC_133_2024. Epub 2024 Aug 23.
Achieving a 'good death' is one of the important goals of palliative care. Providing goal-concordant care and an environment tailored to the patient's preferences can contribute to a 'good death'. However, the concordance rate between the preferred and actual places of death among advanced cancer patients in Japan is less explored. This study aimed to identify the concordance between patients' preferred and actual places of death and the associated factors among patients with advanced cancer in Japan.
Patients with advanced cancer who underwent chemotherapy at Tohoku University Hospital between January 2015 and January 2016 were enrolled and followed up for 5 years. The enrolled patients were asked about their preference for their place of death. The response options were: "Own home," "General ward" and "Palliative care unit (PCU)." We compared the actual place of death with the patient's preference through a follow-up review of the medical records.
A total of 157 patients with advanced cancer were enrolled between January 2015 and January 2016. Of these patients, 22.9% (11/48) died at home according to their preference, 64.0% (16/25) in the general ward and 37.9% (11/29) in the PCU. Only thirty-seven (37.3%) patients died where they wanted, based on the comparison between patients' preferences and actual places of death.
The concordance rate between the preferred and actual places of death is not high in Japan. Improving concordance between patients' preferences and actual places of death has the potential to improve end-of-life care.
实现“善终”是姑息治疗的重要目标之一。提供符合目标的护理以及根据患者偏好量身定制的环境有助于实现“善终”。然而，日本晚期癌症患者首选死亡地点与实际死亡地点之间的一致率鲜有研究。本研究旨在确定日本晚期癌症患者首选死亡地点与实际死亡地点之间的一致性及其相关因素。
纳入2015年1月至2016年1月在东北大学医院接受化疗的晚期癌症患者，并随访5年。询问纳入患者对死亡地点的偏好。回答选项为：“自己家中”、“普通病房”和“姑息治疗单元（PCU）”。我们通过对病历的随访审查，将实际死亡地点与患者偏好进行比较。
2015年1月至2016年1月共纳入157例晚期癌症患者。在这些患者中，22.9%（11/48）按其偏好在家中死亡，64.0%（16/25）在普通病房死亡，37.9%（11/29）在PCU死亡。根据患者偏好与实际死亡地点的比较，只有三十七（37.3%）例患者在他们希望的地点死亡。
在日本，首选死亡地点与实际死亡地点之间的一致率不高。提高患者偏好与实际死亡地点之间的一致性有可能改善临终护理。
