Preferred place of care and place of death of the general public and cancer patients in Japan

Abstract

Dying at a favorite place is one of the important determinants for terminally ill cancer patients. The primary aim was to clarify (1) differences in preferred place of care and place of death among the general public across four areas across Japan and (2) preferred place of care and place of death among community-representative cancer patients. A cross-sectional mail survey was conducted on 8,000 randomly selected general population. We examined preferred place of care and place of death using two vignettes and obtained a total of 3,984 (50%) responses. For the pain scenario, approximately 50% of the general public throughout four areas chose home as their preferred place of care; and for the dependent-without-pain scenario, about 40% chose home as preferred place of care. In cancer patients, for both scenarios, approximately 40% chose home as the preferred place of care, and they were significantly less likely to choose home. The most preferred combination of place of care and place of death was home hospice for both groups. Although there were statistically significant differences in preferred place of care and place of death among the four regions, the absolute difference was less than 8%. Independent determinants of choosing home as place of care included concern about family burden and being unable to adequately respond to sudden changes out of working hours. In conclusion, establishing more accessible home and hospice service is strongly required through arranging regional resources to reduce family burden, alleviating patient-perceived burdens, and improving 24-h support at home.

Determinants of Preference for Home Death Among Terminally Ill Patients With Cancer in Taiwan

“…This rate of preference for home death is higher than the reported rate for terminally ill patients with cancer in Japan (40%; Nakamura et al, 2010;Yamagishi et al, 2012), similar to that in Canada (53.6%; Stajduhar et al, 2008), and lower than the rate reported for patients receiving palliative home care support services (80%; Alonso-Babarro et al, 2011).…”

“…However, current knowledge about the factors correlated with the actual place of death of patients with cancer (AlonsoBabarro et al, 2011;Murray, Fiset, Young, & Kryworuchko, 2009) is more extensive than that about the factors associated with their preferred place of death (Gomes et al, 2012). Only three studies have explored preferred place of death among Asian populations (Choi et al, 2010(Choi et al, , 2005Yamagishi et al, 2012), the social and cultural factors as well as healthcare systems of which differ significantly from those in Western countries.…”

“…Of these Asian studies investigating the place-of-death preferences of patients with cancer, one study (Choi et al, 2010) examined this issue from the perspective of bereaved family members, and the other two studies (Choi et al, 2005;Yamagishi et al, 2012) explored preferred place of death from the perspective of patients with cancer at various, not necessarily terminal, stages of their illness. Patient preferences for place of death may change in response to deterioration of his or her physical condition and exhaustion of family resources as death approaches.…”

Length of home hospice care, family-perceived timing of referrals, perceived quality of care, and quality of death and dying in terminally ill cancer patients who died at home

“…Exclusion criteria included: (1) inability to complete the questionnaire (dementia, cognitive failure, psychiatric illness, language difficulty, or visual loss), (2) severe emotional distress of the family, as determined by the primary responsible physicians, (3) treatment-associated death or death from comorbidity, (4) death in intensive care units, and (5) no family member unavailable. The second criterion was, as in our previous studies [32][33][34][35], adopted on the assumption that primary responsible physicians could identify families who may suffer a serious psychological impact due to the present study, and no formal criteria or psychiatric screening was applied. Families were surveyed 6 to 12 months after the patients' deaths.…”

Preference of the place of death among people of Pune

“…There are a few studies on mixed populations comprising patients and healthy subjects too, such as the one by Yamagishi et al ,[8] while others such as Fukui et al [9] have focussed on a healthy population. These studies take care of the possible differences of opinion between the sick and the healthy members of the population.…”