Miyashita M.,University of Tokyo |
Miyashita M.,Tohoku University |
Kawakami S.,Cancer Net Japan |
Kawakami S.,University of Tokyo |
And 6 more authors.
Supportive Care in Cancer | Year: 2015
Background: The objectives of this study were to compare the importance of components of a good death among cancer patients, the general population, oncologists, and oncology nurses, and explore which patients preferred “fighting against cancer”.Methods: We conducted a cross-sectional anonymous self-reported survey of cancer patients who visited a radiation oncology outpatient clinic, oncologists, and oncology nurses at the Tokyo University Hospital and a random sample of the general population in the Tokyo metropolitan area. The outcomes were 18 previously developed components of a good death in Japanese cancer care consisting of 57 attributes.Results: Three hundred ten patients, 353 subjects from the general population, 109 oncologists, and 366 oncology nurses participated. The desire to “fight against cancer” was highly significantly different between patients and oncologists (effect size [ES] = −1.40; P = 0.001) and patients and oncology nurses (ES = −1.12; P = 0.001). “Physical and cognitive control” was, similarly, highly significantly different between patients and oncologists (ES = −1.30; P = 0.001) and patients and oncology nurses (ES = −1.06; P = 0.001). Patients who emphasized “maintaining hope and pleasure” (P = 0.0001), “unawareness of death” (P = 0.0001), and “good relationship with family” (P = 0.004) favored “fighting against cancer.” The patients, however, who emphasized “physical and psychological comfort” did not significantly favor “fighting against cancer” (P = 0.004).Conclusion: The importance of good death components differed between groups. Medical professionals should be aware of the diversity of values surrounding death and assess the patient’s values and discuss them to support his or her quality of life. In addition, the development of care and a medical/social system to maintain hope and pleasure after failure of anticancer treatment is necessary. © 2014, Springer-Verlag Berlin Heidelberg.
Kawakami S.,Cancer Net Japan |
Yanagisawa A.,Cancer Net Japan |
Konishi T.,Cancer Net Japan |
Konishi T.,University of Tokyo |
And 2 more authors.
Japanese Journal of Cancer and Chemotherapy | Year: 2014
The 2012 revision of the Basic Plan to Promote Cancer Control Programs explicitly recommends the enhancement of peer support. As of October 2013, only 20% of all designated regional and prefectural core hospitals and centers for cancer care formally promote peer support. Accordingly, the national government has been organizing training courses on peer support. Even so, peer support is not readily available. CancerNet Japan, a non-profit organization, has organized a peer support system at four designated cancer care hospitals in the Kanagawa prefecture, in association with the government. Peer supporters are breast cancer survivors who have completed the "Breast Cancer Survivor Coordinator Training Program," a course organized by CancerNet Japan since 2007, and have been officially certified as coordinators after course completion. These peer supporters have not only learned from their own experience but have also studied scientific medical information on cancer. The manner in which supportive activities are conducted in these four hospitals varies according to environment; for example, a dedicated booth may be set up or a standby coordinator may be stationed in a dedicated support room. The most common issue dealt with was the fear expressed by patients or their families, and supporter responses were primarily to attentively listen to them. In this paper, we review our activities with regard to the following three areas of interest: Circled digit one intra-institutional coordination within each hospital, Circled digit two supporter-related issues, and Circled digit three financial resources for efforts involved in the proposed structured peer support system to be adopted at a large number of hospitals nationwide.