Online citations, reference lists, and bibliographies.
← Back to Search

Late Referrals To Specialized Palliative Care Service In Japan.

T. Morita, T. Akechi, M. Ikenaga, Y. Kizawa, H. Kohara, T. Mukaiyama, T. Nakaho, N. Nakashima, Y. Shima, Tatsuhiro Matsubara, Y. Uchitomi
Published 2005 · Medicine

Save to my Library
Download PDF
Analyze on Scholarcy
PURPOSE To clarify the bereaved family's perceptions about the appropriateness of timing when physicians first referred patients to palliative care units, and to identify the factors contributing to family-perceived late referrals. SUBJECTS AND METHODS A multicenter questionnaire survey was conducted on 630 bereaved family members of cancer patents who were admitted to palliative care units in Japan. A total of 318 responses were analyzed (effective response rate, 62%). RESULTS Half of the bereaved family members regarded the timing of referrals to palliative care units as late or very late, while less than 5% of families reported early referrals (very late [19%, n = 59], late [30%, n = 96], appropriate [48%, n = 151], early [1.6%, n = 5], and very early [2.2%, n = 7]). Multiple regression analyses revealed that the independent determinants of family-perceived late referrals were: family belief before admission that palliative care shortens the patient's life, insufficient in-advance discussion about preferred end-of-life care between patients/families and physicians, families' insufficient preparation for changes of patient conditions, and hospital admission before referrals. CONCLUSION In Japan, the timing of referrals to palliative care units was late or very late from the families' perspectives. The independent determinants of family-perceived late referrals were: family misconception about palliative care, inadequate communication with physicians, and families' insufficient preparation for deterioration of patients' conditions. Systematic strategies to overcome these barriers would contribute to providing appropriate palliative care at all stages of cancer.
This paper references
Family satisfaction with inpatient palliative care in Japan
T. Morita (2002)
Concise screening questions for clinical assessments of terminal care: the needs near the end-of-life care screening tool.
L. Emanuel (2001)
Barriers and enablers to hospice referrals: an expert overview.
Betsy T Friedman (2002)
Multiprofessional team approach in palliative care units in Japan
Etsuko Maeyama (2003)
Current status of hospice cancer deaths both in-unit and at home (1995– 2000), and prospects of home care services in Japan
E. Ida (2002)
Attitude and self-reported practice regarding hospice referral in a national sample of internists.
T. Iwashyna (1998)
A Canadian survey of cancer patients' experiences: are their needs being met?
F. Ashbury (1998)
Patients with cancer referred to hospice versus a bridge program: patient characteristics, needs for care, and survival.
D. Casarett (2001)
An Investigation of General Practitioner Referrals to Palliative Care Services
E. Pugh (1996)
Survival of Medicare patients after enrollment in hospice programs.
N. Christakis (1996)
Terminal cancer patients and timing of referral to palliative care: a multicenter prospective cohort study. Italian Cooperative Research Group on Palliative Medicine.
M. Costantini (1999)
Suicidality in terminally ill Japanese patients with cancer
T. Akechi (2004)
Evolution in measuring the quality of dying.
K. Steinhauser (2002)
When Does Palliative Care Begin? A Needs Assessment of Cancer Patients with Recurrent Disease
D. Dudgeon (1995)
Predictors of withdrawal from hospice.
D. Casarett (2001)
Timing of referral of terminally Ill patients to an outpatient hospice
N. Christakis (1994)
Determinants of the place of death among terminally ill cancer patients under home hospice care in Japan
S. Fukui (2003)
Differences in physician access patterns to hospice care.
M. Stillman (1999)
Physicians and hospice care: attitudes, knowledge, and referrals.
K. Ogle (2002)
Barriers to the physician decision to offer hospice as an option for terminal care.
Weggel Jm (1999)

This paper is referenced by
One-year follow-up of an educational intervention for palliative care consultation teams.
Y. Nakazawa (2014)
Assessment of Intervention by a Palliative Care Team Working in a Japanese General Hospital
Koji Amano (2015)
Organisatie van palliatieve zorg in België
M. Keirse (2009)
Knowledge and Attitude toward Hospice Palliative Care among Community-Dwelling Aged Taiwanese—Analysis of Related Factors
Ching-Ping Hsu (2012)
Public awareness, knowledge of availability, and readiness for cancer palliative care services: a population-based survey across four regions in Japan.
K. Hirai (2011)
Referral timing of in-hospital cancer deaths to palliative care in a Saudi tertiary care hospital
S. Alsirafy (2010)
Suggested Reference
Anne O'Callaghan (2014)
Death Pronouncements: Recommendations Based on a Survey of Bereaved Family Members
KusakabeAkihiko (2016)
Current practices in advance care planning: implications for oncology nurses.
A. Cohen (2011)
Timing of palliative care: When to call for a palliative care consult
C. J. R. Schlick (2019)
Chemotherapy prescription appropriateness in end-of-life cancer care: impact of referral to the palliative care specialist at the Cancer Institute of Romagna (IRST)–IRCCS
Mattia Marri (2013)
Preferred place of care and place of death of the general public and cancer patients in Japan
Akemi Yamagishi (2011)
Patient and caregiver experiences with advanced cancer care: a qualitative study informing the development of an early palliative care pathway
S. Ahmed (2020)
The Use of Internet Cancer Support Groups by Ethnic Minorities
E. Im (2008)
Reliability assessment and findings of a newly developed quality measurement instrument: quality indicators of end-of-life cancer care from medical chart review at a Japanese regional cancer center.
K. Sato (2008)
50 – Communication about palliative care and end-of-life planning
Camilla Zimmermann (2011)
Barriers of Transfer to Palliative Care Units in Core Cancer Hospitals from the Viewpoint of Medical Social Workers and Discharge Support and Coordination Nurses
Hiroka Nagaoka (2017)
The influence of familial factors on the choice of the place of death for terminally ill breast cancer patients: a retrospective single-center study
K. Harano (2015)
The impact of an outpatient palliative care consultation on symptom burden in advanced prostate cancer patients.
S. Yennurajalingam (2012)
Triangulation analysis of tele-palliative care implementation in a rural community area in Japan.
N. Aoki (2006)
Identification of Quality Indicators of End-of-Life Cancer Care From Medical Chart Review Using a Modified Delphi Method in Japan
M. Miyashita (2008)
The Project ENABLE II Randomized Controlled Trial to Improve Palliative Care for Patients with Advanced Cancer
Marie Bakitas (2013)
The experience of mesothelioma in northern England.
H. Clayson (2007)
Bereaved cancer carers’ experience of and preference for palliative care
Natasha Sekelja (2009)
Collaboration between physicians and a hospital-based palliative care team in a general acute-care hospital in Japan
N. Tamiya (2010)
Japanese Bereaved Family Members’ Perspectives of Palliative Care Units and Palliative Care
Satomi Kinoshita (2016)
An Aspirin A Day May Keep Blood Clots Far Away
B. Prakash (2013)
Prevalence of palliative patients and their health services utilization in the Regina Qu'Appelle regional health authority
Julia Y. Porter (2007)
Supportive versus palliative care: What's in a name?
N. Fadul (2009)
Pediatric palliative care.
Jeffrey C. Klick (2010)
Family member perspectives of deceased relatives’ end-of-life options on admission to a palliative care unit in Japan
K. Sato (2012)
Late referrals to home palliative care service affecting death at home in advanced cancer patients in Japan: a nationwide survey.
S. Fukui (2011)
See more
Semantic Scholar Logo Some data provided by SemanticScholar