Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-10T15:25:09.655Z Has data issue: false hasContentIssue false

Factors associated with difficulties encountered by nurses in the care of terminally ill cancer patients in hospitals in Japan

Published online by Cambridge University Press:  24 August 2005

TOMOYO SASAHARA
Affiliation:
Department of Adult Nursing/Terminal and Long-term Care Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
MITSUNORI MIYASHITA
Affiliation:
Department of Adult Nursing/Terminal and Long-term Care Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
MASAKO KAWA
Affiliation:
Department of Adult Nursing/Terminal and Long-term Care Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
KEIKO KAZUMA
Affiliation:
Department of Adult Nursing/Terminal and Long-term Care Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

Abstract

Objective: To identify the factors associated with difficulties encountered by nurses working in general wards in hospitals in Japan.

Methods: Questionnaires including items regarding difficulties in providing care to terminally ill cancer patients, the existence of a mentor regarding end-of-life issues, awareness of end-of-life issues, and demographic factors were administered to 375 staff nurses working in general in-patient wards. Multivariate regression analyses were employed to investigate correlations between factors.

Results: Multivariate regression analysis revealed that the existence of a mentor for end-of-life issues was associated with fewer difficulties in all areas other than “Knowledge and skill of nurses.” Clinical experience was inversely related to difficulties in “Communication with patients and families” and “Personal issues.” Greater awareness of end-of-life issues was related to higher difficulties in most areas.

Significance of results: The existence of a mentor was correlated with fewer difficulties in most areas. Support by a palliative care team might be effective in reducing difficulties experienced by nurses and in improving care for terminally ill cancer patients. Basic communication training undertaken sooner after registration might be also useful.

Type
Research Article
Copyright
© 2005 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Alexander, D. & Ritchie, E. (1990). ‘Stressors' and difficulties in dealing with the terminal patient. Journal of Palliative Care, 6, 2833.Google Scholar
Carter, H., Mckinlay, E., Scott, I., et al. (2002). Impact of a hospital palliative care service: Perspective of the hospital staff. Journal of Palliative Care, 18, 160167.Google Scholar
Copp, G. & Dunn, V. (1993). Frequent and difficult problems perceived by nurses caring for the dying in community, hospice and acute care settings. Palliative Medicine, 7, 1925.Google Scholar
Covinsky, K.E., Fuller, J.D., Yaffe, K., et al. (2000). Communication and decision-making in seriously ill patients: Findings of the SUPPORT project. The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments. Journal of the American Geriatric Society, 48, S187S193.Google Scholar
Higginson, I.J., Finlay, I., Goodwin, D.M., et al. (2002). Do hospital-based palliative teams improve care for patients or families at the end of life? Journal of Pain & Symptom Management, 23, 96106.Google Scholar
Hockley, J. (1992). Role of the hospital support team. British Journal of Hospital Medicine, 48, 250253.Google Scholar
Hospice Information. (2002). Hospice and Palliative Care Facts and Figures. London: Author.
Institute for Health Economics and Policy. (2000). A Study of End-of-Life Care Programs and Policies. Tokyo: Author (in Japanese).
Japanese Nursing Association. (1999). 1997 Report on status of nursing personnel. Japanese Nursing Association Research Report no. 54. Tokyo: Japanese Nursing Association Publishing Company (in Japanese).
Kaharu, C. (1990). Evaluation of Nursing Educational Program—The Case Report in Japan. The Japanese Journal of Nursing Research, 23, 7788 (in Japanese).Google Scholar
Kite, S. (1999). Palliative care in hospital. In Providing a Palliative Care Service, Bonsanquet, N. & Salisbury, C. (eds.), pp. 183191. New York: Oxford University Press.
Ministry of Health and Labor, Grant for Scientific Research: Study Group for Promoting Hospice and Palliative Care Service. (2001). Present Status and Future of Hospice/Palliative Care Units in Japan. Osaka: Author (in Japanese).
Pan, C.X., Morrison, R.S., & Meier, D.E. (2001). How prevalent are hospital-based palliative care programs? Status report and future directions. Journal of Palliative Medicine, 4, 315324.Google Scholar
Pankratz, L. & Pankratz, D. (1974). Nursing autonomy and patients' rights: Development of a nursing attitude scale. Journal of Health and Social Behavior, 15, 211216.Google Scholar
Payne, N. (2001). Occupational stressors and coping as determinants of burnout in female hospice nurses. Journal of Advanced Nursing, 33, 396405.Google Scholar
Porta, M., Busquet, X., & Jariod, M. (1997). Attitudes and views of physicians and nurses towards cancer patients dying at home. Palliative Medicine, 11, 116126.Google Scholar
Ramirez, A.J., Graham, J., Richards, M.A., et al. (1995). Burnout and psychiatric disorder among cancer clinicians. British Journal of Cancer, 71, 12631269.Google Scholar
Ross, M., McDonald, B., & McGuinness, J. (1996). The palliative care quiz for nursing (PCQN): The development of an instrument to measure nurses' knowledge of palliative care. Journal of Advanced Nursing, 23, 126137.Google Scholar
Sasahara, T., Miyashita, M., Kawa, M., et al. (2003). Difficulties encountered by nurses in the care of terminally ill cancer patients in general hospitals in Japan. Palliative Medicine, 17, 520526.Google Scholar
Teno, J.M., Clarridge, B.R., Casey, V., et al. (2004). Family perspectives on end-of-life care at the last place of care. Journal of the American Medical Association, 291, 8893.Google Scholar
Vachon, M.L.S. (1995). Staff stress in hospice/palliative care: A review. Palliative Medicine, 9, 91122.Google Scholar
Vachon, M.L.S. (1999). Reflections on the history of occupational stress in hospice/palliative care. Hospice Journal, 14, 229246.Google Scholar
Vachon, M.L.S. (2004). The stress of professional caregivers. In Oxford Textbook of Palliative Medicine, Doyle, D., Hanks, J., Cherny, N. & Calman, K. (eds.), pp. 9921004. New York: Oxford University Press.
Weissman, D.E. (1997). Consultation in palliative medicine. Archives of Internal Medicine, 157, 733737.Google Scholar