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Attitudes toward disease and prognosis disclosure and decision making for terminally ill patients in Japan, based on a nationwide random sampling survey of the general population and medical practitioners

Published online by Cambridge University Press:  25 October 2006

MITSUNORI MIYASHITA,. ,
SHUJI HASHIMOTO ,
MASAKO KAWA ,
YASUO SHIMA ,
HIROMI KAWAGOE ,
TSUNETO HASE ,
YAE SHINJO  and
KEIICHI SUEMASU
MITSUNORI MIYASHITA,.
Affiliation:
Department of Adult Nursing/Palliative Care Nursing, The University of Tokyo, Tokyo, Japan
SHUJI HASHIMOTO
Affiliation:
Department of Hygiene, Fujita Health University School of Medicine, Aichi, Japan
MASAKO KAWA
Affiliation:
Department of Adult Nursing/Palliative Care Nursing, The University of Tokyo, Tokyo, Japan
YASUO SHIMA
Affiliation:
Department of Palliative Medicine, Tsukuba Medical Center Hospital, Ibaraki, Japan
HIROMI KAWAGOE
Affiliation:
St. Luke's College of Nursing, Tokyo, Japan
TSUNETO HASE
Affiliation:
St.John's Society Social Welfare Foundation, Tokyo, Japan
YAE SHINJO
Affiliation:
Jizankai Tsuboi Hospital, Fukushima, Japan
KEIICHI SUEMASU
Affiliation:
Saiseikai Central Hospital, Tokyo, Japan
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Abstract

Objective: Employing a nationwide cross-sectional survey, we investigated the Japanese general population's attitudes toward disease and prognosis disclosure and related factors. Furthermore, we investigated Japanese medical practitioners' attitudes toward disease and prognosis disclosure for patients and decision making.

Methods: A nationwide anonymous questionnaire survey was conducted. A total of 5000 individuals were randomly sampled from the general population and 3104 physicians and 6059 nurses were randomly sampled in Japan.

Results: Finally, 2422 people from the general population (response rate, 48%), 1577 physicians (51%), and 3361 nurses (56%) returned questionnaires. Among the general population, 73% of participants answered that they “want to know” about their disease and prognosis when in an incurable disease state. Ninety percent desired direct disclosure and 8% disclosure through their family. However, few medical practitioners answered “patient himself” (physician 3%, nurses 4%) as the person whom they would primarily notify about the disease and prognosis when in charge of a patient with an incurable disease. On the other hand, physicians answered “family” most frequently (59%), whereas nurses most commonly responded, “depends on patient's condition” (63%).

Significance of research: Several detailed analyses of factors associated with prognosis disclosure were conducted. Japanese physicians need to carefully communicate with the patients individually about whether direct disclosure or disclosure primarily to the family is preferred.

Keywords

AttitudeEnd of life carePrognosis disclosureDecision makingCommunication
Type
Research Article
Information
Palliative & Supportive Care , Volume 4 , Issue 4 , December 2006 , pp. 389 - 398
Copyright
© 2006 Cambridge University Press

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References

REFERENCES

Asai, A., Kishino, M., Tsuguya, F., et al. (1998). A report from Japan: Choices of Japanese patients in the face of disagreement. Journal of Bioethics, 12, 162–172.Google Scholar
Benowitz, S. (1999). To tell the truth: A cancer diagnosis in other cultures is often a family affair. Journal of the National Cancer Institute, 91, 1918–1919.Google Scholar
Charlton, R., Dovey, S., Mizushima, Y., et al. (1995). Attitudes to death and dying in the UK, New Zealand, and Japan. Journal of Palliative Care, 1, 42–47.Google Scholar
Ende, J., Kazis, L., Ash, A., et al. (1989). Measuring patients' desire for autonomy: Decision making and information-seeking preferences among medical patients. Journal of General Internal Medicine, 4, 23–30.Google Scholar
Fetters, M.D. (1998). The family in medical decision making: Japanese perspectives. Journal of Clinical Ethics, 9, 132–146.Google Scholar
Hattori, H., Salzberg, S.M., & Kiang, W.P. (1991). The patient's right to information in Japan—Legal rules and physician's opinions. Social Science and Medicine, 32, 1007–1016.Google Scholar
Holland, J.C., Geary, N., Marchini, A., et al. (1987). An international survey of physician attitudes and practice in regard to revealing the diagnosis of cancer. Cancer Investigation, 5, 151–154.Google Scholar
Irie, M., Mishima, N., & Nagata, S. (1995). Attitude toward terminal care among nursing students. Japanese Journal of Psychosomatic Medicine, 35, 585–592 (in Japanese).Google Scholar
Kai, I., Ohi, G., Yano, E., et al. (1993). Communication between patients and physicians about terminal care: A survey in Japan. Social Science and Medicine, 36, 1151–1159.Google Scholar
Konishi, E. & Davis, A.J. (1999). Japanese nurses' perceptions about disclosure of information at the patients' end of life. Nursing & Health Sciences, 1, 179–187.Google Scholar
Konishi, E. & Davis, A.J. (2001). The right-to-die and the duty-to-die: Perceptions of nurses in the west and in Japan. International Nursing Review, 48, 17–28.Google Scholar
Long, S.O. (1999). Family surrogacy and cancer disclosure: Physician–family negotiation of an ethical dilemma in Japan. Journal of Palliative Care, 15, 31–42.Google Scholar
Long, S.O. & Long, B.D. (1982). Curable cancers and fatal ulcers. Attitudes toward cancer in Japan. Social Science and Medicine, 16, 2101–2108.Google Scholar
Matsumura, S., Fukuhara, S., Bito, S., et al. (1997). Nihon jin no gan kokuchi ni kansuru kibou to sore ni eikyou wo ataeru syoyouin no kentou, toku ni jiritu sei ni tyuumoku site—1995 nen zenkoku tyousa yori. Nihon iji shinpo, 3830, 37–42 (in Japanese).Google Scholar
Ministry of Health and Welfare. (1993). Heisei 4 nendo jinko dotai keizai men tyousa (akusei shinseibutsu), Kosei tokei kyokai Tokyo (in Japanese).
Ministry of Health and Welfare. (1994). Makki iryo wo kangaeru, Daiichi-hoki Tokyo (in Japanese).
Ministry of Health and Welfare. (1995). Heisei 6 nendo jinko dotai keizai men tyousa (Makki kanja he no iryo), Kosei tokei kyokai Tokyo (in Japanese).
Ministry of Health and Welfare. (1998). Heisei 8 nendo ishi, shikaishi, yakuzaishi tyousa. Kousei tokei kyokai Tokyo.
Miyashita, M., Hashimoto, S., Kawa, M., et al. (1999). Attitudes towards terminal care among the general population and medical practitioners in Japan. Nippon Koshu Eisei Zasshi, 46, 391–400 (in Japanese).Google Scholar
Mizushima, Y., Kashii, T., & Hoshino, K.A. (1990). Survey regarding the disclosure of the diagnosis of cancer in Toyama prefecture, Japan. Japanese Journal of Medicine, 29, 146–155.Google Scholar
Ohara, K., Suzuki, Y., Suzuki, Y., et al. (1982). Gan to shi ni tsuite no ishiki tyousa. Nihon iji shinpo, 32050, 43–50 (in Japanese).Google Scholar
Ruhnke, G.W., Wilson, S.R., Akamatsu, T., et al. (2000). Ethical decision making and patient autonomy: A comparison of physicians and patients in Japan and the United States. Chest, 118, 1172–1182.Google Scholar
Tanida, N. (1994). Japanese attitudes towards truth disclosure in cancer. Scandinavian Journal of Social Medicine, 22, 50–57.Google Scholar
Voltz, R., Akabayashi, A., Reese, C., et al. (1997). Organization and patients' perception of palliative care: A crosscultural comparison. Palliative Medicine, 11, 351–357.Google Scholar