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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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