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Views on death with regard to end-of-life care preferences among cancer patients at a Japanese university hospital

Published online by Cambridge University Press:  11 July 2014

Yujiro Kuroda*
Affiliation:
Department of Palliative Medicine, The University of Tokyo Hospital, Tokyo, Japan Department of Public HealthFukushima Medical University School of Medicine, Fukushima City, Japan
Yumi Iwamitsu
Affiliation:
Department of Medical Psychology, Kitasato University, Tokyo, Japan
Mitsunori Miyashita
Affiliation:
Division of Palliative Nursing, Health Sciences, Tohoku University Graduation School of Medicine, Sendai, Miyagi, Japan
Kei Hirai
Affiliation:
Department of Complementary and Alternative Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
Yoshiaki Kanai
Affiliation:
Department of Palliative Medicine, The University of Tokyo Hospital, Tokyo, Japan
Sachiko Kawakami
Affiliation:
CancerNet Japan, Department of Public Relations, Tokyo, Japan
Kimiko Nakano
Affiliation:
Department of Adult Nursing/Palliative Care Nursing, School of Health Sciences and Nursing Sciences, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
Keiichi Nakagawa
Affiliation:
Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan
*
Address correspondence and reprint requests to: Yujiro Kuroda, Department of Public Health, Fukushima Medical University School of Medicine1 Hikarigaoka, Fukushima City, 960-1295, Japan. E-mail: kuroday@fmu.ac.jp

Abstract

Objective:

This study investigates the views on death among cancer patients in Japan and examines how these views are related to age, sex, and physical condition. We also investigate how these views are related to where patients would like to spend their final days and whether or not they would like to be told how long they have left to live.

Method:

We targeted 450 cancer patients receiving outpatient treatment in the radiology department at the University of Tokyo Hospital. We used the Death Attitudes Inventory (DAI) developed by Hirai to measure attitudes about death.

Results:

Of the 450 patients approached, we received responses from 310 (69% collection rate). The results of the t test and one-way ANOVA showed that, in terms of “death anxiety/fear,” the under-65 group (17.73 ± 6.69) scored significantly higher than the 65-and-over group (15.43 ± 7.69, t = 2.685, df = 280, p < 0.01); the group with KPS scores 70 or above (16.88 ± 7.21) scored higher than the group with KPS scores below 70 (12.73 ± 7.09, t = 2.168, df = 280, p = 0.03); and no significant difference was found for sex, metastasis, or treatment stage.

Significance of results:

Our results demonstrate that, although views on death among cancer patients may differ according to sex, age, and physical condition, taking these factors into account when understanding such views can be useful in predicting where patients may wish to spend their final days.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2014 

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References

REFERENCES

Aihara, Y., Sato, E., Hashimoto, H., et al. (2004). Hopes of people in their twenties and thirties living with leukemia lymphoma. Journal Japanese Academy of Nursing Science, 24(4), 8391.Google Scholar
Aziz, N.M. & Rowland, J.H. (2003). Trends and advances in cancer survivorship research: Challenge and opportunity. Seminars in Radiation Oncology, 13(3), 248266.Google Scholar
Cella, D.F. & Tross, S. (1987). Death anxiety in cancer survival: A preliminary cross-validation study. Journal of Personality Assessment, 51(3), 451461.Google Scholar
Chochinov, H.M., Wilson, K.G. & Enns, M. (1995). Desire for death in the terminally ill. The American Journal of Psychiatry, 152(8), 11841191.Google Scholar
Cicirelli, V.G. (1999). Personality and demographic factors in older adults' fear of death. The Gerontologist, 39(5), 269579.CrossRefGoogle ScholarPubMed
Derogatis, L.R., Morrow, G.R. & Fetting, J. (1983). The prevalence of psychiatric disorders among cancer patients. The Journal of the American Medical Association, 249(6), 751757.Google Scholar
Erikson, E.H. (1980). Identity and the life cycle. New York: W.W. Norton.Google Scholar
Feifel, H. & Branscomb, A.B. (1973). Who's afraid of death? Journal of Abnormal Psychology, 81(3), 282288.Google Scholar
Feifel, H. & Hermann, L.J. (1973). Fear of death in the mentally ill. Psychological Reports, 33(3), 931938.Google Scholar
Fortner, B.V. & Neimeyer, R.A. (1999). Death anxiety in older adults: A quantitative review. Death Studies, 23(5), 387411.Google Scholar
Fortner, B.V. & Neimeyer, R.A. (2010). Correlates of death anxiety in older adults: A comprehensive review. New York, Brunner-Routledge.Google Scholar
Fukui, S., Yoshiuchi, K., Fujita, J., et al. (2011). Japanese people's preference for place of end-of-life care and death: A population-based nationwide survey. Journal of Pain and Symptom Management, 42(6), 882892.CrossRefGoogle Scholar
Gesser, G., Wong, P. & Reker, G.T. (1987). Death attitudes across the life-span: The development and validation of the Death Attitude Profile (DAP). Omega: Journal of Death and Dying, 18(2), 113128.Google Scholar
Gonen, G., Kaymak, S.U., Cankurtaran, E.S., et al. (2012). The factors contributing to death anxiety in cancer patients. Journal of Psychosocial Oncology, 30(3), 347358.Google Scholar
Hirai, K. (2000). The study of death attitude: Construction and validation of the Death Attitude Inventory. The Japanese Journal of Clinical Research on Death and Dying, 23(1), 7176.Google Scholar
Ho, S. & Shiu, W. (1995). Death anxiety and coping mechanism of Chinese cancer patients. Omega: Journal of Death and Dying, 31(1), 5965.Google Scholar
Ishida, J. (2007). The study of nursing students' attitudes toward life and death. Kiryu Junior College, 18, 17.Google Scholar
Kaneko, S. (1994). Death anxiety and death perspectives of undergraduate students and their parents. Studies in the Humanities, 46(10), 537564.Google Scholar
Kawai, C. (2004). Adjustment to spousal bereavement and successful aging: A 16-year longitudinal study. Shinrigaku Kenkyu, 75(1), 4958.Google Scholar
Kübler-Ross, E. (2009). On death and dying: What the dying have to teach doctors, nurses, clergy and their own families. New York, Macmillan.Google Scholar
Levinson, D.J. (1990). A theory of life structure development in adulthood. New York: Oxford University Press.Google Scholar
Matsuda, T., Marugame, T., Kamo, K., et al. (2011). Cancer incidence and incidence rates in Japan in 2005: Based on data from 12 population-based cancer registries in the monitoring of cancer incidence in Japan. Japanese Journal of Clinical Oncology, 41(1), 139147.Google Scholar
Mullins, L.C. & Lopez, M.A. (1982). Death anxiety among nursing home residents: A comparison of the young-old and the old-old. Death Education, 6(1), 7586.Google Scholar
Nakagawa, K. (2012). Attitude toward life and death among the general population in Japan. Bulletin of Death and Life Studies, 17, 325344.Google Scholar
Nakamura, T. (1994). The development of children's concepts of death. The Japanese Journal of Developmental Psychology, 5(1), 6171.Google Scholar
Neimeyer, R.A., Wittkowski, J. & Moser, R.P. (2004). Psychological research on death attitudes: An overview and evaluation. Death Studies, 28(4), 309340.Google Scholar
Sonoda, M. (2008). Thoughts on the choice of a hospice for end-of-life care: Three patients with lung cancer. Bulletin of Faculty of Nursing and Nutrition, Kagoshima Immaculate Heart University, 12, 8194.Google Scholar
Sprague, B.L., Dittus, K.L., Pace, C.M., et al. (2013). Patient satisfaction with breast and colorectal cancer survivorship care plans. Clinical Journal of Oncology Nursing, 17(3), 266272.Google Scholar
Tange, C. (2004). Change in attitudes toward death in early and middle adolescence. Journal of the Japan Society of Developmental Psychology, 15(1), 6576.Google Scholar
Tange, C. (2009). Construction of a scale of attitude toward death in adolescence and its validity and reliability. The Japanese Journal of Psychology, 70(4), 327332.Google Scholar
Tate, L.A. (1982). Life satisfaction and death anxiety in aged women. International Journal of Aging & Human Development, 15(4), 299306.Google Scholar
Tomimatsu, R. (2012). Intergenerational study of attitude toward life and death. Kurume University Psychological Research, 11, 4554.Google Scholar
Ushida, T. (2007). How the elderly people aged 75 and over living in a nursing home prepare their death reception. Yamanashi Prefectural University, 9, 112.Google Scholar
Viney, L.L. (1983). Concerns about death among severely ill people. Death Education, 7(2–3), 229243.Google Scholar