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Association between Advance Care Planning by a Visiting Nurse and Achieving the Desired Place of Death for Patients with End-stage Cancer Takako Ishikawa 1 , Sakiko Fukui 2 , Yuko Okamoto 2 1Department of Nursing, Faculty of Human Sciences, Sophia University 2The Japanese Red Cross College of Nursing Keyword: アドバンスケアプランニング , 生活予後の説明 , 希望死亡場所の確認 , 終末期がん患者 , 訪問看護師 , Advance Care Planning , an explanation of the prognosis including problems likely to occur in daily life , confrmation of the chosen place of death , patients with end-stage cancer , visiting nurses pp.123-131
Published Date 2017/12/31
  • Abstract
  • Reference

Purpose: To examine the association between advance care planning (ACP) by a visiting nurse and achieving the desired place of death for patients with end-stage cancer.

Methods: A cross-sectional nationwide questionnaire survey was conducted for visiting nurses at 1,000 randomly selected home care agencies. Items included the actual place of death, patients' preferences for place for death, ACP (support for understanding of life expectancy and confrmation and adjustment of the chosen place of death) by nurses at each home visit, and factors related to ACP in nurses' practice. Logistic regression was conducted with achieving the desired place of death as the dependent variable.

Results: A total of 374 responses were analyzed. Regarding the place of death, 65.0% of patients died at home and 73.8% died at their chosen place. Te rate of an explanation of the prognosis, including problems likely to occur in daily life was low (27.8-31.8%). Factors related to death at the desired place included confrmation of the chosen place of death during the whole period (adjusted odds ratio: 19.92, 95% confdence interval: 9.48-41.87; 21.10, 9.53-46.71; 187.35, 51.79-677.64) and the explanation of the prognosis (2.44, 1.05-5.66) at the progression stage.

Conclusions: Tese results suggest that patients are more likely to die in their desired place if visiting nurses confrm the chosen place of death repeatedly until close to the end of life and explain the infuence of the disease prognosis on daily life, with updates of this information based on changes in symptoms.


Copyright © 2017, Japan Academy of Nursing Science. All rights reserved.

基本情報

電子版ISSN 2185-8888 印刷版ISSN 0287-5330 日本看護科学学会

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