Abstract
We stated in a previous study that it is difficult to carry out advanced medical management and terminal care in the same ward and that it is necessary to separate medical oncology programs by specialties. The object of the present study is to reveal why the number of palliative care units and hospices is not increasing rapidly in Japan. We sent questionnaires to 327 doctors, nurses and other paramedical staff working on the medical wards of the National Cancer Center and of a general hospital as well as in the palliative care units of three general hospitals. 264 (78. 3%) of the subjects returned the questionnaires. The present paper analyzes the responses of 148 nurses in their 20's and 30's. The results may be summarized as follows : 1. Most nurses believe that terminally ill patients are best cared for in palliative care units or hospices. 2. The main reasons cited for the negligible increase in palliative care units and hospices are "the unsettled issue of whether or not to inform the patients of their illness and prognosis", "the lack of death education" and "financial problems in palliative care units which are unprofitable". 3. Over 60% of the nurses at the Cancer Center and in palliative care units consider it generally better to inform the patients and expect the number of palliative care units and hospices to increase in the future. However, approximately 35% of the nurses of the general hospital disagree with the latter opinion although they agree with the former.
