Abstract
Objective : To assess the contributing elements for peaceful death of terminally ill patients who received our home-based palliative care at Nakajima Hospice and Clinic in Tokyo. The focus is on the role and efficacy of clinical spiritual care and counseling offered by the staff chaplain and members of the medical team. Method : Questionnaire survey on written responses from key-persons among the bereaved family members. 311 individuals, 31.6%, responded of total 985 cases surveyed, in 90% of cancer. These cases had been accumulated from April 1995 to April 2014. The content of the questionnaire to be answered emphasized the four elements of the Total Pain including the spiritual pain elements. Result : 91.8% responded to “Highly peaceful death or peaceful on the whole.” The relieving level of pain elements for all four categories of Total Pain resulted as ; the spiritual 55.7% ; the mental 73.5% ; the physical 85.4% ; the social 88.8%. The correlationship between “Alleviation of spiritual pain” and “peaceful death” scored p<0.001. Spiritual care given specifically by Chaplain was recognized as “very useful or useful” by 74.8%, that has correlationship with those who perceived the death “very peaceful” and “peaceful” in score of p=0.021. Conclusion : Significant alleviation of spiritual pain elements is highly necessary for supporting the peaceful death. Though this spiritual care is to be given by any trained members of the team, professional chaplaincy is expected to take effective role of resource person and leadership in this area.
