FACTORS INFLUENCING DECISION-MAKING OF TERMINALLY ILL CANCER PATIENTS’ FAMILIES REGARDING END-OF-LIFE CARE IN A PALLIATIVE CARE WARD IN THE FINAL MONTH: A PRELIMINARY STUDY

Abstract

Objective: This study explored the factors that influence patients with a life expectancy of less than one month in their choice of being admitted to a palliative care ward or other end-of-life (EOL) care institutions.

Methods: The participants consisted of caregiving family members and 14 cancer patients who consulted a Certified Nurse Specialist in Cancer Nursing at the Cancer Nursing Consultation Department of F Hospital from June to September 2014. A self-administered questionnaire survey of patients’ family members was conducted; all patients’ families answered the self-reported questionnaire, Japanese version of the Caregiver Reaction Assessment scale (CRA-J). The participants were dichotomized based on whether the patients were admitted to a palliative care ward and classified as “palliative care ward” and “others”, respectively.

Results: Nine chose the palliative care ward and were admitted within a week. The family care burden score for “Impact on schedule” was significantly higher for the palliative care ward inpatient group than for the non-inpatient group (21.0±1.5 vs. 17.6±1.8; effect size: 0.56, p=0.002).

Discussion: Family burden might influence the choice of facility when patients with a life expectancy of less than one month are admitted to the palliative care ward to reduce the burden of long-term care.

Conclusion: The results of this study show that caregiver support might be needed to reduce the feeling of family burden related to impact on schedule, enabling them to choose the best place for EOL care.