A Cross-sectional Survey on the Use of the Term “Key Person” in Palliative Care Units

Abstract

Objective: To clarify the actual usage of the term “key person” in palliative care units and nurses’ perceptions regarding the requirements for involvement in surrogate decision-making. Methods: A web-based questionnaire survey was conducted targeting nurses working in palliative care units at 25 domestic facilities. Results: 137 responses were received. While 99.2% reported using the term “frequently” or “sometimes,” approximately 30% reported that operational rules were “not standardized” or “unknown.” Decision-making-related matters were the most frequently assigned. Furthermore, approximately 90% of nurses perceived that the key person “always” or “sometimes” fulfilled requirements for surrogate decision-making, including “understanding necessary information,” “comprehending the patient’s wishes,” “respecting advance directives,” and “considering the patient’s best interests.” Conclusion: The term “key person” is frequently used despite its ambiguous definition and operational standards. It is desirable for palliative care providers to avoid relying on ambiguous terms, to carefully consider the most appropriate person for each specific request, and to share information using clear, unambiguous terminology.