2022 年 72 巻 2 号 p. 147-152
Purpose: Palliative care is poorly provided to people dying of amyotrophic lateral sclerosis (ALS) . This study aimed to clarify the circumstances of morphine use in patients with ALS who were treated with morphine in the final stage of their lives, the responses of patients and their families, and the views of home visiting nurses on the use of morphine.
Methods: Semi-structured interviews were conducted with four home visiting nurses having experience in supporting patients with ALS using morphine.
Results: Morphine was primarily administered for respiratory distress, for 0.5 to 7 months. All patients recognized the positive effects of morphine and were treated at home until the end of their lives. While some families were positive about morphine use, others were reluctant to use it but changed their minds after use. Four categories were extracted from home visiting nurses’ views, such as confirmation of morphine effect and approval of morphine use, and the importance of providing explanations to patients and their families.
Conclusion: The use of morphine for treating the symptoms of ALS was effective in alleviating respiratory distress and improving quality of life. Challenges to providing better home-based palliative care with morphine use include improving awareness among physicians and nurses regarding safe management of morphine by reinforcing education and training, and organizing the homecare support system for the management of morphine use at home.
