Palliative Care Research
Online ISSN : 1880-5302
ISSN-L : 1880-5302
Volume 16, Issue 4
Displaying 1-4 of 4 articles from this issue
Original Research
  • Satoru Miwa, Tatsuya Morita, Yoshihisa Matsumoto, Yuko Uehara, Masashi ...
    2021 Volume 16 Issue 4 Pages 281-287
    Published: 2021
    Released on J-STAGE: October 26, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Objective: The aim of this study was to investigate Japanese dialects for expressing symptoms that palliative care specialists believe they should know. Method: A nationwide questionnaire mail survey was conducted between February and April 2020 with 762 palliative care specialists. Japanese dialects and their meanings that specialists need to know when assessing symptoms were surveyed and a content analysis was performed. Results: A total of 492 (64.8%) specialists responded, and 233 (47.4%) mentioned a total of 116 dialects, out of which 101 were used to express symptoms. The dialects were classified into the following categories: “fatigue, unspecified distress, and discomfort” (N=62), “pain” (N=13), “respiratory and cardiovascular symptoms” (N=8),“psychological symptoms” (N=8), “gastrointestinal symptoms” (N=5), and “neurological, muscular, and dermatological symptoms” (N=5). Conclusion: We identified Japanese dialects and their meanings that specialists would need to know when assessing symptoms. The understanding of various dialects may help better assess symptoms.

  • Kayoko Nagaoka, Kumiko Ichimura
    2021 Volume 16 Issue 4 Pages 289-299
    Published: 2021
    Released on J-STAGE: October 26, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Objective: To determine ICU nurses’ perceptions of end-of-life care and the factors associated with these perceptions. Methods: An anonymous self-administered questionnaire was mailed to 650 nurses with at least three years of ICU experience at an emergency and critical care center regarding their basic attributes and their perceptions of end-of-life care. Logistic regression analysis was performed with the constructs of perception of end-of-life care as the dependent variables. Results: A total of 277 valid responses were obtained. The following three constructs of perception of end-of-life care were extracted: difficulty in family care, negative perception of end-of-life care, and positive perception of end-of-life care. “Difficulty in family care” was significantly associated with “10 or more years of ICU experience” and “PNS”; “negative perception of end-of-life care” was significantly associated with “age 30–39,” “age 40 years or older,” and “manuals and guidelines for end-of-life care”; and “positive perception of end-of-life care” was significantly associated with “interest in end-of-life care.” Conclusion: In order to raise awareness of end-of-life care, it is necessary to address factors such as nurses’ personal experiences of and interest in end-of-life care, and use of manuals and guidelines for end-of-life care.

  • Yoko Ohba, Teruaki Tanaka, Masako Sato, Isao Yokota, Chizuko Takigawa
    2021 Volume 16 Issue 4 Pages 307-314
    Published: 2021
    Released on J-STAGE: December 10, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Objective: To investigate the factors that make observed survival of patients with terminal cancer shorter than oncologists’ estimation. Methods: We retrospectively surveyed the medical records of terminal cancer patients who were referred to our palliative care unit with a predicted survival of 1–3 months and discharged dead from hospital within 3 months. Results: A total of 249 patients were eligible for analysis. One hundred and two patients (41%) had observed survival of less than one month (OS1), and 147 (59%) lived for 1–3 months (OS1–3) as expected. Depressed level of consciousness above Japan Coma Scale II and severely reduced oral intake (a few mouthfuls or less) were associated with unexpected shorter survival. The number of patients who died within two days after sudden deterioration of general condition was significantly higher in OS1 than OS1–3. Conclusion: Although survival of patients with the above factors may be shorter than oncologists’ estimation, it is necessary to examine the physician-side factors that contribute to the inaccuracy of prognosis.

Case Report
  • Naho Ihara, Yoko Takino, Miwako Ohgishi, Mari Takeuchi, Akiko Abe, Ken ...
    2021 Volume 16 Issue 4 Pages 301-306
    Published: 2021
    Released on J-STAGE: November 24, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Introduction: The efficacy of fentanyl to relieve dyspnea in comparison to morphine remains to be determined. We report a case in which switching from high-dose intravenous fentanyl to low-dose intravenous morphine relieved dyspnea in a patient with COVID-19 pneumonia. Case: An 85-year-old man who was intubated and mechanically ventilated due to severe COVID-19 pneumonia, received continuous intravenous fentanyl for pain relief. Despite several modulations of the ventilation mode, he showed persistent dyspnea under mechanical ventilation. To relieve his dyspnea, the fentanyl dose was increased to 2,400 μg per day; however, this was ineffective. Our palliative care team intervened and switched the patient’s opioid to 76.8 mg per day of morphine, which was less than the equal conversion based on cancer pain conversion. After this switch, his apparent dyspnea was alleviated, but his respiratory rate decreased. The dose of morphine was gradually reduced to 10 mg per day to alleviate respiratory depression. Discussion: In this case, switching to morphine at doses much lower than the intravenous dose of fentanyl could induce relief of dyspnea. Morphine may be more effective than fentanyl for dyspnea due to COVID-19.

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