がん患者における緩和ケア開始時期の認識と関連要因
【目的】本研究の目的は,がん患者の緩和ケア開始時期の認識と関連要因を明らかにすることである.【方法】がん診療連携拠点病院に入院・通院中のがん患者を対象に無記名自記式質問紙調査を行った.個人属性,がん・治療状況,緩和ケア開始時期の認識,緩和ケアの認知や提供状況を調査し,ロジスティック回帰分析を行った.【結果】3,622名のうち1,981名(54.7%)の回答を得た.1,187名(59.9%)が早期から,414名(20.9%)が終末期からの緩和ケアの認識であった.症状への対応あり(vs.該当,OR=0.56),再発・転移あり(vs.,OR=1.44),40代以下(vs.70代以上,OR=1.67)...
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| Published in | Palliative Care Research Vol. 16; no. 1; pp. 35 - 43 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本緩和医療学会
2021
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1880-5302 |
| DOI | 10.2512/jspm.16.35 |
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| Abstract | 【目的】本研究の目的は,がん患者の緩和ケア開始時期の認識と関連要因を明らかにすることである.【方法】がん診療連携拠点病院に入院・通院中のがん患者を対象に無記名自記式質問紙調査を行った.個人属性,がん・治療状況,緩和ケア開始時期の認識,緩和ケアの認知や提供状況を調査し,ロジスティック回帰分析を行った.【結果】3,622名のうち1,981名(54.7%)の回答を得た.1,187名(59.9%)が早期から,414名(20.9%)が終末期からの緩和ケアの認識であった.症状への対応あり(vs.該当,OR=0.56),再発・転移あり(vs.,OR=1.44),40代以下(vs.70代以上,OR=1.67)は終末期からの緩和ケアの認識と有意に関係した.【考察】症状への対応が必要となる前から緩和ケアの普及啓発を行うことが早期からの緩和ケアの認識を促進する可能性がある. |
|---|---|
| AbstractList | 【目的】本研究の目的は,がん患者の緩和ケア開始時期の認識と関連要因を明らかにすることである.【方法】がん診療連携拠点病院に入院・通院中のがん患者を対象に無記名自記式質問紙調査を行った.個人属性,がん・治療状況,緩和ケア開始時期の認識,緩和ケアの認知や提供状況を調査し,ロジスティック回帰分析を行った.【結果】3,622名のうち1,981名(54.7%)の回答を得た.1,187名(59.9%)が早期から,414名(20.9%)が終末期からの緩和ケアの認識であった.症状への対応あり(vs.該当,OR=0.56),再発・転移あり(vs.,OR=1.44),40代以下(vs.70代以上,OR=1.67)は終末期からの緩和ケアの認識と有意に関係した.【考察】症状への対応が必要となる前から緩和ケアの普及啓発を行うことが早期からの緩和ケアの認識を促進する可能性がある. |
| Author | 竹井, 友理 師岡, 友紀 南口, 陽子 辰巳, 有紀子 荒尾, 晴惠 畠山, 明子 山本, 瀬奈 |
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| References | 14) Philip J, Hudson P, Bostanci A, et al. Metastatic non-small cell lung cancer: a benchmark for quality end-of-life cancer care? Med J Aust 2015; 202: 139-43. 15) Miyashita M, Hirai K, Morita T, et al. Barriers to referral to inpatient palliative care units in Japan: a qualitative survey with content analysis. Support Care Cancer 2008; 16: 217-22. 2) 厚生労働省.がん対策推進基本計画 平成24年6月.https://www.mhlw.go.jp/file/06-Seisakujouhou-10900000-Kenkoukyoku/gan_keikaku02.pdf (2020年7月9日アクセス) 21) 内閣府.がん対策に関する世論調査 平成28年度.https://survey.gov-online.go.jp/h28/h28-gantaisaku/2-4.html (2020年9月12日アクセス) 18) McIlfatrick S, Noble H, McCorry NK, et al. Exploring public awareness and perceptions of palliative care: a qualitative study. Palliat Med 2014; 28: 273-80. 20) 内閣府.がん対策に関する世論調査 平成26年度.https://survey.gov-online.go.jp/h26/h26-gantaisaku/2-4.html (2020年9月12日アクセス) 11) Shalev A, Phongtankuel V, Kozlov E, et al. Awareness and misperceptions of hospice and palliative care: a population-based survey study. Am J Hosp Palliat Care 2018; 35: 431-9. 5) Akiyama M, Hirai K, Takebayashi T, et al. The effects of community-wide dissemination of information on perceptions of palliative care, knowledge about opioids, and sense of security among cancer patients, their families, and the general public. Support Care Cancer 2016; 24: 347-56. 9) Chosich B, Burgess M, Earnest A, et al. Cancer patients’ perceptions of palliative care. Support Care Cancer 2020; 28: 1207-14. 10) Collins A, McLachlan SA, Philip J. Initial perceptions of palliative care: An exploratory qualitative study of patients with advanced cancer and their family caregivers. Palliat Med 2017; 31: 825-32. 7) Yoo SH, Kim M, Yun YH, et al. Attitudes toward early palliative care in cancer patients and caregivers: a Korean nationwide survey. Cancer Med 2018; 7: 1784-93. 8) Akiyama M, Takebayashi T, Morita T, et al. Knowledge, beliefs, and concerns about opioids, palliative care, and homecare of advanced cancer patients: a nationwide survey in Japan. Support Care Cancer 2012; 20: 923-31. 22) Zhu Y, Enguídanos S. When patients say they know about palliative care, how much do they really understand? J Pain Symptom Manage 2019; 58: 460-4. 4) 厚生労働省.がん診療連携拠点病院等の整備について.https://www.mhlw.go.jp/content/000347080.pdf (2020年7月9日アクセス) 12) Zimmermann C, Swami N, Krzyzanowska M, et al. Perceptions of palliative care among patients with advanced cancer and their caregivers. CMAJ 2016; 188: E217-E227. 16) Morita T, Akechi T, Ikenaga M, et al. Late referrals to specialized palliative care service in Japan. J Clin Oncol 2005; 23: 2637-44. 1) Temel JS, Greer JA, Muzikansky A, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 2010; 363: 733-42. 6) Rugno FC, Paiva BS, Nunes JS, et al. “There won’t’ be anything else...it’s over”: perceptions of women referred to palliative care only. Eur J Oncol Nurs 2014; 18: 261-6. 3) 厚生労働省.がん対策推進基本計画 平成30年3月.https://www.mhlw.go.jp/file/06-Seisakujouhou-10900000-Kenkoukyoku/0000196975.pdf (2020年7月9日アクセス) 19) 内閣府.がん対策に関する世論調査 平成24年度.https://survey.gov-online.go.jp/h24/h24-gantaisaku/2-4.html (2020年9月12日アクセス) 23) Thomas BC, NandaMohan V, Nair MK, et al. Gender, age and surgery as a treatment modality leads to higher distress in patients with cancer. Support Care Cancer 2010; 19: 239-50. 13) Hui D, Kim SH, Kwon JH, et al. Access to palliative care among patients treated at a comprehensive cancer center. Oncologist 2012; 17: 1574-80. 17) 林優美,小早川誠,槙埜良江,他.医師・病棟看護師が患者に「緩和ケア」という用語を使用する時期.Palliat Care Res 2016; 11: 209-16. |
| References_xml | – reference: 4) 厚生労働省.がん診療連携拠点病院等の整備について.https://www.mhlw.go.jp/content/000347080.pdf (2020年7月9日アクセス). – reference: 2) 厚生労働省.がん対策推進基本計画 平成24年6月.https://www.mhlw.go.jp/file/06-Seisakujouhou-10900000-Kenkoukyoku/gan_keikaku02.pdf (2020年7月9日アクセス). – reference: 3) 厚生労働省.がん対策推進基本計画 平成30年3月.https://www.mhlw.go.jp/file/06-Seisakujouhou-10900000-Kenkoukyoku/0000196975.pdf (2020年7月9日アクセス). – reference: 19) 内閣府.がん対策に関する世論調査 平成24年度.https://survey.gov-online.go.jp/h24/h24-gantaisaku/2-4.html (2020年9月12日アクセス). – reference: 15) Miyashita M, Hirai K, Morita T, et al. Barriers to referral to inpatient palliative care units in Japan: a qualitative survey with content analysis. Support Care Cancer 2008; 16: 217-22. – reference: 17) 林優美,小早川誠,槙埜良江,他.医師・病棟看護師が患者に「緩和ケア」という用語を使用する時期.Palliat Care Res 2016; 11: 209-16. – reference: 1) Temel JS, Greer JA, Muzikansky A, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 2010; 363: 733-42. – reference: 20) 内閣府.がん対策に関する世論調査 平成26年度.https://survey.gov-online.go.jp/h26/h26-gantaisaku/2-4.html (2020年9月12日アクセス). – reference: 21) 内閣府.がん対策に関する世論調査 平成28年度.https://survey.gov-online.go.jp/h28/h28-gantaisaku/2-4.html (2020年9月12日アクセス). – reference: 23) Thomas BC, NandaMohan V, Nair MK, et al. Gender, age and surgery as a treatment modality leads to higher distress in patients with cancer. Support Care Cancer 2010; 19: 239-50. – reference: 11) Shalev A, Phongtankuel V, Kozlov E, et al. Awareness and misperceptions of hospice and palliative care: a population-based survey study. Am J Hosp Palliat Care 2018; 35: 431-9. – reference: 10) Collins A, McLachlan SA, Philip J. Initial perceptions of palliative care: An exploratory qualitative study of patients with advanced cancer and their family caregivers. Palliat Med 2017; 31: 825-32. – reference: 8) Akiyama M, Takebayashi T, Morita T, et al. Knowledge, beliefs, and concerns about opioids, palliative care, and homecare of advanced cancer patients: a nationwide survey in Japan. Support Care Cancer 2012; 20: 923-31. – reference: 9) Chosich B, Burgess M, Earnest A, et al. Cancer patients’ perceptions of palliative care. Support Care Cancer 2020; 28: 1207-14. – reference: 5) Akiyama M, Hirai K, Takebayashi T, et al. The effects of community-wide dissemination of information on perceptions of palliative care, knowledge about opioids, and sense of security among cancer patients, their families, and the general public. Support Care Cancer 2016; 24: 347-56. – reference: 16) Morita T, Akechi T, Ikenaga M, et al. Late referrals to specialized palliative care service in Japan. J Clin Oncol 2005; 23: 2637-44. – reference: 22) Zhu Y, Enguídanos S. When patients say they know about palliative care, how much do they really understand? J Pain Symptom Manage 2019; 58: 460-4. – reference: 6) Rugno FC, Paiva BS, Nunes JS, et al. “There won’t’ be anything else...it’s over”: perceptions of women referred to palliative care only. Eur J Oncol Nurs 2014; 18: 261-6. – reference: 7) Yoo SH, Kim M, Yun YH, et al. Attitudes toward early palliative care in cancer patients and caregivers: a Korean nationwide survey. Cancer Med 2018; 7: 1784-93. – reference: 13) Hui D, Kim SH, Kwon JH, et al. Access to palliative care among patients treated at a comprehensive cancer center. Oncologist 2012; 17: 1574-80. – reference: 12) Zimmermann C, Swami N, Krzyzanowska M, et al. Perceptions of palliative care among patients with advanced cancer and their caregivers. CMAJ 2016; 188: E217-E227. – reference: 18) McIlfatrick S, Noble H, McCorry NK, et al. Exploring public awareness and perceptions of palliative care: a qualitative study. Palliat Med 2014; 28: 273-80. – reference: 14) Philip J, Hudson P, Bostanci A, et al. Metastatic non-small cell lung cancer: a benchmark for quality end-of-life cancer care? Med J Aust 2015; 202: 139-43. |
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| Title | がん患者における緩和ケア開始時期の認識と関連要因 |
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