TOHOKU UNIVERSITY Researchers - Mitsunori Miyashita

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Mitsunori Miyashita

Section

Graduate School of Medicine

Job title

Professor

Degree

博士（保健学）（東京大学）
修士（保健学）（東京大学）

researchmap

https://researchmap.jp/read0052721

J-GLOBAL ID

200901087844570356

Research History 3

2009/10 - Present

東北大学大学院　医学系研究科保健学専攻緩和ケア看護学分野　教授
2007/04 - 2009/09

東京大学大学院　医学系研究科健康科学・看護学専攻緩和ケア看護学分野　講師
1997/04 - 2007/03

東京大学大学院　医学系研究科健康科学・看護学専攻　助手

Education 2

University of Tokyo　Graduate School of Medicine　School of Health Sciences and Nursing

1995/04 - 1997/03
University of Tokyo　Faculty of Medicine　School of Health Sciences and Nursing

1990/04 - 1994/03

Research Interests 10

がん看護
看護
終末期医療
ターミナルケア
緩和ケア
Epidemiology
Nursing
End-of-life care
Terminal care
Palliative care

Research Areas 2

Life sciences / Internal medicine - General /
Life sciences / Clinical nursing /

Papers 526

Resilience and coping styles in family caregivers of terminally ill patients: A cross-sectional survey. International-journal

Yoichi Shimizu, Akitoshi Hayashi, Isseki Maeda, Tomofumi Miura, Akira Inoue, Mayuko Takano, Maho Aoyama, Kento Masukawa, Mitsunori Miyashita

Palliative & supportive care　1-8　2024/10/23

DOI： 10.1017/S1478951524001135 　

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OBJECTIVES: Coping styles can be improved by dyadic palliative care interventions and may alleviate patients' and family caregivers' distress. Moreover, family caregivers' preloss resilience protects against depression after bereavement. This study aimed to determine the types of coping styles can be encouraged to increase resilience. METHODS: A self-reported questionnaire survey was administered to family caregivers at the 4 palliative care units, and their resilience was assessed using the Connor-Davidson Resilience Scale (CD-RISC) and their coping styles were assessed using the Brief Coping Orientation to Problem Experienced, as well as their background characteristics. RESULTS: Among 291 caregivers with a mean CD-RISC score of 56.2 (standard deviation: 16.13), internal locus of control, educational level, and history of psychotropic drug use were associated with resilience. After adjusting for the aforementioned factors, more frequent use of positive coping styles such as active coping (Spearman's ρ = 0.29), acceptance (ρ = 0.29), positive reframing (ρ = 0.29), planning (ρ = 0.24), and humor (ρ = 0.18), was found to be associated with higher resilience. On the contrary, more frequent use of negative coping styles such as behavioral disengagement (ρ = -0.38), self-blame (ρ = -0.27), and denial (ρ = -0.14) was found to be associated with less resilience. SIGNIFICANCE OF RESULTS: By assessing internal locus of control, educational level, and history of psychotropic medication use of family caregivers, as factors associated with their respective resilience, may help identify less resilient family caregivers who are at risk for developing major depression after bereavement. In addition, coping skill-based educational interventions targeting patients and their family caregivers that focus on specific coping styles associated with resilience may increase family caregivers' resilience, resulting in less emotional distress and a lower risk of major depression after bereavement.
Enhancing end-of-life care quality and achieving a good death for the elderly in Japan. International-journal

Richi Takahashi, Yoko Nakazawa, Mitsunori Miyashita, Tatsuya Morita, Yasuyuki Okumura, Yoshiyuki Kizawa, Shohei Kawagoe, Hiroshi Yamamoto, Emi Takeuchi, Risa Yamazaki, Asao Ogawa

Archives of gerontology and geriatrics　124　105471-105471　2024/09

DOI： 10.1016/j.archger.2024.105471 　

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BACKGROUND: In the context of an aging populations, there is an escalating need for palliative care tailored to the needs of the elderly. This study aimed to assess differences in symptoms and good death among the elderly, along with the structures and processes involved in end-of life care, and to explore the impact of age on achieving a good death. METHODS: We conducted a questionnaire survey for bereaved family members of patients with cancer, heart disease, stroke, pneumonia, and kidney failure in 2019 and 2020. The study population was categorized into the following age groups: ≤64, 65-74, 75-84, and ≥85. The outcomes included symptom intensity, achievement of a good death, and receipt of quality care. RESULTS: In total, 62,576 bereaved family members agreed to participate in the survey (response rate; 54.0 %). The weighted percentages of 'severe' and 'very severe' symptoms decreased with age. These trends were observed across age groups, even among the elderly. The strongest effect of age on achieving a good death was found for 'feeling that life is complete' with reference to those aged ≤64 years: 65-74 years (odds ratio [OR]; 2.09, 95 % CI; 1.94 to 2.25), 75-84 years (OR; 4.86, 95 % CI; 4.52 to 5.22) and ≥85 years (OR; 12.8, 95 % CI; 11.9 to 13.8). CONCLUSION: Age-specific differences were observed in quality of death, quality of care, and symptom intensity. It is important to provide individualized consideration for each age group rather than categorizing them broadly as the elderly when caring for them.
Preferred and Actual Places of Death Among Patients with Advanced Cancer: A Single-centre Cohort Study in Japan

Tomoo Ikari, Yusuke Hiratsuka, Takayuki Oishi, Mitsunori Miyashita, Tatsuya Morita, Jennifer W. Mack, Yoshinari Okada, Natsuko Chiba, Chikashi Ishioka, Akira Inoue

Indian Journal of Palliative Care　30　268-274　2024/08/23
Publisher: Scientific Scholar
DOI： 10.25259/ijpc_133_2024 　

ISSN： 0973-1075

eISSN： 1998-3735

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Objectives: Achieving a ‘good death’ is one of the important goals of palliative care. Providing goal-concordant care and an environment tailored to the patient’s preferences can contribute to a ‘good death’. However, the concordance rate between the preferred and actual places of death among advanced cancer patients in Japan is less explored. This study aimed to identify the concordance between patients’ preferred and actual places of death and the associated factors among patients with advanced cancer in Japan. Materials and Methods: Patients with advanced cancer who underwent chemotherapy at Tohoku University Hospital between January 2015 and January 2016 were enrolled and followed up for 5 years. The enrolled patients were asked about their preference for their place of death. The response options were: “Own home,” “General ward” and “Palliative care unit (PCU).” We compared the actual place of death with the patient’s preference through a follow-up review of the medical records. Results: A total of 157 patients with advanced cancer were enrolled between January 2015 and January 2016. Of these patients, 22.9% (11/48) died at home according to their preference, 64.0% (16/25) in the general ward and 37.9% (11/29) in the PCU. Only thirty-seven (37.3%) patients died where they wanted, based on the comparison between patients’ preferences and actual places of death. Conclusion: The concordance rate between the preferred and actual places of death is not high in Japan. Improving concordance between patients’ preferences and actual places of death has the potential to improve end-of-life care.
Associations of nutrition impact symptoms with depression in patients with advanced cancer. International-journal

Koji Amano, Satomi Okamura, Yoshinobu Matsuda, Vickie E Baracos, Naoharu Mori, Tomofumi Miura, Ryohei Tatara, Takaomi Kessoku, Keita Tagami, Hiroyuki Otani, Masanori Mori, Tomohiko Taniyama, Nobuhisa Nakajima, Erika Nakanishi, Jun Kako, Tatsuya Morita, Mitsunori Miyashita

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer　32　(7)　445-445　2024/06/19

DOI： 10.1007/s00520-024-08645-6 　

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PURPOSE: Advanced cancer patients have nutrition impact symptoms (NISs), while many of them have depressive moods. This study aimed to determine the associations of NISs with depression. METHODS: This study was a secondary analysis. The dietary intake and 19 NISs in patients receiving palliative care were evaluated using 10-point scales, and the patients were categorized into two groups (non-depression and depression groups) using the cutoff based on the Patient Health Questionnaire-9 (PHQ-9). To determine associations between depression and the number of NISs with a score of ≥ 4, the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the logistic regression model were calculated. RESULTS: A total of 225 participants were divided into the non-depression group (n = 148) and the depression group (n = 77). The prevalence of depression was 34.2%. Dietary intake was lower, and the number of NISs with a score of ≥ 4 was higher in the depression group (both p < 0.001). All NISs were more severe in the depression group. Significant differences were observed in 15 of the 19 NISs. In the logistic regression model, significantly higher adjusted ORs were observed in the groups with 4-6 NISs and 7 or more NISs with a score of ≥ 4 (10.76 [95% CI, 2.07-55.91], p = 0.016; 17.02 [95% CI, 3.08-94.22], p < 0.001) than in the group with no NISs with a score of ≥ 4. CONCLUSION: Having four or more NISs with a score ≥ 4 was associated with depression.
Development and validation of clinical implementation methods for patient-reported outcomes in Japanese multi-center palliative care units

Nao Ito, Azusa Sato, Kana Takeuchi, Tomoko Shigeno, Hiroko Sasaki, Maho Aoyama, Mitsunori Miyashita

Journal of Patient-Reported Outcomes　8　(1)　2024/05/14
Publisher: Springer Science and Business Media LLC
DOI： 10.1186/s41687-024-00730-y 　

eISSN： 2509-8020

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Abstract Background Patient-Reported Outcomes (PROs) are recommended for use in clinical oncology. However, they are not routinely used in professional palliative care practices in Japan. The reasons include both patient and healthcare provider factors and the implementation of PROs. This study aimed to develop and validate clinical implementation methods for PROs in Japanese palliative care units. Methods The Consolidated Framework for Implementation Research (CFIR) was conducted with four palliative care units in Japan. The study was conducted in six steps: unit assessment, development and implementation of a PRO implementation plan, PRO post-implementation survey and analysis of its utilization, a review of the PRO implementation process, creation of a PRO implementation method in a palliative care unit, and use and verification of the implementation method. Steps 1–5 were the development phase, and step 6 was the verification phase. Results Interviews were conducted with healthcare providers prior to PRO implementation. Intervention characteristics, patient needs in the palliative care unit, and factors related to the organization were identified as barriers. The implementation plan was developed, and the core members were selected. The implementation procedures were created in the above mentioned steps. PROs were used in the palliative care units. The same was true in the validation phase. Conclusions This study guided PROs in specialized palliative care unit in a clinical setting. The method was developed and validated for the implementation of PROs in the palliative care unit. In the PRO implementation process, it was important to assess the unit, address the barriers to implementation, and reduce the burden on healthcare providers. Furthermore, healthcare providers had to be supported by the champion, a person responsible for the implementation of PROs in the palliative care unit.
A palliative care goals model for people with dementia and their family: Consensus achieved in an international Delphi study International-journal International-coauthorship Peer-reviewed

Mayumi Nishimura, Karen Harrison Dening, Elizabeth L. Sampson, Edison Iglesias de Oliveira Vidal, Miharu Nakanishi, Nathan Davies, Wilson Abreu, Sharon Kaasalainen, Yvonne Eisenmann, Laura Dempsey, Kirsten J. Moore, Sascha R. Bol, Judith M.M. Meijers, Natashe Lemos Dekker, Mitsunori Miyashita, Takeo Nakayama, Jenny T. van der Steen

Palliative Medicine　in press　2024/04/18

DOI： 10.1177/02692163241234579 　
Reliability and validity of the Japanese version of the Parenting Concerns Questionnaire

Misa Yanai, Maho Aoyama, Kazuhiro Kosugi, Akemi Tsumura, Erika Nakanishi, Mitsunori Miyashita

Japanese Journal of Clinical Oncology　2024/04/10
Publisher: Oxford University Press (OUP)
DOI： 10.1093/jjco/hyae041 　

eISSN： 1465-3621

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Abstract Objective Cancer patients with children are increasing; however, few studies have quantitatively assessed the parenting concerns of cancer patients with children. The Parenting Concerns Questionnaire was developed in the USA in 2012 and is the only instrument to measure the parenting concerns of cancer patients with children. This study aimed to develop a Japanese version of the Parenting Concerns Questionnaire and evaluate its reliability and validity. Methods An Internet survey was conducted among cancer patients registered with ‘Cancer Parents’, an Internet community site for cancer patients, who have children aged &lt;18 years, and 174 responses were recorded. Two weeks later, a retest was conducted, and responses were obtained from 87 patients. Results Based on confirmatory factor analysis of the factor structure proposed by the authors of the original version, factors ‘I. The impact of my illness on the child’s daily life (five items)’, ‘II. The impact of my illness on the child’s feelings (five items)’ and ‘III. Concerns about my parenting partner (five items)’ were consistent with the original version. Cronbach’s alpha coefficients for all items and by factors were 0.86, 0.79, 0.86 and 0.86. The Parenting Concerns Questionnaire total scores correlated with Hospital Anxiety and Depression Scale (r = 0.52), the Functional Assessment of Cancer Therapy General (r = −0.56), Family Assessment Device-General Functioning (r = 0.51) and Multidimensional Scale of Perceived Social Support (r = −0.47). The intraclass correlation coefficients for all items and by factors were 0.81, 0.71, 0.77 and 0.85. Conclusions The Japanese version of the Parenting Concerns Questionnaire has satisfactory reliability and validity.
Preferences of bereaved family members on communication with physicians when discontinuing anticancer treatment: referring to the concept of nudges

Saran Yoshida, Kei Hirai, Fumio Ohtake, Kento Masukawa, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

Japanese Journal of Clinical Oncology　2024/03/28
Publisher: Oxford University Press (OUP)
DOI： 10.1093/jjco/hyae038 　

eISSN： 1465-3621

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Abstract Background This study aimed to clarify the situation and evaluate the communication on anticancer treatment discontinuation from the viewpoint of a bereaved family, in reference to the concept of nudges. Methods A multi-center questionnaire survey was conducted involving 350 bereaved families of patients with cancer admitted to palliative care units in Japan. Results The following explanations were rated as essential or very useful: (i) treatment would be a physical burden to the patient (42.9%), (ii) providing anticancer treatment was impossible (40.5%), (iii) specific disadvantages of receiving treatment (40.5%), (iv) not receiving treatment would be better for the patient (39.9%) and (v) specific advantages of not receiving treatment (39.6%). The factors associated with a high need for improvement of the physician’s explanation included lack of explanation on specific advantages of not receiving treatment (β = 0.228, P = 0.001), and lack of explanation of ‘If the patient’s condition improves, you may consider receiving the treatment again at that time.’ (β = 0.189, P = 0.008). Conclusions Explaining the disadvantages of receiving treatment and the advantages of not receiving treatment, and presenting treatment discontinuation as the default option were effective in helping patients’ families in making the decision to discontinue treatment. In particular, explanation regarding specific advantages of not receiving treatment was considered useful, as they caused a lower need for improvement of the physicians’ explanation.
Associations of nutrition impact symptoms with dietary intake and eating-related distress in patients with advanced cancer.

Amano K, Baracos VE, Mori N, Okamura S, Yamada T, Miura T, Tatara R, Kessoku T, Matsuda Y, Tagami K, Otani H, Mori M, Taniyama T, Nakajima N, Nakanishi E, Kako J, Morita T, Miyashita M

Clinical nutrition ESPEN　2024/02/26

DOI： 10.1016/j.clnesp.2024.02.027 　

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<h4>Background & aims</h4>There is no definition of nutrition impact symptoms (NISs) in cancer care. Moreover, there is a lack of evidence on the associations of NISs with dietary intake and eating-related distress (ERD) in advanced cancer. Therefore, this study aimed to determine the associations of NISs with dietary intake and ERD in patients with advanced cancer.<h4>Methods</h4>This study entailed a secondary analysis of a multicenter self-reported questionnaire designed to develop measurements that assess ERD experienced by patients. Participants evaluated their dietary intake and 19 symptoms regarded as NISs using a 10-point scale. To determine the association between dietary intake and the number of NISs with a score ≥4, estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the logistic regression model were calculated. Furthermore, to assess the association between ERD and the number of NISs with a score ≥4, multiple regression analysis was performed.<h4>Results</h4>A total of 302 patients were included in the analysis. The higher the number of NISs with a score ≥4, the lower the dietary intake tended to be. In the logistic regression model, significantly higher adjusted ORs than in the no NISs with a score ≥4 group were observed in the 4-6 NISs group, 7-9 NISs group, and 10 or more group (0.19 [95% CI, 0.07-0.52], p = 0.001; 0.11 [95% CI, 0.03-0.42], p = 0.001; 0.07 [95% CI, 0.01-0.36], p = 0.002, respectively). In the multiple regression analysis, the number of NISs with a score ≥4 was identified as one of the factors significantly associated with ERD.<h4>Conclusions</h4>Having 4 or more NISs with a score ≥4 was shown to be predictive of the likelihood of reduced dietary intake. Furthermore, the higher the number of NISs with a score ≥4, the more likely the eating-related quality of life was impaired in advanced cancer.
Development of a short form of the Japanese version of the Caregiver Reaction Assessment (<scp>CRA‐J</scp>‐10) among informal caregivers of older adults

Taiji Noguchi, Takeshi Nakagawa, Xueying Jin, Ayane Komatsu, Shintaro Togashi, Mitsunori Miyashita, Tami Saito

Geriatrics & Gerontology International　24　(3)　290-296　2024/02/10
Publisher: Wiley
DOI： 10.1111/ggi.14824 　

ISSN： 1444-1586

eISSN： 1447-0594

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Aim To support informal caregivers, a simple assessment tool capturing the multidimensional nature of caregiving experiences, including negative and positive aspects, is required. We developed a short form of the Japanese version of the Caregiver Reaction Assessment (CRA‐J), a multidimensional assessment scale for caregiver experiences. Methods The internet survey involved 934 Japanese informal caregivers aged 20–79 years (mean age = 58.8 years; 50.2% women) who completed questionnaires, including the CRA‐J 18 items (CRA‐J‐18), consisting of five domains, such as impacts on schedule and finances and positive experiences of caregiving. A 10‐item short version of the CRA‐J (CRA‐J‐10; 0–50 points), which was prepared by selecting the two items with the highest factor loadings from each domain, was tested for model fit by confirmatory factor analysis (CFA) and was analyzed for correlations with the CRA‐J‐18, Zarit Burden Interview (ZBI), Positive Aspects of Caregiving Scale (PACS), Patient Health Questionnaire‐9 (PHQ‐9), and WHO‐Five Well‐Being Index (WHO‐5). The area under the curve (AUC) in the receiver operating characteristic was evaluated as discriminability for depressive symptoms (PHQ‐9 ≥ 10 points). Results The CFA indicated a good model fit in the CRA‐J‐10. The CRA‐J‐10 correlated well with the CRA‐J‐18 and other variables (CRA‐J‐18, r = 0.970; ZBI, r = 0.747; PACS, r = −0.467; PHQ‐9, r = 0.582; WHO‐5, r = −0.588) and showed good discriminant performance for the presence of depressive symptoms (AUC = 0.793, 95% confidence interval = 0.762–0.823). Conclusions The CRA‐J‐10 allows a simple assessment of caregiver experiences, helping support informal caregivers. Geriatr Gerontol Int 2024; 24: 290–296.
Development of quality indicators for palliative care in intensive care units and pilot testing them via electronic medical record review. International-journal

Yuta Tanaka, Kento Masukawa, Hideaki Sakuramoto, Akane Kato, Yuichiro Ishigami, Junko Tatsuno, Kaori Ito, Yoshiyuki Kizawa, Mitsunori Miyashita

Journal of intensive care　12　(1)　1-1　2024/01/09

DOI： 10.1186/s40560-023-00713-z 　

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BACKGROUND: Patients in intensive care units (ICUs) often require quality palliative care for relief from various types of suffering. To achieve quality palliative care, specific goals need to be identified, measured, and reported. The present study aimed to develop quality indicators (QIs) for palliative care in ICUs, based on a systematic review and modified Delphi method, and test their feasibility by reviewing electronic medical record (EMR) data. METHODS: The current study was performed in two phases: the development of QIs using the modified Delphi method, and pilot-testing the quality of palliative care in ICUs based on EMR review. The pilot test included 262 patients admitted to the general or emergency ICU at a university hospital from January 1, 2019, to June 30, 2019. RESULTS: A 28-item QI set for palliative care in ICUs was developed based on the consensus of 16 experts. The Delphi process resulted in low measurability ratings for two items: "Assessment of the patient's psychological distress" and "Assessment of the patient's spiritual and cultural practices." However, these items were determined to be important for quality care from the perspective of holistic assessment of distress and were adopted in the final version of the QI set. While the pilot test results indicated the feasibility of the developed QIs, they suggested that the frequency of care performance varied, and certain aspects of palliative care in ICUs needed to be improved, namely (1) regular pain assessment, (2) identification of the patient's advance directive and advance care planning for treatment, (3) conducting an interdisciplinary family conference on palliative care, and (4) assessment of psychological distress of family members. CONCLUSIONS: The QI set, developed using the modified Delphi method and tested using EMR data, provided a tool for assessing the quality of palliative care in ICUs. In the two ICUs considered in this study, aspects of the palliative care process with a low performance frequency were identified, and further national surveys were recommended. It is necessary to conduct ongoing surveys at more facilities to improve the quality of palliative care in ICUs.
Good Death and Quality of End-of-Life Care in Patients with Coexisting Cancer and Dementia: Perspective of Bereaved Families. International-journal

Ayumi Takao, Harue Arao, Sena Yamamoto, Miwa Aoki, Katsuyasu Kouda, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Kento Masukawa, Mitsunori Miyashita

Palliative medicine reports　5　(1)　215-224　2024

DOI： 10.1089/pmr.2023.0083 　

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BACKGROUND: Patients with coexisting cancer and dementia often have complex health care needs and face challenges in achieving a good death. OBJECTIVES: To evaluate good death achievement and end-of-life (EOL) care in patients with coexisting cancer and dementia from the perspective of bereaved families. DESIGN: Cross-sectional nationwide postal survey. SETTING/SUBJECTS: Bereaved families of patients with cancer who died in hospice and palliative care units across Japan. MEASUREMENTS: Bereaved families completed an anonymous, self-reported questionnaire. Their perspective on achieving a good death was assessed using the Good Death Inventory (GDI) (total score: 18-126). The Revised Care Evaluation Scale-short version (CES2) was used to assess EOL care (total score: 10-60). We examined the Brief Grief Questionnaire (BGQ) (total score: 0-10) and Patient Health Questionnaire 9 (PHQ9) (total score: 0-27). RESULTS: Data from 670 participants were analyzed, including 83 (12.4%) bereaved families of patients with coexisting cancer and dementia. No statistical differences were observed in the total GDI score for 18 items (dementia comorbidity vs. nondementia comorbidity groups, mean ± standard deviation, respectively, 78.4 ± 17.7 vs. 80.0 ± 15.5, adjusted [adj] P = 0.186), CES2 score (49.70 ± 9.22 vs. 48.82 ± 8.40, adj P = 0.316), BGQ score (3.40 ± 2.41 vs. 4.36 ± 2.28, adj P = 0.060), and PHQ9 score (4.67 ± 4.71 vs. 5.50 ± 5.37, adj P = 0.788). CONCLUSIONS: GDI, CES2, BGQ, and PHQ9 scores did not differ significantly between groups, regardless of the presence of dementia in hospice and palliative care units. Patients with coexisting cancer and dementia can achieve a good death by high-quality EOL care.
Cancer Pain Management in Patients Receiving Inpatient Specialized Palliative Care Services. International-journal

Keita Tagami, Shih-Wei Chiu, Kazuhiro Kosugi, Hiroto Ishiki, Yusuke Hiratsuka, Masaki Shimizu, Masanori Mori, Emi Kubo, Tomoo Ikari, Sayaka Arakawa, Tetsuya Eto, Mayu Shimoda, Hideyuki Hirayama, Kaoru Nishijima, Kota Ouchi, Tatsunori Shimoi, Tomoko Shigeno, Takuhiro Yamaguchi, Mitsunori Miyashita, Tatsuya Morita, Akira Inoue, Eriko Satomi

Journal of pain and symptom management　67　(1)　27-38　2024/01

DOI： 10.1016/j.jpainsymman.2023.09.015 　

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CONTEXT: Cancer pain is a common complication that is frequently undertreated in patients with cancer. OBJECTIVES: This study is aimed at assessing the time needed to achieve cancer pain management goals through specialized palliative care (SPC). METHODS: This was a multicenter, prospective, longitudinal study of inpatients with cancer pain who received SPC. Patients were continuously followed up until they considered cancer pain management successful, and we estimated this duration using the Kaplan-Meier method. We investigated the effectiveness of pain management using multiple patient-reported outcomes (PROs) and quantitative measures, including pain intensity change in the Brief Pain Inventory. A paired-sample t-test was used to compare the pain intensity at the beginning and end of the observation period. RESULTS: Cancer pain management based on the PROs was achieved in 87.9% (385/438) of all cases. In 94.5% (364/385) of these cases, cancer pain management was achieved within 1 week, and the median time to pain management was 3 days (95% confidence interval [CI], 2-3). The mean worst pain intensity in the last 24 h at the start and end of observation were 6.9 ± 2.2 and 4.0 ± 2.3, respectively, with a difference of -2.9 (95% CI, -3.2 to -2.6; p < 0.01). Overall, 81.6% of the patients reported satisfaction with cancer pain management, and 62 adverse events occurred. CONCLUSION: SPC achieved cancer pain management over a short period with a high level of patient satisfaction resulting in significant pain reduction and few documented adverse events.
Factors associated with the preparedness for bereavement in families of patients with cancer: A secondary analysis of a nationwide bereaved family survey. International-journal

Sakiko Matsuzaka, Akiho Ohba, Kento Masukawa, Maho Aoyama, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

Psycho-oncology　33　(1)　e6276　2024/01

DOI： 10.1002/pon.6276 　

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OBJECTIVES: Insufficient preparedness for bereavement can affect a family's psychological health status after bereavement. However, factors associated with preparedness remain unclear. This study aimed to identify factors associated with preparedness for bereavement in families of patients with cancer. METHODS: We conducted a secondary analysis of a nationwide bereaved family survey in Japan, analyzing data from 9123 family members of patients with cancer. Logistic regression analysis was conducted to explore how sociodemographic factors, health status, and perceived care for patients and families were associated with preparedness for bereavement. RESULTS: Of the 9123 families, 1338 (15.1%) were not prepared for bereavement. Factors associated with insufficient preparedness for bereavement (all p < 0.001) were found as follows: patients' spouses (OR = 2.54), receiving care in acute hospitals (OR = 1.83), worse psychological health status during caregiving (OR = 2.13), lower social support for family members (OR = 1.90), wrong patients' awareness of medical condition from family's perspective (OR = 1.75-2.12), family preference of more aggressive treatment rather than palliative care (OR = 1.71) or not sure (OR = 2.31), not wanting to know information about the patient's prognosis (OR = 1.64-1.77), end-of-life discussion with physician 1 month before patient's death (OR = 1.45), and late or early end-of-life discussions with physician and family (OR = 1.78-1.95). CONCLUSIONS: This study's results might assist clinicians in assessing and identifying families who are not prepared for bereavement; however, preparedness for bereavement may have been associated with other factors.
End-of-Life Discussions and Their Timing for Patients With Cardiovascular Diseases - From the Perspective of Bereaved Family Members.

Keitaro Shinada, Takashi Kohno, Keiichi Fukuda, Michiaki Higashitani, Naoto Kawamatsu, Takeshi Kitai, Tatsuhiro Shibata, Makoto Takei, Kotaro Nochioka, Gaku Nakazawa, Hiroki Shiomi, Mitsunori Miyashita, Atsushi Mizuno

Circulation journal : official journal of the Japanese Circulation Society　88　(1)　135-143　2023/12/25

DOI： 10.1253/circj.CJ-23-0507 　

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BACKGROUND: Enhanced discussions regarding end-of-life (EOL) are crucial to provide appropriate care for seriously ill patients. However, the current status of EOL discussions, especially their timing and influencing factors, among patients with cardiovascular diseases (CVD) remains unknown.Methods and Results: We conducted a cross-sectional questionnaire survey of bereaved family members of CVD patients who died at 10 tertiary care institutes in Japan. In all, 286 bereaved family members (38.2% male; median age 66.0 [interquartile range 58.0-73.0] years) of CVD patients were enrolled; of these, 200 (69.9%) reported that their families had had EOL discussions with physicians. The major topic discussed was resuscitation (79.0%), and 21.5% discussed the place of EOL care. Most discussions were held during hospitalization of the patient (88.2%). More than half (57.1%) the discussions were initiated less than 1 month before the patient died, and 22.6% of family members felt that this timing of EOL discussions was late. Bereaved family members' perception of late EOL discussions was associated with the family members aggressive attitude towards life-prolonging treatment, less preparedness for bereavement, and less satisfaction with EOL care. CONCLUSIONS: Approximately 70% of bereaved family members of CVD patients had EOL discussions, which were often held shortly before the patient died. Further research is required to establish an ideal approach to EOL discussions at an appropriate time, which may improve the quality of EOL care.
Continuous Electrocardiographic Monitoring for 24 Hours Before Death in Patients with Terminal Cancer. International-journal

Ko Sato, Mika Baba, Tatsuya Morita, Kento Masukawa, Yasuo Shima, Satoru Tsuneto, Yoshiyuki Kizawa, Mitsunori Miyashita

The American journal of hospice & palliative care　10499091231222184-10499091231222184　2023/12/13

DOI： 10.1177/10499091231222184 　

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BACKGROUND: Purposeless physiological monitoring at the end-of-life is not recommended. However, studies on how families feel regarding the death of patients with terminal cancer without continuous electrocardiographic monitoring (CEM) are lacking. OBJECTIVES: To explore the impact on the quality of care and the feelings and psychological distress experienced by families when CEM is not used during the 24 hours preceding a patient's death. METHODS: In this multicenter cross-sectional, self-report questionnaires were distributed to 1087 bereaved families at Japanese specialized palliative care units in 2018. RESULTS: Out of 671 responses, 394 valid responses were analyzed. Families of nonmonitored patients (NM-group) accounted for 79.2%, while those with bedside electrocardiogram monitoring (MB-group) and remote nurse station monitoring (MC-group) comprised 11.9% and 8.9%, respectively. In the NM-group, 85.5% expressed satisfaction without CEM, which was more than 10% lower than other groups. While 14% in the NM-group desired patient monitoring, families who received adequate explanations about CEM had lower proportions compared to the MB-group (P = .021). Univariate analyses showed no significant differences in evaluations of the quality of care and families' psychological distress (mean scores of Overall Care Satisfaction, Care Evaluation Scale, Good Death Inventory, Brief Grief Questionnaires) across all groups. CONCLUSION: While the majority of NM-group were satisfied with their patient's care without CEM, the proportion of dissatisfied families was higher than in other groups. Although not using CEM is not a major hindrance to end-of-life care for patients with terminal cancer, providing sufficient explanations may be important for satisfactory care.
Aggressive End-of-Life Treatments Among Inpatients With Cancer and Non-cancer Diseases Using a Japanese National Claims Database. International-journal

Shintaro Togashi, Kento Masukawa, Maho Aoyama, Kazuki Sato, Mitsunori Miyashita

The American journal of hospice & palliative care　10499091231216888-10499091231216888　2023/11/29

DOI： 10.1177/10499091231216888 　

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To describe aggressive treatments at end-of-life among inpatients with cancer and non-cancer diseases and to evaluate factors associated with these treatments using the Japanese national database (NDB). We conducted a retrospective cohort study among inpatients aged ≥ 20 years who died between 2012 and 2015 using a sampling dataset of NDB. The outcome was the proportion of aggressive treatments in the last 14 days of life. We considered the underlying causes of death as cancer, dementia/senility, and heart, cerebrovascular, renal, liver, respiratory, and neurodegenerative diseases. We analyzed 54,105 inpatients, with underlying cause of death distributed as follows: cancer, 24.9%; heart disease, 16.5%; respiratory disease, 12.3%; and cerebrovascular disease, 9.7%. The proportion of intensive care unit (ICU) admission was 9.7%, being the highest in heart disease (20.5%), followed by cerebrovascular diseases (12.6%), and least in dementia/senility (.6%). The proportion of cardiopulmonary resuscitation was 19.6%, being the highest in heart disease (38.1%), followed by renal diseases (19.5%), and least in cancer (6.2%). Multivariate logistic regression analysis revealed that having heart diseases, cerebrovascular diseases, younger age, less comorbidities, and shorter length of stay were associated with an increasing risk of aggressive treatments in the last 14 days of life. The proportion of aggressive treatments at the end-of-life varies depending on the disease; additionally, these treatments were associated with having heart diseases, younger age, less comorbidity, and shorter length of stay. Our findings may help develop and set benchmarks for quality indicators at the end-of-life for patients with non-cancer diseases.
Ambulance use and emergency department visits among people with dementia: A cross-sectional survey. International-journal

Katsumi Nasu, Mitsunori Miyashita, Kayo Hirooka, Takuro Endo, Hiroki Fukahori

Nursing & health sciences　2023/11/21

DOI： 10.1111/nhs.13066 　

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This study aimed to explore factors associated with ambulance use and emergency department (ED) visits among people with dementia in the month before death. A web-based survey of bereaved family caregivers of people with dementia was conducted in March 2020. Multivariate logistic regression analyses were conducted with ambulance use and ED visits in the month before death as dependent variables. Age and gender of people with dementia and their family caregivers, home care use, decision-makers, comorbidities, degree of independence in daily living, and caregivers' preparedness for death were independent variables. Data were collected from 817 caregivers of people with dementia who had died at hospitals (52.4%), long-term care facilities (25.0%), or own homes (22.4%). Caregivers' lack of preparedness for death was significantly associated with ambulance use in the month before death. Comorbidites and males with dementia were significantly associated with ED visits in the month before death. Better death preparedness of family caregivers may reduce ambulance use for symptoms that can be more effectively addressed by palliative care than acute care for people with dementia.
Prevalence of opioid-induced adverse events across opioids commonly used for analgesic treatment in Japan: a multicenter prospective longitudinal study

Yusuke Hiratsuka, Keita Tagami, Akira Inoue, Mamiko Sato, Yasufumi Matsuda, Kazuhiro Kosugi, Emi Kubo, Maika Natsume, Hiroto Ishiki, Sayaka Arakawa, Masaki Shimizu, Naosuke Yokomichi, Shih-Wei Chiu, Mayu Shimoda, Hideyuki Hirayama, Kaoru Nishijima, Kota Ouchi, Tatsunori Shimoi, Tomoko Shigeno, Takuhiro Yamaguchi, Mitsunori Miyashita, Tatsuya Morita, Eriko Satomi

Supportive Care in Cancer　31　(12)　2023/10/16
Publisher: Springer Science and Business Media LLC
DOI： 10.1007/s00520-023-08099-2 　

ISSN： 0941-4355

eISSN： 1433-7339

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Abstract Purpose Although opioids have been shown to be effective for cancer pain, opioid-induced adverse events (AEs) are common. To date, little is known about the differences in risks of AEs by opioid type. This study was performed to compare the prevalence of AEs across opioids commonly used for analgesic treatment in Japan. Methods This study was conducted as a preplanned secondary analysis of a multicenter prospective longitudinal study of inpatients with cancer pain who received specialized palliative care for cancer pain relief. We assessed daily AEs until termination of follow-up. We rated the severity of AEs based on the Common Terminology Criteria for Adverse Events version 5.0. We computed adjusted odds ratios for each AE (constipation, nausea and vomiting, delirium, and drowsiness) with the following variables: opioid, age, sex, renal dysfunction, and primary cancer site. Results In total, 465 patients were analyzed. Based on the descriptive analysis, the top four most commonly used opioids were included in the analysis: oxycodone, hydromorphone, fentanyl, and tramadol. With respect to the prevalence of AEs among all analyzed patients, delirium (n = 25, 6.3%) was the most frequent, followed by drowsiness (n = 21, 5.3%), nausea and vomiting (n = 19, 4.8%), and constipation (n = 28, 4.6%). The multivariate logistic analysis showed that no single opioid was identified as a statistically significant independent predictor of any AE. Conclusion There was no significant difference in the prevalence of AEs among oxycodone, fentanyl, hydromorphone, and tramadol, which are commonly used for analgesic treatment in Japan.
Effects of Bathing in a Tub on Physical and Psychological Symptoms of End-of-Life Cancer Patients: An Observational, Controlled Study. International-journal

Eriko Hayashi, Maho Aoyama, Fumiyasu Fukano, Junko Takano, Yoichi Shimizu, Mitsunori Miyashita

Journal of hospice and palliative nursing : JHPN : the official journal of the Hospice and Palliative Nurses Association　24　(1)　30-39　2021/09/20

DOI： 10.1097/NJH.0000000000000803 　

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This observational, controlled study explored the effects of bathing on the physical and psychological aspects of terminal cancer patients on a palliative care ward. With nurses' assistance, the patients evaluated and recorded the severity of their symptoms at 10:00 AM, 30 minutes after initial bathing, and at 5:00 PM. The bathing care was provided as routine care according to the patients' wishes. Twelve symptoms were measured using 9 items (numbers 1-9) from the Edmonton Symptom Assessment System-Revised Japanese version and 3 items from the Cancer Fatigue Scale. Outcomes were compared between bathing days and nonbathing days (control) and between before and after bathing. Of the 57 bathers, data were available for both bathing days and nonbathing days for 42 bathers. In the comparison between bathing and nonbathing days, tiredness was significantly improved (effect size [ES], 0.35; P = .02). On the basis of the pre-post bathing comparison, 6 symptoms, namely, tiredness (ES, 0.40; P < .01), lack of appetite (ES, 0.36; P = .01), decreased well-being (ES, 0.33; P = .01), anxiety (ES, 0.36; P = .01), pain (ES, 0.31; P = .02), and depression (ES, 0.30; P = .02), were significantly improved. Bathing in a tub effectively improves tiredness and might be effective for distressing symptoms in end-of-life cancer patients.
Comparison of two measures for Complicated Grief: Brief Grief Questionnaire (BGQ) and Inventory of Complicated Grief (ICG). International-journal

Naoko Igarashi, Maho Aoyama, Masaya Ito, Satomi Nakajima, Yukihiro Sakaguchi, Tatsuya Morita, Yasuo Shima, Mitsunori Miyashita

Japanese journal of clinical oncology　51　(2)　252-257　2021/02/08

DOI： 10.1093/jjco/hyaa185 　

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OBJECTIVE: No prior studies have used a single sample of bereaved families of cancer patients to compare multiple scales for assessing Complicated Grief. Here, we compare the two measures. METHODS: We sent a questionnaire to the bereaved families of cancer patients who had died at 71 palliative care units nationwide. RESULTS: The analysis included 3173 returned questionnaires. Prevalence of Complicated Grief was 7.8% by Brief Grief Questionnaire (with a cutoff score of 8) and 15.5% for Inventory of Complicated Grief (with a cutoff score of 26). The Spearman's correlation coefficient between the Brief Grief Questionnaire and the Inventory of Complicated Grief was 0.79, and a ceiling effect was seen for the distribution of the Brief Grief Questionnaire scores. Although 6.4% of respondents scored both 8 or higher on the Brief Grief Questionnaire and 26 or higher on the Inventory of Complicated Grief, only 1.4% scored both 8 or higher on the Brief Grief Questionnaire and <26 on the Inventory of Complicated Grief. In contrast, 9.1% scored <8 on the Brief Grief Questionnaire but 26 or higher on the Inventory of Complicated Grief. CONCLUSION: The prevalence of Complicated Grief was estimated to be higher by the Inventory of Complicated Grief than by the Brief Grief Questionnaire in this sample. Patients with severe Complicated Grief might be difficult to discriminate their intensity of grief by the Brief Grief Questionnaire. Once the diagnostic criteria of Complicated Grief are established, further research, such as optimization of cutoff points and calculations of sensitivity and specificity, will be necessary.
Defining a good death for people with dementia: A scoping review

Zaiya Takahashi, Miyae Yamakawa, Miharu Nakanishi, Hiroki Fukahori, Naoko Igarashi, Maho Aoyama, Kazuki Sato, Shima Sakai, Hiroko Nagae, Mitsunori Miyashita

Japan Journal of Nursing Science　2021/01/13
Publisher: Wiley
DOI： 10.1111/jjns.12402 　

ISSN： 1742-7932

eISSN： 1742-7924
A Population-Based Mortality Follow-Back Survey Evaluating Good Death for Cancer and Noncancer Patients: A Randomized Feasibility Study. International-journal

Yoko Nakazawa, Emi Takeuchi, Mitsunori Miyashita, Kazuki Sato, Asao Ogawa, Hiroya Kinoshita, Yoshiyuki Kizawa, Tatsuya Morita, Masashi Kato

Journal of pain and symptom management　61　(1)　42-53　2021/01

DOI： 10.1016/j.jpainsymman.2020.07.013 　

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CONTEXT: Evaluation of end-of-life care is a key element in quality improvement, and population-based mortality follow-back designs have been used in several countries. This design was adapted to evaluate a good death in Japan. OBJECTIVES: This study aimed to explain the scientific background and rationale for assessing the feasibility of a mortality follow-back survey using a randomized design. DESIGN: We used a cross-sectional questionnaire survey to assess feasibility using response rate, sample representativeness, effect on response rate with two methods, and survey acceptability. SETTING/PARTICIPANTS: The subjects were 4812 bereaved family members of patients who died from the major five causes of death: cancer, heart disease, cerebrovascular disease, pneumonia, or kidney failure, using mortality data. RESULTS: Overall, 682 (14.2%) questionnaires could not be delivered, and 2294 (55.5%) family members agreed to participate in the survey. There was little difference in the distribution of characteristics between the study subjects and the full population, and sample representativeness was acceptable. Sending the questionnaire with a pen achieved a higher response rate than without (weighted: 48.2% vs. 40.8%; P < 0.001). In follow-up contact, there was no difference in response rate between resending the questionnaire and a reminder letter alone (weighted: 32.9% vs. 32.4%; P = 0.803). In total, 84.8% (weighted) of the participants agreed with improving quality of care through this kind of survey. CONCLUSION: This study demonstrated the feasibility of conducting a population-based mortality follow-back survey using a randomized design. An attached pen with the questionnaire was effective in improving the response rate.
Quality indicators of palliative care for acute cardiovascular diseases. International-journal Peer-reviewed

Atsushi Mizuno, Mitsunori Miyashita, Takashi Kohno, Yasuharu Tokuda, Shuhei Fujimoto, Masato Nakamura, Morimasa Takayama, Koichiro Niwa, Terunobu Fukuda, Shinichi Ishimatsu, Satomi Kinoshita, Shogo Oishi, Hiroki Mochizuki, Akemi Utsunomiya, Yasuko Takada, Ryota Ochiai, Toshiaki Mochizuki, Ken Nagao, Saran Yoshida, Akitoshi Hayashi, Ryuichi Sekine, Toshihisa Anzai

Journal of cardiology　2020/03/18

DOI： 10.1016/j.jjcc.2020.02.010 　

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BACKGROUND: Although recent attention to palliative care for patients with cardiovascular diseases has been increasing, there are no specific recommendations on detailed palliative care practices. We proceed on a discussion of the appropriateness and applicability of potential quality indicators for acute cardiovascular diseases according to our previous systematic review. METHODS: We created a multidisciplinary panel of 20 team members and 7 external validation clinicians composed of clinical cardiologists, a nutritionist, a physiotherapist, a clinical psychologist, a critical and emergent care specialist, a catheterization specialist, a primary care specialist, a palliative care specialist, and nurses. After crafting potential indicators, we performed a Delphi rating, ranging from "1 = minimum" to "9 = maximum". The criterion for the adoption of candidate indicators was set at a total mean score of seven or more. Finally, we subcategorized these indicators into several domains by using exploratory factor analysis. RESULTS: Sixteen of the panel members (80%) were men (age, 49.5 ± 13.7 years old). Among the initial 32 indicators, consensus was initially reached on total 23 indicators (71.8%), which were then summarized into 21 measures by selecting relatively feasible time variations. The major domains were "symptom palliation" and "supporting the decision-making process". Factor analysis could not find optimal model. Narratively-developed seven sub-categories included "presence of palliative care team", "patient-family relationship", "multidisciplinary team approach", "policy of approaching patients", "symptom screening and management", "presence of ethical review board", "collecting and providing information for decision-maker", and "determination of treatment strategy and the sharing of the care team's decision". CONCLUSION: In this study we developed 21 quality indicators, which were categorized into 2 major domains and 7 sub-categories. These indicators might be useful for many healthcare providers in the initiation and enhancement of palliative care practices for acute cardiovascular diseases in Japan.
Advance care planning for adults with heart failure. International-journal Peer-reviewed

Yuri Nishikawa, Natsuko Hiroyama, Hiroki Fukahori, Erika Ota, Atsushi Mizuno, Mitsunori Miyashita, Daisuke Yoneoka, Joey Sw Kwong

The Cochrane database of systematic reviews　2　(2)　CD013022　2020/02/27

DOI： 10.1002/14651858.CD013022.pub2 　

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BACKGROUND: People with heart failure report various symptoms and show a trajectory of periodic exacerbations and recoveries, where each exacerbation event may lead to death. Current clinical practice guidelines indicate the importance of discussing future care strategies with people with heart failure. Advance care planning (ACP) is the process of discussing an individual's future care plan according to their values and preferences, and involves the person with heart failure, their family members or surrogate decision-makers, and healthcare providers. Although it is shown that ACP may improve discussion about end-of-life care and documentation of an individual's preferences, the effects of ACP for people with heart failure are uncertain. OBJECTIVES: To assess the effects of advance care planning (ACP) in people with heart failure compared to usual care strategies that do not have any components promoting ACP. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, CINAHL, Social Work Abstracts, and two clinical trials registers in October 2019. We checked the reference lists of included studies. There were no restrictions on language or publication status. SELECTION CRITERIA: We included randomised controlled trials (RCTs) that compared ACP with usual care in people with heart failure. Trials could have parallel group, cluster-randomised, or cross-over designs. We included interventions that implemented ACP, such as discussing and considering values, wishes, life goals, and preferences for future medical care. The study participants comprised adults (18 years of age or older) with heart failure. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted outcome data from the included studies, and assessed their risk of bias. We contacted trial authors when we needed to obtain missing information. MAIN RESULTS: We included nine RCTs (1242 participants and 426 surrogate decision-makers) in this review. The meta-analysis included seven studies (876 participants). Participants' mean ages ranged from 62 to 82 years, and 53% to 100% of the studies' participants were men. All included studies took place in the US or the UK. Only one study reported concordance between participants' preferences and end-of-life care, and it enrolled people with heart failure or renal disease. Owing to one study with small sample size, the effects of ACP on concordance between participants' preferences and end-of-life care were uncertain (risk ratio (RR) 1.19, 95% confidence interval (CI) 0.91 to 1.55; participants = 110; studies = 1; very low-quality evidence). It corresponded to an assumed risk of 625 per 1000 participants receiving usual care and a corresponding risk of 744 per 1000 (95% CI 569 to 969) for ACP. There was no evidence of a difference in quality of life between groups (standardised mean difference (SMD) 0.06, 95% CI -0.26 to 0.38; participants = 156; studies = 3; low-quality evidence). However, one study, which was not included in the meta-analysis, showed that the quality of life score improved by 14.86 points in the ACP group compared with 11.80 points in the usual care group. Completion of documentation by medical staff regarding discussions with participants about ACP processes may have increased (RR 1.68. 95% CI 1.23 to 2.29; participants = 92; studies = 2; low-quality evidence). This corresponded to an assumed risk of 489 per 1000 participants with usual care and a corresponding risk of 822 per 1000 (95% CI 602 to 1000) for ACP. One study, which was not included in the meta-analysis, also showed that ACP helped to improve documentation of the ACP process (hazard ratio (HR) 2.87, 95% CI 1.09 to 7.59; participants = 232). Three studies reported that implementation of ACP led to an improvement of participants' depression (SMD -0.58, 95% CI -0.82 to -0.34; participants = 278; studies = 3; low-quality evidence). We were uncertain about the effects of ACP on the quality of communication when compared to the usual care group (MD -0.40, 95% CI -1.61 to 0.81; participants = 9; studies = 1; very low-quality evidence). We also noted an increase in all-cause mortality in the ACP group (RR 1.32, 95% CI 1.04 to 1.67; participants = 795; studies = 5). The studies did not report participants' satisfaction with care/treatment and caregivers' satisfaction with care/treatment. AUTHORS' CONCLUSIONS: ACP may help to increase documentation by medical staff regarding discussions with participants about ACP processes, and may improve an individual's depression. However, the quality of the evidence about these outcomes was low. The quality of the evidence for each outcome was low to very low due to the small number of studies and participants included in this review. Additionally, the follow-up periods and types of ACP intervention were varied. Therefore, further studies are needed to explore the effects of ACP that consider these differences carefully.
Development and validation of the Comprehensive Quality of Life Outcome (CoQoLo) inventory for patients with advanced cancer. International-journal Peer-reviewed

Miyashita M, Wada M, Morita T, Ishida M, Onishi H, Tsuneto S, Shima Y

BMJ Support Palliat Care　9　(1)　75-83　2019/03

DOI： 10.1136/bmjspcare-2014-000725 　

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BACKGROUND: The purpose of this study was to develop a scale capable of measuring comprehensive quality of life (QOL) outcomes based on the concept of a good death for patients with advanced cancer. METHODS: We conducted an anonymous cross-sectional questionnaire survey on inpatients being treated at the Oncology Clinic in Saitama Medical University International Medical Center and seven palliative units throughout Japan. RESULTS: A total of 405 patients with cancer participated in this study. Factor analysis of scores on the Comprehensive Quality of Life Outcome (CoQoLo) inventory revealed 28 items and the following 10 subscales: physical and psychological comfort; staying in a favourite place; maintaining hope and pleasure; good relationships with medical staff; not being a burden to others; good relationships with family; independence; environmental comfort; being respected as an individual; and having a fulfilling life. The total CoQoLo score was moderately correlated with satisfaction (r=0.34) and overall QOL (r=0.34), and moderately correlated with feelings of support and security regarding cancer care (r=0.44). Cronbach's α and the intraclass correlation coefficient of the total score were 0.90 and 0.79, respectively. No significant correlation was found between the total CoQoLo score and self-reported Eastern Cooperative Oncology Group performance status (r=-0.01). CONCLUSIONS: These results suggest that the CoQoLo has sufficient reliability and validity and therefore provides an accurate measure of QOL outcomes independent of the general physical condition of the patient.
Validation of the Integrated Palliative care Outcome Scale (IPOS) - Japanese Version International-journal Peer-reviewed

Sakurai H, Miyashita M, Imai K, Miyamoto S, Otani H, Oishi A, Kizawa Yoshiyuki, Matsushima E

Jpn J Clin Oncol　49　(3)　257-262　2019/01

DOI： 10.1093/jjco/hyy203 　

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BACKGROUND: To improve palliative care practice, the need for patients-reported outcome measures is increasing globally. The Integrated Palliative care Outcome Scale (IPOS) is a streamlined outcome scale developed to comprehensively evaluate patients' distress. The goal of this study is to assess the reliability and validity of IPOS-Japanese version in cancer patients. METHODS: This is a multicenter, cross-sectional observational study. We assessed the missing values, prevalence, test-retest reliability, criterion validity and known-group validity in Japanese adult cancer patients. Patients provided responses to IPOS, European Organization for Research and Treatment for Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30), and Functional Assessment of Chronic Illness Therapy- Spiritual 12 (FACIT-Sp12). Our medical staff provided responses to Support Team Assessment Schedule (STAS). RESULTS: One hundred forty-two patients were enrolled at six palliative care facilities. Missing values accounted for less than 1% of most items, with a maximum of 2.8%. The prevalence of symptoms was 17.7-88.7%. The intra-class correlation coefficient ranged from 0.522 to 0.951. The range of correlation coefficients with EORTC-QLQ-C30, FACIT-Sp12 and STAS as gold standards was 0.013 to 0.864 (absolute values). Total IPOS scores were positively correlated with Eastern Corporative Oncology Group Performance Status (P < 0.001). CONCLUSION: IPOS-Japanese version is a valid and reliable tool. The scale is useful in assessing physical, psychological, social and spiritual symptoms and in measuring outcomes of adult cancer patients in Japan.
End-of-life care for cancer patients in Japanese acute care hospitals: A nationwide retrospective administrative database survey. International-journal Peer-reviewed

Yuko Sato, Mitsunori Miyashita, Kazuki Sato, Kenji Fujimori, Koichi Benjamin Ishikawa, Hiromasa Horiguchi, Kiyohide Fushimi, Chikashi Ishioka

Japanese journal of clinical oncology　48　(10)　877-883　2018/10/01

DOI： 10.1093/jjco/hyy117 　

ISSN： 0368-2811

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Background: End-of-life (EOL) cancer care in Japanese acute care hospitals has not been well described. Methods: We aimed to assess the aggressiveness of EOL care and examine common treatments administered to cancer patients using a health administrative database. Subjects are adult cancer patients who died at acute care hospitals between April 2011 and March 2014. Data from the Japanese Diagnosis Procedure Combination database were analysed to measure the aggressiveness of care (chemotherapy, intensive care unit [ICU] admission and cardiopulmonary resuscitation [CPR]) and describe procedures and prescriptions administered in the last 14 and 30 days of life, disaggregated by hospital case volume: high, intermediate and low volumes. Results: Of 248,978 cancer decedents, 170,024 died in high-, 70,231 in intermediate- and 8,723 in low-volume hospitals. Aggressive treatment in the last 14 days of life included chemotherapy (9.4%, 7.3%, and 5.4%, respectively), ICU admission (3.0%, 2.0%, and 2.4%) and CPR (5.8%, 6.4%, and 8.3%). Opioids were administered to 66.0%, 59.0% and 49.4% patients, while Palliative Care Team intervention was performed for 8.5%, 2.2% and 2.0% of patients, respectively in the last 30 days. In high-volume hospitals, radiotherapy and certified outpatient chemotherapy fees were more frequent. Catecholamines and hyperalimentation were more frequently administered in low-volume hospitals. Conclusion: This is the first study to assess EOL care among Japanese acute care hospitals. More frequent use of chemotherapy at high-volume hospitals may reflect a well-established cancer treatment system. The approach for low-volume hospitals might improve the EOL care for all cancer patients in Japan.
Improved knowledge of and difficulties in palliative care among physicians during 2008 and 2015 in Japan: Association with a nationwide palliative care education program Peer-reviewed

Yoko Nakazawa, Ryo Yamamoto, Masashi Kato, Mitsunori Miyashita, Yoshiyuki Kizawa, Tatsuya Morita

Cancer　124　(3)　626-635　2018/02/01

DOI： 10.1002/cncr.31071 　

ISSN： 1097-0142 0008-543X
The distress and benefit to bereaved family members of participating in a post-bereavement survey Peer-reviewed

Mitsunori Miyashita, Maho Aoyama, Saki Yoshida, Yuji Yamada, Mutsumi Abe, Kazuhiro Yanagihara, Akemi Shirado, Mariko Shutoh, Yoshiaki Okamoto, Jun Hamano, Aoi Miyamoto, Misato Nakahata

Japanese Journal of Clinical Oncology　48　(2)　135-143　2018/02/01

DOI： 10.1093/jjco/hyx177 　

ISSN： 1465-3621 0368-2811
Development the Care Evaluation Scale Version 2.0: a modified version of a measure for bereaved family members to evaluate the structure and process of palliative care for cancer patient Peer-reviewed

Mitsunori Miyashita, Maho Aoyama, Misato Nakahata, Yuji Yamada, Mutsumi Abe, Kazuhiro Yanagihara, Akemi Shirado, Mariko Shutoh, Yoshiaki Okamoto, Jun Hamano, Aoi Miyamoto, Saki Yoshida, Kazuki Sato, Kei Hirai, Tatsuya Morita

BMC PALLIATIVE CARE　16　(1)　8　2017/01

DOI： 10.1186/s12904-017-0183-2 　

ISSN： 1472-684X
Population-Based Quality Indicators for Palliative Care Programs for Cancer Patients in Japan: A Delphi Study Peer-reviewed

Yoko Nakazawa, Masahi Kato, Saran Yoshida, Mitsunori Miyashita, Tatsuya Morita, Yoshiyuki Kizawa

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　51　(4)　652-661　2016/04

DOI： 10.1016/j.jpainsymman.2015.11.011 　

ISSN： 0885-3924

eISSN： 1873-6513
Development and validation of the Comprehensive Quality of Life Outcome (CoQoLo) inventory for patients with advanced cancer. International-journal Peer-reviewed

Miyashita M, Wada M, Morita T, Ishida M, Onishi H, Tsuneto S, Shima Y

BMJ supportive & palliative care　9　(1)　75-83　2015/10

DOI： 10.1136/bmjspcare-2014-000725 　

ISSN： 2045-435X

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BACKGROUND: The purpose of this study was to develop a scale capable of measuring comprehensive quality of life (QOL) outcomes based on the concept of a good death for patients with advanced cancer. METHODS: We conducted an anonymous cross-sectional questionnaire survey on inpatients being treated at the Oncology Clinic in Saitama Medical University International Medical Center and seven palliative units throughout Japan. RESULTS: A total of 405 patients with cancer participated in this study. Factor analysis of scores on the Comprehensive Quality of Life Outcome (CoQoLo) inventory revealed 28 items and the following 10 subscales: physical and psychological comfort; staying in a favourite place; maintaining hope and pleasure; good relationships with medical staff; not being a burden to others; good relationships with family; independence; environmental comfort; being respected as an individual; and having a fulfilling life. The total CoQoLo score was moderately correlated with satisfaction (r=0.34) and overall QOL (r=0.34), and moderately correlated with feelings of support and security regarding cancer care (r=0.44). Cronbach's α and the intraclass correlation coefficient of the total score were 0.90 and 0.79, respectively. No significant correlation was found between the total CoQoLo score and self-reported Eastern Cooperative Oncology Group performance status (r=-0.01). CONCLUSIONS: These results suggest that the CoQoLo has sufficient reliability and validity and therefore provides an accurate measure of QOL outcomes independent of the general physical condition of the patient.
遺体へのケアを看護師が家族と一緒に行うことについての家族の体験と評価

山脇道晴, 森田達也, 清原恵美, 清水恵, 恒藤暁, 志真泰夫, 宮下光令

がん看護　20　(6)　670-675　2015/09
Publisher:
ISSN： 1342-0569

eISSN： 2432-8723
Cross-sectional online survey of research productivity in young Japanese nursing faculty Peer-reviewed

Yumiko Oyama, Hiroki Fukahori, Mitsunori Miyashita, Miho Narama, Ayumi Kono, Fumi Atogami, Masayo Kashiwagi, Keiko Okaya, Emiko Takamizawa, Toyoko Yoshizawa

JAPAN JOURNAL OF NURSING SCIENCE　12　(3)　198-207　2015/07

DOI： 10.1111/jjns.12060 　

ISSN： 1742-7932

eISSN： 1742-7924
A Nationwide Survey of Quality of End-of-Life Cancer Care in Designated Cancer Centers, Inpatient Palliative Care Units, and Home Hospices in Japan: The J-HOPE Study Peer-reviewed

Mitsunori Miyashita, Tatsuya Morita, Kazuki Sato, Satoru Tsuneto, Yasuo Shima

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　50　(1)　38-+　2015/07

DOI： 10.1016/j.jpainsymman.2015.01.007 　

ISSN： 0885-3924

eISSN： 1873-6513
Independent Validation of the Japanese Version of the EORTC QLQ-C15-PAL for Patients With Advanced Cancer Peer-reviewed

Mitsunori Miyashita, Makoto Wada, Tatsuya Morita, Mayumi Ishida, Hideki Onishi, Yasutsuna Sasaki, Masaru Narabayashi, Tomomi Wada, Mei Matsubara, Chizuko Takigawa, Takuya Shinjo, Akihiko Suga, Satoshi Inoue, Masayuki Ikenaga, Hiroyuki Kohara, Satoru Tsuneto, Yasuo Shima

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　49　(5)　953-959　2015/05

DOI： 10.1016/j.jpainsymman.2014.11.299 　

ISSN： 0885-3924

eISSN： 1873-6513
Effect of fan for dyspnea in terminally ill cancer patients:Case series study

角甲純, 關本翌子, 小川朝生, 宮下光令

Palliat Care Res (Web)　10　(1)　147-152 (J-STAGE)-152　2015
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.10.147 　

ISSN： 1880-5302

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The effects of a fan to reduce dyspnea have been evaluated in several trials worldwide, however, there has been no clinical report in terminal cancer patients in Japan. We conducted a retrospective chart review to examine whether a fan is useful for dyspnea in terminally ill cancer patients. We reviewed medical and nursing records and selected all patients（n＝9）who received a fan from July 2013 and January 2014. The primary outcome measure was a decrease dyspnea measured by a visual analogue scale（VAS；0＝no shortness of breath, 100＝worst shortness of breath）. There was a significant difference in the VAS score after treatment with the fan（40.2±11.8 versus 15.6±14.9, P＝0.004）. Our results suggest that a fan may help in reduces the sensation of dyspnea in patients with terminal cancer. Future prospective study is needed.
The importance of good death components among cancer patients, the general population, oncologists, and oncology nurses in Japan: patients prefer "fighting against cancer" Peer-reviewed

Mitsunori Miyashita, Sachiko Kawakami, Daiki Kato, Hideomi Yamashita, Hiroshi Igaki, Kimiko Nakano, Yujiro Kuroda, Keiichi Nakagawa

SUPPORTIVE CARE IN CANCER　23　(1)　103-110　2015/01

DOI： 10.1007/s00520-014-2323-z 　

ISSN： 0941-4355

eISSN： 1433-7339
Effects of organization-related variables on evaluation of palliative care by informal caregivers

竹内真帆, 清水恵, 森田達也, 佐藤一樹, 三浦世理佳, 今野美咲, 佐藤香織, 内山美里, 高橋なつき, 泉佳那, 恒藤暁, 志真泰夫, 宮下光令

Palliat Care Res (Web)　9　(4)　101-111　2014/12
Publisher:
DOI： 10.2512/jspm.9.101 　

ISSN： 1880-5302

eISSN： 1880-5302
Care Evaluation Scale-Patient Version: Measuring the Quality of the Structure and Process of Palliative Care From the Patient's Perspective Peer-reviewed

Mitsunori Miyashita, Makoto Wada, Tatsuya Morita, Mayumi Ishida, Hideki Onishi, Satoru Tsuneto, Yasuo Shima

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　48　(1)　110-118　2014/07

DOI： 10.1016/j.jpainsymman.2013.08.019 　

ISSN： 0885-3924

eISSN： 1873-6513
Studies on the role of palliative care and home health care for cancer patients at the time of disaster based on the interview survey of healthcare in the affected coastal region of the East Japan Earthquake

菅野喜久子, 木下寛也, 森田達也, 佐藤一樹, 清水恵, 秋山聖子, 村上雅彦, 宮下光令

Palliative Care Research (Web)　9　(4)　131-139 (J-STAGE)-139　2014
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.9.131 　

ISSN： 1880-5302

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East Japan earthquake after cancer is not little survey about patients with palliative care and home health care. In this study, the cancer during an earthquake which aims to make recommendations for future large－scale disasters, and investigation of actual conditions of palliative care and home health care system or manual for basic data. Healthcare in the stricken coastal region 53 conducted semi－structured interviews. Results than cancer healthcare for patients with palliative care and home health care experience is 【cancer providing healthcare to patients with disabilities】【patient lost during the tsunami damage and evacuation oral medication continued failure】【failure of the medical provision of in－home patients by disruption of lifeline】【regional health providers and backward medical assistance and emergency medical group with disabilities】【mental care to medical staff】【disorder of the nuclear power plant accident community health providers】 of 6 organized by category. Be prepared for major disasters, disasters when cancer patients with palliative care and home care issues and how to respond it became evident.
Effects of a programme of interventions on regional comprehensive palliative care for patients with cancer: A mixed-methods study Peer-reviewed

Tatsuya Morita, Mitsunori Miyashita, Akemi Yamagishi, Miki Akiyama, Nobuya Akizuki, Kei Hirai, Chizuru Imura, Masashi Kato, Yoshiyuki Kizawa, Yutaka Shirahige, Takuhiro Yamaguchi, Kenji Eguchi

The Lancet Oncology　14　(7)　638-646　2013/06

DOI： 10.1016/S1470-2045(13)70127-X 　

ISSN： 1470-2045 1474-5488
Care for Imminently Dying Cancer Patients: Family Members' Experiences and Recommendations Peer-reviewed

Takuya Shinjo, Tatsuya Morita, Kei Hirai, Mitsunori Miyashita, Kazuki Sato, Satoru Tsuneto, Yasuo Shima

JOURNAL OF CLINICAL ONCOLOGY　28　(1)　142-148　2010/01

DOI： 10.1200/JCO.2009.23.2793 　

ISSN： 0732-183X

eISSN： 1527-7755
The palliative care knowledge test: reliability and validity of an instrument to measure palliative care knowledge among health professionals

Y. Nakazawa, M. Miyashita, T. Morita, M. Umeda, Y. Oyagi, T. Ogasawara

PALLIATIVE MEDICINE　23　(8)　754-766　2009/12

DOI： 10.1177/0269216309106871 　

ISSN： 0269-2163
Quality Indicators of End-of-Life Cancer Care from the Bereaved Family Members' Perspective in Japan Peer-reviewed

Mitsunori Miyashita, Tatsuya Morita, Takayuki Ichikawa, Kazuki Sato, Yasuo Shima, Yosuke Uchitomi

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　37　(6)　1019-1026　2009/06

DOI： 10.1016/j.jpainsymman.2008.05.015 　

ISSN： 0885-3924

eISSN： 1873-6513
Evaluation of end-of-life cancer care from the perspective of bereaved family members: The Japanese experience

Mitsunori Miyashita, Tatsuya Morita, Kei Hirai

JOURNAL OF CLINICAL ONCOLOGY　26　(23)　3845-3852　2008/08

DOI： 10.1200/JCO.2007.15.8287 　

ISSN： 0732-183X
Good death inventory: A measure for evaluating good death from the bereaved family member's perspective

Mitsunori Miyashita, Tatsuya Morita, Kazuki Sato, Kei Hirai, Yasuo Shima, Yosuke Uchitomi

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　35　(5)　486-498　2008/05

DOI： 10.1016/j.jpainsmman.2007.07.009 　

ISSN： 0885-3924
Barriers to referral to inpatient palliative care units in Japan: a qualitative survey with content analysis

Mitsunori Miyashita, Kei Hirai, Tatsuya Morita, Makiko Sanjo, Yosuke Uchitomi

SUPPORTIVE CARE IN CANCER　16　(3)　217-222　2008/03

DOI： 10.1007/s00520-007-0215-1 　

ISSN： 0941-4355
Preferences regarding end-of-life cancer care and associations with good-death concepts: a population-based survey in Japan

M. Sanjo, M. Miyashita, T. Morita, K. Hirai, M. Kawa, T. Akechi, Y. Uchitomi

ANNALS OF ONCOLOGY　18　(9)　1539-1547　2007/09

DOI： 10.1093/annonc/mdm199 　

ISSN： 0923-7534
Good death in cancer care: a nationwide quantitative study

M. Miyashita, M. Sanjo, T. Morita, K. Hirai, Y. Uchitomi

ANNALS OF ONCOLOGY　18　(6)　1090-1097　2007/06

DOI： 10.1093/annonc/mom068 　

ISSN： 0923-7534
Quality indicator in palliative care: A review

宮下光令, 佐藤一樹, 森田達也, 濱島ちさと, 祖父江友孝

Palliat Care Res (Web)　2　(2)　401-415　2007
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.2.401 　

ISSN： 1880-5302

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As measuring the quality of palliative care is considered to be important, quality indicators (QIs) that are able to extracted from medical database or from medical chart review have recently been developed in Western countries. In this paper, we reviewed the development of QIs and actual measurements collected in palliative care settings. The present results indicate that QIs based on data extracted from such sources as the cancer registry, medical claim, and palliative care databases, include items regarding aggressive treatment, hospice use, and intensive care units visits. Furthermore, QIs based on data extracted from medical chart reviews were developed for use with community-dwelling elderly patients. As with other QIs, QIs utilized at ICUs, QIs utilized at nursing homes, and evaluation of care from the perspective of bereaved families was conducted. In the future, QI items and methods appropriate for Japanese medical settings should be developed and their feasibility, reliability, and validity should be examined.
Good death in Japanese cancer care: A qualitative study Peer-reviewed

K Hirai, M Miyashita, T Morita, M Sanjo, Y Uchitomi

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　31　(2)　140-147　2006/02

DOI： 10.1016/j.jpainsymman.2005.06.012 　

ISSN： 0885-3924
Association between hydration volume and symptoms in terminally ill cancer patients with abdominal malignancies

T Morita, Hyodo, I, T Yoshimi, M Ikenaga, Y Tamura, A Yoshizawa, A Shimada, T Akechi, M Miyashita, Adachi, I

ANNALS OF ONCOLOGY　16　(4)　640-647　2005/04

DOI： 10.1093/annonc/mdi121 　

ISSN： 0923-7534
Reliability and validity of the Japanese version of the Support Team Assessment Schedule (STAS-J). International-journal Peer-reviewed

Miyashita M, Matoba K, Sasahara T, Kizawa Y, Maruguchi M, Abe M, Kawa M, Shima Y

Palliative & supportive care　2　(4)　379-385　2004/12

ISSN： 1478-9515

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OBJECTIVE: The aim of this project was to develop an appropriate and valid instrument for assessment by medical professionals in Japanese palliative care settings. METHODS: We developed a Japanese version of the Support Team Assessment Schedule (STAS-J), using a back translation method, and tested its reliability and validity. In the reliability study, 16 nurses and a physician who work in a palliative care unit evaluated 10 hypothetical cases twice at 3-month intervals. For the validity study, external researchers interviewed 50 patients with matignancy and their families and compared the results with ratings by the nurses in the palliative care unit. RESULTS: Our results with hypothetical cases were: interrater reliability weighted kappa = 0.53-0.77 and intrarater reliability weighted kappa = 0.64-0.85. In the validity study comparing nurse evaluations and the results of interviews with patients and families, complete agreement was 36-70%, and close agreement (+/-1) was 74-100%. As a whole, weighted kappa were low: between -0.07 and 0.51. Our results were similar to those in the United Kingdom and Canada. SIGNIFICANCE OF RESULTS: Although this research was conducted under methodologically limited conditions, we concluded that the STAS-J is a reliable tool and its validity is acceptable. The STAS-J should become a valuable tool, not only for daily clinical use, but also for research.
Development and validation of the Terminal Delirium-Related Distress Scale - Shortform. International-journal

Megumi Uchida, Tatsuo Akechi, Tatsuya Morita, Kento Masukawa, Yoshiyuki Kizawa, Satoru Tsuneto, Mitsunori Miyashita

Palliative & supportive care　23　e78　2025/03/14

DOI： 10.1017/S1478951525000227 　

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BACKGROUND: We previously developed a 24-item Terminal Delirium-Related Distress Scale (TDDS) to evaluate patient and family distress due to terminal delirium. However, a scale with fewer evaluation items was needed to reduce the burden on terminally ill patients and their families. Thus, the TDDS Shortform (TDDS-SF) was developed, and the validity and reliability of the scale were evaluated. OBJECTIVES: The aim of this study is to evaluate the validity and reliability of TDDS-SF. METHODS: Items with insufficient loading (<0.6) based on factor analysis were removed from the TDDS. Palliative care experts reviewed each item and checked the structure of the scale. Based on their feedback, we developed the TDDS-SF, a 15-item questionnaire consisting of 4 subscales, including "Care for the family," "Ability to communicate," "Psychiatric symptoms," and "Adequate information and discussion about treatment for delirium." A cross-sectional, self-completed questionnaire survey of bereaved families of cancer patients who were admitted to a hospice/palliative care unit was conducted in August 2018. The survey included the TDDS-SF, Good Death Inventory (GDI), Care Evaluation Scale (CES), and distress score in the Delirium Experience Questionnaire. The validity, including construct validity, convergent validity, discriminant validity, and internal consistency, and reliability, including the Cronbach's alpha coefficient for internal consistency, of the TDDS-SF were evaluated. RESULTS: The study included 366 bereaved family members. Factor analysis revealed good construct validity. Convergent validity was demonstrated based on good correlations with the CES (r = - 0.54, P < 0.001) and the GDI (r = - 0.54, P < 0.001). Discriminant validity was demonstrated by a low correlation (r = 0.23, P < 0.001) with the distress scores of bereaved families. The internal consistency was also good (Cronbach's alpha = 0.70-0.94). SIGNIFICANCE OF RESULTS: The TDDS-SF is a valid and feasible tool for assessing irreversible terminal delirium-related distress. A study targeting patients and their families with end-of-life delirium is planned for the near future.
Concept of good death in people with dementia: a cross‐sectional questionnaire survey of bereaved family members and medical professionals

Mitsunori Miyashita, Mizuho Nonaka, Maho Aoyama, Miharu Nakanishi, Miyae Yamakawa, Hiroki Fukahori, Kazuki Sato, Zaiya Takahashi, Hiroko Nagae, Tatsuya Morita

Psychogeriatrics　25　(2)　2025/02/26
Publisher: Wiley
DOI： 10.1111/psyg.70015 　

ISSN： 1346-3500

eISSN： 1479-8301

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Abstract Background There is limited quantitative evidence regarding good death for people with dementia. Aims To clarify which components of good death are important for people with dementia and to identify the component structure of good death through explanatory factor analysis. Design A web‐based questionnaire survey was conducted where bereaved family members and professionals were asked to rate the importance of the 44 items identified from previous qualitative interviews as components of ‘good death’. Setting/participants A total of 618 bereaved family members of people with dementia, and 206 physicians, nurses and care workers, each, involved in dementia care. Results A total of 1236 participant responses were analyzed. The exploratory factor analysis identified the following four factors as the concepts of good death for people with dementia: ‘Comfort, security, and safety’, ‘Relationships’, ‘Independence’, and ‘Personhood care’. The top five items that bereaved families indicated as important were ‘dying at peace’ (97%), ‘being free from pain and physical distress’ (97%), ‘being calm’ (96%), ‘being clean’ (96%), and ‘receiving necessary daily living assistance’ (96%). The items with the lowest scores were ‘being cared for by family’ (53%), ‘living with faith’ (54%), and ‘remaining in people's memory after one's death’ (67%). We found only small differences between the opinions of the bereaved family members and medical professionals. Conclusions The components of good death which stakeholders consider important provide useful information for developing care implementation strategies for dying people with dementia.
Analysis of medical practices used as indicators in the fourth basic plan for the promotion of cancer control in Japan. International-journal

Richi Takahashi, Yoko Nakazawa, Mitsunori Miyashita, Saho Wada, Yutaka Matsuoka

Japanese journal of clinical oncology　2025/02/02

DOI： 10.1093/jjco/hyaf022 　

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BACKGROUND: In the Fourth Basic Plan to Promote Cancer Control Programs, the number of medical practices using claims data from the National Database (NDB) is measured as a clinical indicator. This study aimed to clarify the characteristics of patients who received care as an indicator of medical practices using more manageable claims data. METHODS: We used the claims data collected by the DeSC Healthcare, Inc., and included patients diagnosed with cancer between 2017 and 2022 in this study. We compared age and cancer type distributions between the study population and population estimates, as well as cancer-specific medical practices with the NDB open data. We also described the number of medical practices, patients, and the percentage of patients receiving care by age and region. The percentage of female patients who underwent treatment was also calculated. RESULTS: A total of 1 251 850 patients was included. The distribution of cancer types was similar to the estimated prevalence, and the number of medical practices resembled the NDB open data; however, the age distribution was skewed. The highest median number of medical procedures per patient was six for specialized palliative care, whereas the others were one medical procedure per patient. The percentage of patients receiving care according to age was classified into three groups: increased with age, decreased with age, and peaked in their 40s. The percentage of patients receiving care varied by region depending on the type of medical practice. Of the patients who received care for lymphedema, 93.8% were female. CONCLUSION: The background information of cancer patients who received designated care may help interpret the total number of medical practices used as clinical indicators in cancer control programs.
Hospital function-associated deaths among patients with cancer: a comprehensive national study using death records in Japan. International-journal

Richi Takahashi, Yoko Nakazawa, Norihito Etoh, Yoshiyuki Kizawa, Mitsunori Miyashita, Jun Hamano

Japanese journal of clinical oncology　2025/01/09

DOI： 10.1093/jjco/hyae189 　

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BACKGROUND: In Japan, about 70%-80% of cancer deaths occur in hospitals. The actual number of cancer patients who die in hospitals where palliative care is available is not clear. This study aimed to examine whether hospitals where cancer patients died offered palliative care. METHODS: Patients aged ≥20 who died of cancer in 2018 were included. We used the Japanese death records and publicly available data on hospital functions. Cancer death numbers and hospitals were summarized according to hospital function and age group. Logistic regression analysis was performed to examine the death influence in patients with cancer in designated cancer hospitals. RESULTS: The study included 302 511 patients, and 168 835 patients (55.8%) died in hospitals with palliative care. In hospitals without palliative care, those with 100-199 and 200-499 beds had more deaths than hospitals not in these ranges of beds. Their median number of deaths per year was 17 and 26, respectively. Categorized by the death numbers per hospital without palliative care, hospitals with 20-49 cancer deaths were common. In the designated cancer hospitals, younger patients aged 20-29 had a higher odds ratio (OR) for death (4.28) than those aged 70-79. Blood cancer had a higher OR (2.36) than colorectal and rectal cancer. CONCLUSION: Our findings suggest that outreach of palliative care to hospitals with 100-199 or 200-499 beds and 20-49 deaths lacking palliative care could effectively improve end-of-life cancer care.
Associations Between Anticipatory Grief and Post-Bereavement Depression and Post-Loss Grief of Family Members of Dying Patients With Cancer in Palliative Care Units: A Cohort Study. International-journal

Reina Gotoh, Yoichi Shimizu, Akitoshi Hayashi, Maeda Isseki, Tomofumi Miura, Akira Inoue, Mayuko Takano, Kento Masukawa, Maho Aoyama, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

The American journal of hospice & palliative care　10499091241313299-10499091241313299　2025/01/07

DOI： 10.1177/10499091241313299 　

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Objectives: Anticipatory grief is associated with post-bereavement grief; however, reports on the influence of pre-loss depression are limited. Therefore, we investigated the association between the anticipatory grief of family members and post-loss and post-depression grief adjusted for pre-loss depression. Methods: This cohort study included the family members of dying patients with cancer. Questionnaires were distributed to them during hospitalization in four inpatient palliative care units from 2016 to 2017. We also administered follow-up questionnaires after their bereavement in 2018. The pre-bereavement questionnaire consisted of three items from the Anticipatory Grief Scale for Families Caring for a Terminally Ill Person for assessing anticipated grief and the Patient Health Questionnaire 9 for assessing depression. The Brief Grief Questionnaire was used to assess post-loss grief. Results: We distributed 181 pre-bereavement questionnaires to the family members; 112 (62%) responded to the pre-bereavement survey, out of which 71 (63%) responded to the post-bereavement survey. Anticipatory grief was significantly associated with pre-loss (ρ = 0.37, ρ < 0.001) and post-loss (ρ = 0.24, P = 0.009) depression and marginally associated with post-loss grief (ρ = 0.15, P = 0.10). Pre-loss depression was also significantly associated with post-loss depression (ρ = 0.50, P < 0.001) and post-loss grief (ρ = 0.41, P < 0.001). However, anticipatory grief was not significantly associated with post-loss depression (P = 0.35) and post-loss grief (P = 0.65) after adjusting for pre-loss depression. Significance of Results: Bereaved families who experienced anticipatory grief had worse post-bereavement depression. However, this association was not statistically significant after adjusting for pre-bereavement depression. Post-bereavement depression may be in a continuum with pre-loss depression, and anticipatory grief does not independently affect post-loss reactions.
Using voice recognition and machine learning techniques for detecting patient-reported outcomes from conversational voice in palliative care patients.

Lei Dong, Hideyuki Hirayama, XueJiao Zheng, Kento Masukawa, Mitsunori Miyashita

Japan journal of nursing science : JJNS　22　(1)　e12644　2025/01

DOI： 10.1111/jjns.12644 　

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AIM: Patient-reported outcome measures (PROMs) are increasingly used in palliative care to evaluate patients' symptoms and conditions. Healthcare providers often collect PROMs through conversations. However, the manual entry of these data into electronic medical records can be burdensome for healthcare providers. Voice recognition technology has been explored as a potential solution for alleviating this burden. However, research on voice recognition technology for palliative care is lacking. This study aimed to verify the use of voice recognition and machine learning to automatically evaluate PROMs using clinical conversation voice data. METHODS: We recruited 100 home-based palliative care patients from February to May 2023, conducted interviews using the Integrated Palliative Care Outcome Scale (IPOS), and transcribed their voice data using an existing voice recognition tool. We calculated the recognition rate and developed a machine learning model for symptom detection. Model performance was primarily evaluated using the F1 score, harmonic mean of the model's positive predictive value, and recall. RESULTS: The mean age of the patients was 80.6 years (SD, 10.8 years), and 34.0% were men. Thirteen patients had cancer, and 87 did not. The patient voice recognition rate of 55.6% (SD, 12.1%) was significantly lower than the overall recognition rate of 76.1% (SD, 6.4%). The F1 scores for the five total symptoms ranged from 0.31 to 0.46. CONCLUSION: Although further improvements are necessary to enhance our model's performance, this study provides valuable insights into voice recognition and machine learning in clinical settings. We expect our findings will reduce the burden of recording PROMs on healthcare providers, increasing the wider use of PROMs.
Social factors affecting home-based end-of-life care for patients with cancer and primary caregivers. International-journal

Shuji Hiramoto, Ryu Hashimoto, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Kento Masukawa, Mitsunori Miyashita, Masahito Hitosugi

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer　33　(1)　54-54　2024/12/26

DOI： 10.1007/s00520-024-09074-1 　

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OBJECTIVE: This study aimed to explore the social factors of patients and caregivers, including those related to their wishes for home-based end-of-life care that influence its fulfillment. METHODS: A secondary analysis was conducted using the dataset (home-based end-of-life care N = 625, hospital end-of-life care N = 7603) Comprehensive patient-based survey conducted by The Study on Quality Evaluation of Hospice and Palliative Care by Bereaved Caregivers (J-HOPE 4) and multivariate analysis (multiple logistic regression) to explore the impact of social factors of patients and caregivers on the fulfillment of home-based end-of-life care. The explanatory variables included 11 social factors of patients, such as age and sex, and 18 social factors of primary caregivers. RESULTS: For patients with medical expenses less than 900 USD (OR, 2.05), annual income of fewer than 36,000 USD (OR 0.669), preferences for home care (OR 1.49), preferences to die at home (OR 1.58), wish to die at home (OR 1.52), and lack of patient's financial well-being (OR 0.72) were significant factors associated with home-based end-of-life care. Significant factors relating to caregivers included male caregivers (OR 0.66), poor mental state (OR 0.79), ability to provide daily care (OR 3.02), experience of caring for a deceased family member (OR 0.66), presence of alternative caregivers (OR 0.78), and cohabitation with caregivers (OR 1.47). CONCLUSION: Patient preferences, social situations, primary caregivers' social situations, and mental states influenced home-based end-of-life care.
Current Status of and Barriers to Primary Palliative Care Recognized by Critical Care Specialist Nurses: A Nationwide Cross-Sectional Questionnaire Survey in Japan

Akane Kato, Yuta Tanaka, Yoshiyuki Kizawa, Hiroaki Yamase, Asami Tado, Junko Tatsuno, Mitsunori Miyashita

American Journal of Hospice and Palliative Medicine®　2024/12/05
Publisher: SAGE Publications
DOI： 10.1177/10499091241303675 　

ISSN： 1049-9091

eISSN： 1938-2715

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Objectives: To investigate the current state of primary palliative care practice in Japanese critical care settings, identify care perceived as equivalent to primary palliative care, and explore the barriers. Methods: We employed a quantitative descriptive questionnaire survey with a nationwide cross-sectional design involving 740 critical care specialist nurses. Results: Questionnaires were received from 384 nurses, yielding a response rate of 51.9%. Nurses recognized typical palliative care provided to cancer patients, such as “relieving suffering at end-of-life” (95.3%), “pain management” (88.8%), and “caring for patients’ psychological suffering” (88.3%), as primary palliative care in the critical care setting. They also recognized “monitoring and management of delirium” (68.5%), “caring for patients’ social suffering” (63.5%), and “preventing post-intensive care syndromes” (61.7%) less frequently as aspects of primary palliative care in critical care settings. Additionally, the recognition was lower among emergency department nurses than intensive care unit nurses. The nurses recognized inadequate overall palliative care practices, especially regarding patients’ social (72.1%) and spiritual (76.8%) suffering. They recognized “insufficient knowledge and skills among critical care medical staff” (70.6%) and “unable to confirm the patients’ preferences to treatment goals” (54.4%) as barriers to providing primary palliative care. The barriers that nurses recognized less often were “uncertainty about palliative care in critical care settings” (6.8%) and “disagreements among nursing teams regarding providing palliative care” (8.3%). Conclusion: Specialist nurses understood palliative care but felt unprepared in primary palliative care due to limited knowledge. Improved education in primary palliative care and patient-family communication is needed in Japan’s critical care settings.
Unapproved and unproven cancer treatments in patients admitted to palliative care units. International-journal

Hideko Akagi, Noriyuki Katsumata, Kozue Suzuki, Kento Masukawa, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer　32　(12)　841-841　2024/12/02

DOI： 10.1007/s00520-024-09057-2 　

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PURPOSE: To clarify the current use of unapproved and unproven cancer treatment (UUCT) among the bereaved families of patients with cancer who died in palliative care units, the financial burden and psychological experiences of the families, and the relationship between patients in palliative care who used UUCT and communication with their physicians'. METHODS: This study was conducted as part of a cross-sectional, anonymous nationwide survey of the bereaved family members of cancer patients who died in palliative care unit in Japan. RESULTS: Questionnaires were sent to 1,039 bereaved family members, and responses were received from 661 (64%). Of these, 558 were included in the study after excluding the 103 who did not complete the questionnaire. A total of 7.3% (41 of 558) of patients received UUCT. Of these, 34% (14 of 41) of patients were informed that the treatment was in the research phase, and 49% (20 of 41) were informed that the efficacy of the treatment was unknown. Regarding expectations for UUCT, 61% (25/41) expected to be cured, and 80% (33/41) expected it to slow disease progression. In multivariate logistic regression analysis, use of complementary and alternative medicine (CAM) was associated with receiving UUCT (p = 0.024), and patients who could discuss CAM with their doctors tended to receive UUCT (p = 0.054). CONCLUSION: Patients in palliative care unit who expect to cure tended to receive UUCT. These results highlight the challenge of telling patients that UUCT is ineffective and informing them of their prognosis and severe medical conditions.
Protocol of a nation-wide post-bereavement survey on quality of hospice and palliative care: J-HOPE 5 study

Maho Aoyama, Masanori Mori, Tatsuya Morita, Satoru Tsuneto, Mitsunori Miyashita

BMC Palliative Care　23　(1)　2024/12

DOI： 10.1186/s12904-024-01600-6 　

eISSN： 1472-684X
The Distress and Benefits of the Bereaved Family Survey: A Mortality Follow-Back Survey. International-journal

Mai Hosokawa, Yoko Nakazawa, Mitsunori Miyashita, Kento Masukawa, Momoka Sato, Tatsuya Morita, Yasuyiki Okumura, Yoshiyuki Kizawa, Shohei Kawagoe, Hiroshi Yamamoto, Emi Takeuchi, Risa Yamazaki, Asao Ogawa

Journal of pain and symptom management　2024/11/04

DOI： 10.1016/j.jpainsymman.2024.10.029 　

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CONTEXT: The Bereaved Family Survey is an important method for evaluating the quality of palliative care. OBJECTIVES: To examine the distress and benefits of bereaved families of patients with or without cancer, who participated in a Bereaved Family Survey, and identify factors associated with distress and benefits. METHODS: We conducted a nationwide cross-sectional, self-reported questionnaire mail survey among the bereaved families of patients who died of cancer, heart disease, cerebrovascular disease, pneumonia, or kidney failure. Participants answered questions on a four-point Likert scale measuring the distress and benefit associated with participating in the Bereaved Family Survey. We conducted a qualitative analysis of responses to open-ended questions about the distress and benefits of participating in the survey to comprehensively examine the distress and benefits of participating in the survey. RESULTS: Questionnaires were distributed to 115,816 eligible bereaved family members between February 2019 and February 2020; 62,576 (54.0%) family members returned valid responses. Distress and benefits accounted for 51.4% and 49.3%, respectively. The results of the binomial logistic analysis for distress were significantly higher among cancer patients (P < 0.001-0.003), 20-39-year-old patients (P < 0.001), female bereaved family members (P < 0.001), and bereaved family members with poor mental health statuses (P < 0.001). Factors related to "benefit" were significantly higher among over-80-year-old bereaved family members (P < 0.001), higher care evaluation scale (CES) scores (P < 0.001), and higher good death inventory (GDI) scores (P < 0.001). CONCLUSION: Bereaved family members experience both distress and benefits. There is need to devise ways to reduce distress and increase its benefits to continue assessing the quality of palliative care.
死亡前の介護保険制度利用状況に関する遺族の評価

高橋理智, 中澤葉宇子, 宮下光令, 森田達也, 奥村泰之, 木澤義之, 川越正平, 山本寛, 竹内恵美, 山崎里紗, 小川朝生

厚生の指標　71　(8)　40-47　2024/08
Publisher: (一財)厚生労働統計協会
ISSN： 0452-6104
Bereaved family members' perspectives on quality of death in deceased acute cardiovascular disease patients compared with cancer patients - a comparison of the J-HOPE3 study and the quality of palliative care in heart disease (Q-PACH) study. International-journal

Takahiro Suzuki, Mitsunori Miyashita, Takashi Kohno, Jeffrey Rewley, Naoko Igarashi, Maho Aoyama, Michiaki Higashitani, Naoto Kawamatsu, Takeshi Kitai, Tatsuhiro Shibata, Makoto Takei, Kotaro Nochioka, Gaku Nakazawa, Hiroki Shiomi, Shigeru Tateno, Toshihisa Anzai, Atsushi Mizuno

BMC palliative care　23　(1)　188-188　2024/07/26

DOI： 10.1186/s12904-024-01521-4 　

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BACKGROUND: Outcome measures during acute cardiovascular disease (CVD) phases, such as quality of death, have not been thoroughly evaluated. This is the first study that compared the family members' perceptions of quality of death in deceased CVD patients and in deceased cancer patients using a bereaved family survey. METHODS: Retrospectively sent questionnaire to consecutive family members of deceased patients with CVD from ten tertiary hospitals from October 2017 to August 2018. We used the short version of the Good Death Inventory (GDI) and assessed overall care satisfaction. Referencing the GDI, the quality of death was compared between CVD patients admitted to a non-palliative care unit (non-PCU) and cancer patients in palliative care units (PCU) and non-PCUs in the Japan Hospice and Palliative Care Evaluation Study (J-HOPE Study). Additionally, in the adjusted analysis, multivariable linear regression was performed for total GDI score adjusted by the patient and participant characteristics to estimate the difference between CVD and other patients. RESULTS: Of the 243 bereaved family responses in agreement (response rate: 58.7%) for CVD patients, deceased patients comprised 133 (54.7%) men who were 80.2 ± 12.2 years old on admission. The GDI score among CVD patients (75.0 ± 15.7) was lower (worse) than that of cancer patients in the PCUs (80.2 ± 14.3), but higher than in non-PCUs (74.4 ± 15.2). After adjustment, the total GDI score for CVD patients was 7.10 points lower [95% CI: 5.22-8.97] than for cancer patients in PCUs and showed no significant differences compared with those in non-PCUs (estimates, 1.62; 95% CI [-0.46 to 5.22]). CONCLUSIONS: The quality of death perceived by bereaved family members among deceased acute CVD patients did not differ significantly from that of deceased cancer patients in general wards, however, was significantly lower than that of deceased cancer patients admitted in PCUs.
緩和ケア病棟に紹介された患者の複雑性(complexity)と緩和ケアの病期(Phase of Illness)との関連

大日方裕紀, 宮下光令, 前田一石

Palliative Care Research　19　(Suppl.)　S.308-S.308　2024/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
Dying Patients’ Quality of Care for Five Common Causes of Death: A Nationwide Mortality Follow-Back Survey

Yoko Nakazawa, Mitsunori Miyashita, Tatsuya Morita, Yasuyuki Okumura, Yoshiyuki Kizawa, Shohei Kawagoe, Hiroshi Yamamoto, Emi Takeuchi, Risa Yamazaki, Asao Ogawa

Journal of Palliative Medicine　2024/05/21

DOI： 10.1089/jpm.2023.0645 　

ISSN： 1096-6218 1557-7740
Automatic Pain Detection Algorithm for Patients with Cancer Pain Using Wristwatch Wearable Devices.

Hideyuki Hirayama, Shiori Yoshida, Konosuke Sasaki, Emi Yuda, Kento Masukawa, Mamiko Sato, Tomoo Ikari, Akira Inoue, Yoshihide Kawasaki, Mitsunori Miyashita

EMBC　1-4　2024

DOI： 10.1109/EMBC53108.2024.10781536 　
認知症有病者の遺族および診療やケアに携わる医療者自身が認知症になった場合に希望する死亡場所とその関連要因：インターネット調査 Peer-reviewed

林ゑり子, 山田藍, 青山真帆, 升川研人, 宮下光令

日本看護科学会誌　43　215-224　2023/09/13

DOI： 10.5630/jans.43.215 　
The effect of palliative care team intervention and symptom improvement using patient-reported outcomes: a multicenter prospective observational study. International-journal

Hideyuki Hirayama, Eriko Satomi, Yoshiyuki Kizawa, Mayuko Miyazaki, Keita Tagami, Ryuichi Sekine, Kozue Suzuki, Nobuyuki Yotani, Koji Sugano, Hirofumi Abo, Akihiro Sakashita, Kazuki Sato, Sari Nakagawa, Yoko Nakazawa, Jun Hamano, Mitsunori Miyashita

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer　31　(7)　439-439　2023/07/03

DOI： 10.1007/s00520-023-07912-2 　

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PURPOSE: Hospital-based palliative care teams (HPCTs) are widespread internationally, but multicenter studies about their effectiveness, using patient-reported outcomes (PROs), are limited to Australia and a few other countries. We conducted a multicenter, prospective observational study in Japan to explore the effectiveness of the HPCTs using PROs. METHODS: Nationwide, eight hospitals participated in the study. We included newly referred patients for one month in 2021 and followed them for one month. We asked the patients to complete the Integrated Palliative Care Outcome Scale or the Edmonton Symptom Assessment System as PROs at the time of the intervention, three days later, and weekly after the intervention. RESULTS: A total of 318 participants were enrolled, of whom 86% were patients with cancer, 56% were undergoing cancer treatment, and 20% received the Best Supportive Care. After one week, the following 12 symptoms showed more than a 60% improvement from severe to moderate or less: vomiting (100%), shortness of breath (86%), nausea (83%), practical problems (80%), drowsiness (76%), pain (72%), poor sharing of feelings with family or friends (72%), weakness (71%), constipation (69%), not feeling at peace (64%), lack of information (63%), and sore or dry mouth (61%). Symptoms with improvement from severe/moderate to mild or less were vomiting (71%) and practical problems (68%). CONCLUSION: This multicenter study showed that HPCTs effectively improved symptoms in several severe conditions, as assessed by PROs. This study also demonstrated the difficulty of relieving symptoms in patients in palliative care and the need for improved care.
緩和ケア病棟における質改善活動の実態と遺族調査におけるアウトカムとの関連

田口菜月, 升川研人, 青山真帆, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research　18　(3)　193-200　2023/07
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
Difficulty swallowing and food bolus obstruction in advanced cancer: association with the cachexia-related quality of life. International-journal

Hiroyuki Otani, Koji Amano, Tatsuya Morita, Tomofumi Miura, Naoharu Mori, Ryohei Tatara, Takaomi Kessoku, Akihiro Tokoro, Keita Tagami, Masanori Mori, Tomohiko Taniyama, Nobuhisa Nakajima, Erika Nakanishi, Jun Kako, Mitsunori Miyashita

Annals of palliative medicine　2023/06/05

DOI： 10.21037/apm-22-1203 　

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BACKGROUND: Swallowing disorders including difficulty swallowing and food bolus obstruction, result in reduced dietary intake-a common occurrence that leads to cachexia in patients with advanced cancer. This study examined the effects of swallowing difficulty and food bolus obstruction on cachexia-related quality of life (QOL). METHODS: This study secondarily analyzed data from a self-reported questionnaire survey of adult patients with advanced cancer at 11 palliative care services. Difficulty swallowing and food bolus obstruction were measured using the 11-point Numeric Rating Scale (NRS), whereas dietary intake and cachexia-related QOL were assessed using the Ingesta-Verbal/Visual Analog Scale and the Functional Assessment of Anorexia/ Cachexia Therapy Anorexia/Cachexia Subscale. A multiple logistic regression model was employed to determine the factors associated with varying degrees of difficulty swallowing and food bolus obstruction. RESULTS: Of the invited 495 patients, 378 agreed to participate (response rate 76.4%). After excluding participants with missing data, the data of 332 participants were analyzed; 26.5% had difficulty swallowing (NRS ≥1) and 28.3% had food bolus obstruction (NRS ≥1). Multivariate analysis revealed a substantial association between difficulty swallowing and food bolus obstruction and a decrease in cachexia-related QOL, regardless of performance status and the existence of cachexia. The coefficients for difficulty swallowing and food bolus obstruction were -6.34 [95% confidence interval (CI): -9.55 to -3.14, P<0.001] and -5.88 (95% CI: -8.68 to -3.09, P<0.001), respectively. CONCLUSIONS: Cachexia-related QOL deteriorated as difficulty swallowing and food bolus obstruction worsened; thus, healthcare providers must diagnose and treat swallowing disorders in a timely manner to prevent progression of cachexia and improve cachexia-related QOL.
Validity and reliability of the Integrated Palliative Care Outcome Scale for non-cancer patients.

Yoko Ishii, Nao Ito, Yuko Matsumura, Maho Aoyama, Izumi Kohara, Kunihiko Murai, Kazuhisa Takeuchi, Takako Yokoyama, Masako Miyashita, Mitsunori Miyashita

Geriatrics & gerontology international　2023/05/28

DOI： 10.1111/ggi.14603 　

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AIM: This study assessed the validity and reliability of the Integrated Palliative Care Outcome Scale for non-cancer patients. METHODS: We recruited 223 non-cancer patients receiving palliative care and their healthcare providers (222) across two home care facilities and two hospitals for a cross-sectional study. We assessed the construct validity and known-group validity of the Integrated Palliative Care Outcome Scale. The weighted kappa and interclass correlation coefficients were assessed to ascertain reliability. RESULTS: The scale scores were significantly higher for the 'non-stable' group (worsening condition group) measured in the palliative care phase than for the 'stable' group (P < 0.001). Regarding validity, Spearman's correlations between similar items on the Integrated Palliative Care Outcome Scale and Edmonton Symptom Assessment System ranged from 0.61 to 0.94. Regarding reliability, the weighted kappa coefficients ranged from 0.53 to 0.81 for patients and from 0.58 to 0.90 for healthcare providers. For inter-rater reliability between patients and healthcare providers, the weighted kappa coefficients for each item ranged from 0.03 to 0.42. CONCLUSION: This study confirmed the validity and reliability of the Integrated Palliative Care Outcome Scale for non-cancer patients requiring palliative care. However, the inter-rater reliability indicates poor agreement between the assessments of patients and healthcare providers. This highlights the discrepancies between both their assessments and the importance of the patient's assessment. Geriatr Gerontol Int 2023; ••: ••-••.
Nationwide Survey on Caregiver Burden When Supporting Terminal Cancer Patients with Dementia: Bereaved Family Members' Perspective. International-journal

Ayumi Takao, Harue Arao, Sena Yamamoto, Miwa Aoki, Katsuyasu Kouda, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Kento Masukawa, Mitsunori Miyashita

Journal of palliative care　8258597231169625-8258597231169625　2023/04/17

DOI： 10.1177/08258597231169625 　

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The prevalence of dementia and cancer has increased in recent years. The presence of dementia complicates the care of terminal cancer patients and affects their family caregivers. However, palliative care research seldom focuses on the family caregivers of patients with terminal cancer and dementia. This study aimed to evaluate the degree and factors of caregiver burden in cancer patients with dementia who died in hospice palliative care units. Methods: A nationwide cross-sectional survey was conducted among bereaved family members of patients with cancer who died in palliative care units. An anonymous self-report questionnaire was sent to bereaved family members, and they were asked if they were aware of the diagnosis of dementia. The short version of the Caregiver Consequence Inventory was used to measure caregiver burden. Results: The analysis included 670 bereaved family members. Of these, 83 (12.4%) were bereaved family members of terminal cancer patients with dementia. The caregiver burden was statistically significantly higher (3.61 ± 1.58 vs 3.22 ± 1.47; p < 0.036) among family caregivers of terminal cancer patients with dementia. Longer anti-cancer treatment duration (odd ratio, 4.63), poor mental and physical health of family caregivers (odds ratio, 2.05 and 2.20, respectively), pain (odd ratio, 1.72), and dyspnea (odds ratio, 1.67) were contributing factors for caregiver burden. Conclusions: Family caregivers of terminal cancer patients with dementia require care that considers the characteristics of the two serious diseases. Considering the goal of anti-cancer treatment and symptom relief may be a useful strategy for reducing caregiver burden.
Routine patient assessment and the use of patient-reported outcomes in specialized palliative care in Japan. International-journal

Nao Ito, Yoko Ishii, Maho Aoyama, Hirofumi Abo, Akihiro Sakashita, Yuko Matsumura, Mitsunori Miyashita

Journal of patient-reported outcomes　7　(1)　25-25　2023/03/09

DOI： 10.1186/s41687-023-00565-z 　

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BACKGROUND: Discrepancies in symptom assessment between providers and patients are reported in cancer care, and the use of patient-reported outcome measures (PROMs) has been recommended for patients receiving palliative care. However, the status of the routine use of PROMs in palliative care in Japan is presently unclear. Therefore, this study aimed to clarify this complex question. To this end, we administered a questionnaire survey either online or via telephone interviews (questionnaire: sent to 427 designated cancer hospitals, 423 palliative care units [PCUs], and 197 home hospices; interviews: conducted at 13 designated cancer hospitals, nine PCUs, and two home hospices). RESULTS: Questionnaires were returned from 458 institutions (44% response rate). We found that 35 palliative care teams (PCTs, 15%), 66 outpatient palliative care services (29%), 24 PCUs (11%) and one (5%) home hospice routinely used PROMs. The most frequently implemented instrument was the Comprehensive Care Needs Survey questionnaire. Moreover, 99 institutions (92%) that routinely used PROMs responded these instruments as useful in relieving patients' symptoms; and moreover, the response rate in regard to usefulness in symptom management was higher than that of institutions that did not routinely use PROMs (p = 0.002); > 50% of the institutions that routinely used PROMs stated that use of these instruments was influenced by disease progression and patients' cognitive function. Moreover, 24 institutions agreed to be interviewed, and interviews demonstrated the benefits of and the barriers to the implementation of PROMs. Effective methods used in the implementation of PROMs were introduced as efforts to reduce the burden placed on patients and to promote healthcare providers' education in the use of PROMs. CONCLUSIONS: This survey quantified the status of the routine use of PROMs within specialized palliative care in Japan, revealed barriers to wider PROM use, and identified needed innovations. Only 108 institutions (24%) routinely used PROMs within specialized palliative care. Based on the results of the study, it is necessary to carefully consider the usefulness of PROs in clinical palliative care, perform careful selection of PROMs according to the patient's condition, and evaluate how specifically to introduce and operate PROMs.
Quality indicators for palliative care in intensive care units: a systematic review. International-journal

Yuta Tanaka, Kento Masukawa, Arisa Kawashima, Hideyuki Hirayama, Mitsunori Miyashita

Annals of palliative medicine　2023/03/03

DOI： 10.21037/apm-22-1005 　

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BACKGROUND: Establishing appropriate quality assessment indicators for palliative care in intensive care units (ICUs) is vital. This systematic review summarizes the existing quality indicators (QIs) for palliative care in ICUs. It assesses the methodological quality of QI development to pave the way for more valid QIs. METHODS: A literature search was conducted using MEDLINE, PsycINFO, CINAHL, Cochrane databases, and the Ichushi-web database for Japanese literature for all studies published until November 2021. The included QIs were drawn from the National Consensus Project for Quality Palliative Care (NCP) and the Donabedian model of quality. Methodological quality was assessed based on the appraisal of indicators through the research and evaluation tool. RESULTS: Five studies were included, from which 109 indicators were extracted: 78% were process indicators, 5% were outcome indicators, and 17% were structure indicators. The most common indicators addressed the palliative care domain of "ethical and legal aspects of care" (n=38, 30%). Another distinctive feature of some indicators was a focus on supporting ICU staff. Regarding methodological quality, the "scientific evidence" varied (11-89%). Most of the data on QI measures and data sources were obtained from a review of electronic medical records (EMRs). Administrative data also provided a few measurable indicators. CONCLUSIONS: Out of all the QIs covered in this review, most were process indicators, and only a few were outcome indicators. Ethical and legal aspects of care and support for the ICU staff emerged as unique to palliative care. Although the existing QIs can be used for palliative care in ICUs, more specific indicators are urgently needed. Continuous quality assessment and improvement, as well as the addition of more palliative care practices in ICUs, would provide further evidence and help develop valid QIs.
Impact of taste/smell disturbances on dietary intakes and cachexia-related quality of life in patients with advanced cancer. International-journal

Hiroyuki Otani, Koji Amano, Tatsuya Morita, Tomofumi Miura, Naoharu Mori, Ryohei Tatara, Takaomi Kessoku, Yoshinobu Matsuda, Keita Tagami, Masanori Mori, Tomohiko Taniyama, Nobuhisa Nakajima, Erika Nakanishi, Jun Kako, Akemi Naito Shirado, Naosuke Yokomichi, Mitsunori Miyashita

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer　31　(2)　141-141　2023/01/30

DOI： 10.1007/s00520-023-07598-6 　

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PURPOSE: Taste and smell are used to enjoy meals; however, impairments of these sensory perceptions seriously impact health and eating habits. This study is aimed at investigating the impact of taste and smell disturbances on dietary intakes and cachexia-related quality of life (QOL) in patients with advanced cancer. METHODS: Using a self-report questionnaire, we surveyed patients with advanced cancer undergoing treatment at 11 palliative care centers. Multivariate analyses were conducted to explore the impact of taste and smell disturbances on dietary intakes and cachexia-related QOL. Dietary intakes were assessed using the Ingesta-Verbal/Visual Analog Scale, while taste and smell disturbances were assessed using an 11-point Numeric Rating Scale (NRS). Cachexia-related QOL was assessed using the Functional Assessment of Anorexia/Cachexia Therapy Anorexia Cachexia Subscale (FAACT ACS). RESULTS: Overall, 378 patients provided consent to participate. After excluding patients with missing data, data were analyzed for 343 patients. Among them, 35.6% (n = 122; 95% [confidence interval (CI)] 0.28-0.38) and 20.9% (n = 72; 95% CI 0.17-0.25) experienced disturbances in taste (NRS ≥ 1) and smell (NRS ≥ 1), respectively. Multivariate analyses revealed that, independent of performance status and cancer cachexia, taste and smell disturbances were significantly associated with worse dietary intakes and deteriorating FAACT ACS scores. CONCLUSION: More severe taste and smell disturbances were associated with poorer dietary intakes and cachexia-related QOL. Diagnosing and treating such disturbances may improve dietary intakes and cachexia-related QOL, regardless of performance status and cachexia.
Prognostic awareness in Japanese patients with advanced cancer: a follow-up cohort study

Yusuke Hiratsuka, Takayuki Oishi, Mitsunori Miyashita, Tatsuya Morita, Jennifer W Mack, Hiroo Imai, Takahiro Mori, Masato Sakayori, Masanori Mori, Isseki Maeda, Jun Hamano, Chikashi Ishioka, Akira Inoue

Japanese Journal of Clinical Oncology　2023/01/16
Publisher: Oxford University Press (OUP)
DOI： 10.1093/jjco/hyad002 　

eISSN： 1465-3621

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Abstract Background Patients with advanced cancer have been reported to be more likely to receive goal-concordant care if they have accurate prognostic awareness. However, many patients do not have this awareness. This study aimed to examine the prognostic awareness among Japanese patients with advanced cancer. Methods This single-center, follow-up cohort study included Japanese patients with advanced cancer who received chemotherapy at Tohoku University Hospital between January 2015 and January 2016. Patients were surveyed at enrollment and followed up for clinical events for 5 years thereafter. We compared (i) the patients’ prognostic awareness with both actual survival time and physician’s prediction of survival and (ii) physician’s prediction of survival time with actual survival. Factors associated with accurate prognostic awareness were identified by univariate analysis. Results Of the 133 patients eligible for the study, 57 patients were analyzed. Only 10 (17.5%) patients had accurate prognostic awareness. Forty-three patients (75.4%) were optimistic about their prognosis; &gt;80% of patients were more optimistic than their physicians about their prognosis. The physicians’ predictions were accurate in for patients (37.5%). Accurate prognostic awareness was associated with physician’s explanation of the prognosis and patients’ perception of a good death. Conclusions A majority of the patients with advanced cancer in this study had prognostic awareness that was more optimistic in comparison with their actual survival, and most were more optimistic than their physicians about their prognosis. Further research is needed to develop programs to facilitate the discussion of life expectancy with patients in a manner that is consistent with their preferences.
Web-Based Post-Bereavement Survey System in Specialized Palliative Care: A Feasibility Pilot Study

Tomoyo Sasahara, Kazuki Sato, Atsushi Hashimoto, Asuko Sekimoto, Sachiko Okayama, Yoshihiko Sakashita, Yoshiaki Satake, Takayuki Hisanaga, Yasuo Shima, Mitsunori Miyashita

The Tohoku Journal of Experimental Medicine　261　(3)　249-256　2023
Publisher: Tohoku University Medical Press
DOI： 10.1620/tjem.2023.j073 　

ISSN： 0040-8727

eISSN： 1349-3329
Attitudes and Barriers of Physicians toward Palliative Care in Critical Care Setting:Qualitative Content Analysis Using Open-ended Data from Nationwide Self-administrated Questionnaire Survey in Japan

Yuta Tanaka, Akane Kato, Kaori Ito, Yuko Igarashi, Satomi Kinoshita, Yoshiyuki Kizawa, Mitsunori Miyashita

Palliative Care Research　18　(2)　129-136　2023
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.18.129 　

eISSN： 1880-5302
Need for Improvement in Death Pronouncements in Palliative Care Units. International-journal

Jun Hamano, Kento Masukawa, Satoru Tsuneto, Yasuo Shima, Tatsuya Morita, Yoshiyuki Kizawa, Mitsunori Miyashita

Palliative medicine reports　4　(1)　350-357　2023

DOI： 10.1089/pmr.2023.0053 　

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BACKGROUND: Death pronouncement is an important moment that can impact a family's bereavement process; however, necessary improvements in physicians' behavior during death pronouncement remain unclear. OBJECTIVES: To explore whether the lack of certain behaviors by the physician was associated with a perceived need for improving death pronouncement for advanced cancer patients in palliative care units (PCUs). METHODS: This study was a secondary analysis of a nationwide multicenter questionnaire survey conducted in 2018 that targeted bereaved family members of cancer patients who died in PCUs. We performed univariate analysis to investigate the need to improve behavior toward death pronouncement. We performed bivariate analysis to investigate the relationship among the need for improvement in behavior toward death pronouncement, physician attribution (primary responsible physician, a member of the same team, and another physician), and nine specific behaviors. RESULTS: Four hundred twenty-two questionnaires (64.2%) were returned. We analyzed 356 responses and found that 32.5% perceived the need to improve death pronouncement. Lack of certain behaviors at death pronouncement, especially not explicitly explaining the cause of death to family members (odds ratio: 11.89, p < 0.001), were positively associated with the need for improvement. There were significant differences among the types of physician attribution regarding the need for improvement (primary responsible physician vs. a member of the same team vs. another physician [15.1% vs. 42.6% vs. 45.7%, p < 0.001]). CONCLUSION: There was a significant positive association between the lack of certain behaviors toward death pronouncement and the need for improvement. The major lack of behavior toward death pronouncement was not explicitly explaining the cause of death to family members and not calling out to the patient before beginning the patient's examination.
Integrated Palliative care Outcome Scale（IPOS）の非がん患者への実施可能性と表面的・内容的妥当性の検討

Yoko Ishii, Nao Ito, Yuko Matsumura, Takako Yokoyama, Maho Aoyama, Mitsunori Miyashita

Palliative Care Research　18　(4)　283-291　2023
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.18.283 　

eISSN： 1880-5302
がん疼痛マネジメントの看護実践尺度の開発と信頼性・妥当性の検討

高橋紀子, 青山真帆, 佐藤一樹, 清水陽一, 五十嵐尚子, 宮下光令

Palliative Care Research　18　(1)　19-29　2023
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
Validation study on definition of cause of death in Japanese claims data. International-journal

Fumiya Ito, Shintaro Togashi, Yuri Sato, Kento Masukawa, Kazuki Sato, Masaharu Nakayama, Kenji Fujimori, Mitsunori Miyashita

PloS one　18　(3)　e0283209　2023

DOI： 10.1371/journal.pone.0283209 　

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Identifying the cause of death is important for the study of end-of-life patients using claims data in Japan. However, the validity of how cause of death is identified using claims data remains unknown. Therefore, this study aimed to verify the validity of the method used to identify the cause of death based on Japanese claims data. Our study population included patients who died at two institutions between January 1, 2018 and December 31, 2019. Claims data consisted of medical data and Diagnosis Procedure Combination (DPC) data, and five definitions developed from disease classification in each dataset were compared with death certificates. Nine causes of death, including cancer, were included in the study. The definition with the highest positive predictive values (PPVs) and sensitivities in this study was the combination of "main disease" in both medical and DPC data. For cancer, these definitions had PPVs and sensitivities of > 90%. For heart disease, these definitions had PPVs of > 50% and sensitivities of > 70%. For cerebrovascular disease, these definitions had PPVs of > 80% and sensitivities of> 70%. For other causes of death, PPVs and sensitivities were < 50% for most definitions. Based on these results, we recommend definitions with a combination of "main disease" in both medical and DPC data for cancer and cerebrovascular disease. However, a clear argument cannot be made for other causes of death because of the small sample size. Therefore, the results of this study can be used with confidence for cancer and cerebrovascular disease but should be used with caution for other causes of death.
The impact of stressful life events after bereavement: a nationwide cross-sectional survey. International-journal

Yoichi Shimizu, Kento Masukawa, Maho Aoyama, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

Journal of pain and symptom management　65　(4)　273-284　2022/12/27

DOI： 10.1016/j.jpainsymman.2022.12.012 　

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CONTEXT: Bereaved family members sometimes experience distress due to stressful life events. However, the effects of this distress on depression and grief remain unclear. OBJECTIVES: To clarify the degree of distress due to post-bereavement stressful life events, its associated factors, especially social isolation, and its effects on major depressive disorder (MDD) and complicated grief (CG) risks among bereaved family members of patients with cancer. METHODS: This cross-sectional questionnaire survey was conducted in 2018 as part of the J-HOPE4 study. We recruited 1740 bereaved family members of patients with cancer who died from July to August of 2018. We assessed distress due to post-bereavement stressful life events with the Bereavement Secondary Stressor Scale, social isolation with the Lubben Social Network Scale Short-Form, and the MDD and CG risk with the Patient Health Questionnaire-9 and Brief Grief Questionnaire, respectively. RESULTS: Among the 913 (52.5%) respondents, 88%, 57%, 46%, 28%, and 19% experienced distress due to incidental tasks, daily life difficulties, financial problems, problems with other people, and deterioration of family relationships, respectively. More distress was associated with higher risks of MDD (odds ratio [OR] = 2.5, p < 0.01) and CG (OR = 2.5, p < 0.01). Social isolation and specific backgrounds were associated with more distress in response to stressful life events. CONCLUSION: Most family members experienced distress due to stressful life events, which were risk factors for MDD and CG. Assessing risk factors for maladaptation to post-bereavement life changes and enhancing readiness to adapt to them is important.
Development of a list of competencies and entrustable professional activities for resident physicians during death pronouncement: a modified Delphi study

Takaomi Kessoku, Yu Uneno, Yuka Urushibara-Miyachi, Kiyofumi Oya, Akihiko Kusakabe, Atsushi Nakajima, Noritoshi Kobayashi, Yasushi Ichikawa, Mitsunori Miyashita, Manabu Muto, Masanori Mori, Tatsuya Morita

BMC Medical Education　22　(1)　2022/12

DOI： 10.1186/s12909-022-03149-5 　

eISSN： 1472-6920
Development and validation of questionnaires for eating‐related distress among advanced cancer patients and families International-journal Peer-reviewed

Koji Amano, Tatsuya Morita, Tomofumi Miura, Naoharu Mori, Ryohei Tatara, Takaomi Kessoku, Yoshinobu Matsuda, Keita Tagami, Hiroyuki Otani, Masanori Mori, Tomohiko Taniyama, Nobuhisa Nakajima, Erika Nakanishi, Jun Kako, Hiroto Ishiki, Hiromichi Matsuoka, Eriko Satomi, Jane B. Hopkinson, Vickie E. Baracos, Mitsunori Miyashita

Journal of Cachexia, Sarcopenia and Muscle　14　(1)　310-325　2022/11/20
Publisher: Wiley
DOI： 10.1002/jcsm.13133 　

ISSN： 2190-5991

eISSN： 2190-6009

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BACKGROUND: Eating-related distress (ERD) is one type of psychosocial distress among advanced cancer patients and family caregivers. Its alleviation is a key issue in palliative care; however, there is no validated tool for measuring ERD. METHODS: The purpose of this study was to validate tools for evaluating ERD among patients and family caregivers. The study consisted of a development and validation/retest phase. In the development phase, we made preliminary questionnaires for patients and family caregivers. After face validity and content validity, we performed an exploratory factor analysis and discussed the final adoption of items. In the validation/retest phase, we examined factor validity with an exploratory factor analysis. We calculated Pearson's correlation coefficients between the questionnaire for patients, the Functional Assessment of Anorexia/Cachexia Therapy Anorexia Cachexia Subscale (FAACT ACS) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Cachexia 24 (EORTC QLQ-CAX24) and Pearson's correlation coefficients between the questionnaire for family caregivers and the Caregiver Quality of Life Index-Cancer (CQOLC) for concurrent validity. We calculated Cronbach's alpha coefficients (Cronbach's alpha) and intraclass correlation coefficients (ICCs) for internal consistency and test-retest reliability. We performed the Mann-Whitney U test between the questionnaires and cancer cachexia based on criteria from the international consensus for known-group validity. RESULTS: In the development phase, 162 pairs of patients and family caregivers were asked to participate, and 144 patients and 106 family caregivers responded. In the validation/retest phase, 333 pairs of patients and family caregivers were asked to participate, and 234 patients and 152 family caregivers responded. Overall, 183 patients and 112 family caregivers did the retest. Seven conceptual groups were extracted for the ERD among patients and family caregivers, respectively. Patient factors 1-7 correlated with FAACT ACS (r = -0.63, -0.43, -0.55, -0.40, -0.38, -0.54, -0.38, respectively) and EORTC QLQ-CAX24 (r = 0.58, 0.40, 0.60, 0.49, 0.38, 0.59, 0.42, respectively). Family factors 1-7 correlated with CQOLC (r = -0.34, -0.30, -0.37, -0.37, -0.46, -0.42, -0.40, respectively). The values of Cronbach's alpha and ICC of each factor and all factors of patients ranged from 0.84 to 0.96 and 0.67 to 0.83, respectively. Those of each factor and all factors of family caregivers ranged from 0.84 to 0.96 and 0.63 to 0.84, respectively. The cachexia group of patients had significantly higher scores than the non-cachexia group for each factor and all factors. CONCLUSIONS: Newly developed tools for measuring ERD experienced by advanced cancer patients and family caregivers have been validated.
Factors related to suicidal ideation among bereaved family members of patients with cancer: Results from a nationwide bereavement survey in Japan. International-journal

Maho Aoyama, Mitsunori Miyashita, Kento Masukawa, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Tatsuo Akechi

Journal of affective disorders　316　91-98　2022/11/01

DOI： 10.1016/j.jad.2022.08.019 　

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BACKGROUND: Bereaved family members are known to have a higher risk of suicide, although relevant research is lacking. We aimed to clarify the percentage of bereaved family members of patients with cancer who experience suicidal ideation and the associated factors. METHODS: We conducted a secondary analysis of two cross-sectional nationwide bereavement surveys in Japan, analyzing data from a total of 17,237 bereaved family members of patients with cancer. The Patient Health Questionnaire 8 (PHQ-8) and Item 9 of the PHQ-9 were used to assess depression (PHQ-8 score ≥10) and suicidal ideation, respectively. We assessed items such as socio-demographic data, complicated grief (CG), preparedness for bereavement, and perceived social support. Logistic regression analysis was used to reveal factors related to suicidal ideation. RESULTS: Overall, 11 % of subjects reported some amount of suicidal ideation in the previous two weeks, with a suicidal ideation rate as high as 42 % among those with a higher risk of depression. Significant associations (all p < 0.0001) were found between suicidal ideation and the family member's depressive state (OR: 10.01), poor physical health status during caregiving (OR: 1.24), poor psychological health status during caregiving (OR: 1.38) pre-existing mental illness (OR: 1.38), insufficient preparedness for bereavement (OR: 0.59), and poor perceived social support (OR: 1.42). LIMITATIONS: The respondents were limited to family members of patients with cancer in Japan, and the study involved cross-sectional self-reported data. CONCLUSIONS: Clinicians should identify bereaved family members at a high risk of suicide by carefully assessing these risk factors identified in the present study.
Symptoms, performance status and phase of illness in advanced cancer: multicentre cross-sectional study of palliative care unit admissions

Hironori Ohinata, Maho Aoyama, Yusuke Hiratsuka, Masanori Mori, Ayako Kikuchi, Hiroaki Tsukuura, Yosuke Matsuda, Kozue Suzuki, Hiroyuki Kohara, Isseki Maeda, Tatsuya Morita, Mitsunori Miyashita

BMJ Supportive & Palliative Care　spcare-2022　2022/10/27
Publisher: BMJ
DOI： 10.1136/spcare-2022-003806 　

ISSN： 2045-435X

eISSN： 2045-4368

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Objectives To clarify the relationship between Phase of Illness at the time of admission to palliative care units and symptoms of patients with advanced cancer. Methods This study was a secondary analysis of the East Asian collaborative cross-cultural Study to Elucidate the Dying process. Palliative physicians recorded data, including Phase of Illness, physical function and the Integrated Palliative care Outcome Scale. We used multinomial logistic regression to analyse ORs for factors associated with Phase of Illness. Twenty-three palliative care units in Japan participated from January 2017 to September 2018. Results In total, 1894 patients were analysed—50.9% were male, mean age was 72.4 (SD±12.3) years, and Phase of Illness at the time of admission to the palliative care unit comprised 177 (8.9%) stable, 579 (29.2%) unstable, 921 (46.4%) deteriorating and 217 (10.9%) terminal phases. Symptoms were most distressing in the terminal phase for all items, followed by deteriorating, unstable and stable (p<0.001). The stable phase had lower association with shortness of breath (OR 0.73, 95% CI 0.57 to 0.94) and felt at peace (OR 0.73, 95% CI 0.56 to 0.90) than the unstable phase. In the deteriorating phase, weakness or lack of energy (OR 1.20, 95% CI 1.02 to 1.40) were higher, while drowsiness (OR 0.82, 95% CI 0.71 to 0.97) and felt at peace (OR 0.81, 95% CI 0.71 to 0.94) were significantly lower. Conclusion Our study is reflective of the situation in palliative care units in Japan. Future studies should consider the differences in patients’ medical conditions and routinely investigate patients’ Phase of Illness and symptoms. Trial registrarion number UMIN000025457
Comparative study of clinicians' and family members' perceptions of patients' end-of-life experiences. International-journal

Kozue Suzuki, Tatsuya Morita, Masanori Mori, Yukari Azuma, Hiromi Funaki, Koji Amano, Kengo Imai, Keiko Tanaka, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Kento Masukawa, Mitsunori Miyashita

BMJ supportive & palliative care　2022/10/11

DOI： 10.1136/spcare-2022-003883 　

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OBJECTIVE: End-of-life experiences (ELEs), such as deathbed visions (DBVs), have been reported worldwide. However, ELEs have rarely been discussed in clinical practice, possibly because of the different perceptions of ELEs among clinicians and families. Therefore, this study aimed to investigate the differences in perception regarding ELEs, especially DBVs, between clinicians and families. METHODS: We conducted a multicentre, prospective and observational study with patients with cancer. After the patients' death, clinicians recorded their perceptions of patients' ELEs during the palliative care unit admission, and bereaved families responded to a questionnaire about ELEs. The primary outcome was the frequency and concordance of DBVs from the perspective of bereaved family members and clinicians. The second outcome was each group's frequency of terminal lucidity and terminal coincidence. RESULTS: The study included 443 patients. DBVs were reported more frequently by family members than clinicians (14.0% vs 2.7%, p<0.001). Among family members, terminal lucidity and terminal coincidence were observed at 7% and 7.9%, respectively, while only one case each was reported by clinicians. CONCLUSIONS: Clinicians and family members may perceive ELEs differently. Enabling patients and their families to talk about ELEs would assist in optimising grief care.
Non-pharmacological interventions for cancer-related fatigue in terminal cancer patients: a systematic review and meta- analysis International-journal Peer-reviewed

Mai Hosokawa, Masami Ito, Ayumi Kyota, Kazue Hirai, Miyae Yamakawa, Mitsunori Miyashita

Annals of Palliative Medicine　11　(11)　3382-3393　2022/10

DOI： 10.21037/apm-22-655 　

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BACKGROUND: Cancer-related fatigue (CRF) is a highly distressing symptom in patients with cancer. Although various interventions have been reported to reduce fatigue, few are available for use in terminally ill cancer patients, and it is unknown which interventions are effective. They are also often difficult to implement in terminally ill patients with cancer. We, therefore, assessed the recommended interventions to reduce CRF in terminally ill cancer patients. METHODS: Four electronic databases were searched to identify studies published between January 2015 and March 2021. The inclusion criteria were terminally ill cancer patients; non-pharmacological interventions; studies in which usual care or control groups were compared, or comparisons were made prior to the post-intervention period; studies in which the primary outcome was fatigue scale or symptom scale (including those measuring fatigue on a subscale); and experimental study designs including randomised controlled trials (RCTs) and quasi-experimental studies. A summary of the data extracted from each study was created. We also conducted a meta-analysis of the RCTs. RESULTS: A total of 1,954 publications were identified from the initial database, eight of which were included in this study. Three RCTs and five non-RCTs were included in the final evaluation. Most of the studies had a small number of participants. We conducted a meta-analysis of two of the three RCTs included in this study. There was insufficient evidence to determine the effects of the interventions compared to the controls [standard mean difference, -0.05; 95% confidence interval (CI): -0.48 to 0.37; two studies; 290 participants; I2=65%]. CONCLUSIONS: Few reports exist on non-pharmacological interventions for patients with terminal cancer and there was insufficient evidence to determine the effect of the interventions on fatigue. This highlights the lack of RCTs on non-pharmacological procedures and therapies for reducing fatigue.
Complexity in the context of palliative care: a systematic review. International-journal

Hironori Ohinata, Maho Aoyama, Mitsunori Miyashita

Annals of palliative medicine　2022/09/30

DOI： 10.21037/apm-22-623 　

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BACKGROUND: People receiving palliative care have complex, wide-ranging, and changing needs, not just physical distress, but also psychosocial, practical, and spiritual. Influences on complexity in palliative care are different among healthcare providers and may depend on diverse aspects of the patient's condition, time, and environment. Therefore, this study aimed to integrate and describe the perspective of complexity in palliative care. METHODS: We used an integrative review, which is a method of compiling, summarizing, and analyzing existing insights from previous studies. We conducted an electronic literature search in MEDLINE (Ovid), PsycINFO (EBSCOhost), Web of Science Core Collection, and CINAHL (EBSCOhost), examining literature from May 1972 to September 2020 and updated in December 2020. Subsequently, synthesis without meta-analysis of the findings was completed. RESULTS: We identified 32 peer-reviewed articles published in English. The included literature mainly originated in Europe and the United States. The research methods included quantitative studies (n=13), qualitative studies (n=12), case studies (n=3), and reviews (n=4). We identified 29 that influenced complexity in palliative care, 25 perceptions of the patient, including background and physical, psychological, social, and spiritual; two perceptions in the healthcare setting; and two perceptions in the socio-cultural setting. Above all, the perceptions of complexity in palliative care included younger age, prognosis, and spirituality. In addition, we added the identified perceptions of complexity with references to the complexity model in palliative care. DISCUSSION: Although this review was limited in its search strategy and some data sources may have been overlooked, it still provided perceptions that influenced complexity in palliative care. These complex influencing perceptions are necessary for patients to receive appropriate palliative care at the right time and for health care providers to conduct a multi-disciplinary team approach. Furthermore, longitudinal prospective data are needed to examine the changes and relationships among complexity over time.
Availability of and factors related to interventional procedures for refractory pain in patients with cancer: a nationwide survey International-journal

Yuko Uehara, Yoshihisa Matsumoto, Toshifumi Kosugi, Miyuki Sone, Naoki Nakamura, Akio Mizushima, Mitsunori Miyashita, Tatsuya Morita, Takuhiro Yamaguchi, Eriko Satomi

BMC Palliative Care　21　(1)　166-166　2022/09/26

DOI： 10.1186/s12904-022-01056-6 　

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BACKGROUND: Cancer pain may be refractory to standard pharmacological treatment. Interventional procedures are important for quality of analgesia. The aim of the present study was to clarify the availability of four interventional procedures (celiac plexus neurolysis/splanchnic nerve neurolysis, phenol saddle block, epidural analgesia, and intrathecal analgesia), the number of procedures performed by specialists, and their associated factors. In addition, we aimed to establish how familiar home hospice physicians and oncologists are with the different interventional procedures available to manage cancer pain. METHODS: A cross-sectional survey using a self-administered questionnaire was conducted. Subjects were certified pain specialists, interventional radiologists, home hospice physicians, and clinical oncologists. RESULTS: The numbers of valid responses/mails were 545/1,112 for pain specialists, 554/1,087 for interventional radiology specialists, 144/308 for home hospice physicians, and 412/800 for oncologists. Among pain specialists, depending on intervention, 40.9-75.2% indicated that they perform each procedure by themselves, and 47.5-79.8% had not performed any of the procedures in the past 3 years. Pain specialists had performed the four procedures 4,591 times in the past 3 years. Among interventional radiology specialists, 18.1% indicated that they conduct celiac plexus neurolysis/splanchnic nerve neurolysis by themselves. Interventional radiology specialists had performed celiac plexus neurolysis/splanchnic nerve neurolysis 202 times in the past 3 years. Multivariate analysis revealed that the number of patients seen for cancer pain and the perceived difficulty in gaining experience correlated with the implementation of procedures among pain specialists. Among home hospice physicians and oncologists, depending on intervention, 3.5-27.1% responded that they were unfamiliar with each procedure. CONCLUSIONS: Although pain specialists responded that the implementation of each intervention was possible, the actual number of the interventions used was limited. As interventional procedures are well known, it is important to take measures to ensure that pain specialists and interventional radiology physicians are sufficiently utilized to manage refractory cancer pain.
Factors associated with good death of patients with advanced cancer: a prospective study in Japan. International-journal

Tomoo Ikari, Yusuke Hiratsuka, Shao-Yi Cheng, Mitsunori Miyashita, Tatsuya Morita, Masanori Mori, Yu Uneno, Koji Amano, Yuko Uehara, Takashi Yamaguchi, Isseki Maeda, Akira Inoue

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer　2022/09/20

DOI： 10.1007/s00520-022-07363-1 　

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PURPOSE: It is important for palliative care providers to identify what factors are associated with a "good death" for patients with advanced cancer. We aimed to identify factors associated with a "good death" evaluated by the Good Death Scale (GDS) score among inpatients with advanced cancer in palliative care units (PCUs) in Japan. METHODS: The study is a sub-analysis of a multicenter prospective cohort study conducted in Japan. All variables were recorded on a structured data collecting sheet designed for the study. We classified each patient into better GDS group or worse GDS group, and examined factors associated with better GDS using multivariate analysis. RESULTS: Between January and December 2017, 1896 patients were enrolled across 22 PCUs in Japan. Among them, a total of 1157 patients were evaluated. Five variables were significantly associated with a better GDS score in multivariate analysis: preferred place of death at PCU (odds ratio [OR] 2.85; 95% confidence interval [CI] 1.72-4.71; p < 0.01), longer survival time (OR 1.02; 95% CI 1.00-1.03; p < 0.01), not sudden death (OR 1.96; 95% CI 1.27-3.04; p < 0.01), better spiritual well-being in the last 3 days in life (OR 0.53; 95% CI 0.42-0.68; p < 0.01), and better communication between patient and family (OR 0.81; 95% CI 0.66-0.98; p = 0.03). CONCLUSIONS: We identified factors associated with a "good death" using GDS among advanced cancer patients in Japanese PCUs. Recognition of factors associated with GDS could help to improve the quality of end-of-life care.
Beliefs and Perceptions About Parenteral Nutrition and Hydration by Advanced Cancer Patients

Akiko Abe, Koji Amano, Tatsuya Morita, Tomofumi Miura, Naoharu Mori, Ryohei Tatara, Takaomi Kessoku, Yoshinobu Matsuda, Keita Tagami, Hiroyuki Otani, Masanori Mori, Tomohiko Taniyama, Nobuhisa Nakajima, Erika Nakanishi, Jun Kako, Daisuke Kiuchi, Hiroto Ishiki, Hiromichi Matsuoka, Eriko Satomi, Mitsunori Miyashita

Palliative Medicine Reports　3　(1)　132-139　2022/08/01
Publisher: Mary Ann Liebert Inc
DOI： 10.1089/pmr.2022.0009 　

eISSN： 2689-2820
緩和ケア病棟の遺族のCOVID-19による面会制限に対する思い日本ホスピス緩和ケア協会によるインターネット遺族調査

宮下光令, 笹原朋代, 安部奈津子, 橋本淳, 橋本孝太郎, 佐藤一樹, 關本翌子, 田上祐輔, 升川研人, 安保博文, 田村恵子, 志真泰夫

Palliative Care Research　17　(Suppl.)　S.203-S.203　2022/07
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
Nationwide survey on family caregiver-perceived experiences of patients with cancer of unknown primary site. International-journal

Kyoko Ishida, Kazuki Sato, Hirokazu Komatsu, Tatsuya Morita, Tatsuo Akechi, Megumi Uchida, Kento Masukawa, Naoko Igarashi, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita, Shoko Ando

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer　30　(7)　6353-6363　2022/07

DOI： 10.1007/s00520-022-07070-x 　

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PURPOSE: Cancer of unknown primary site (CUP) is an aggressive disease with poor prognosis. As research on the experiences of CUP patients and their families is scarce, this study aimed to compare the family caregiver-perceived burden of CUP with that of common cancers (lung, colon, and stomach cancers). The association between family caregiver-perceived burden and CUP patients' quality of life (QOL) at end-of-life and family depression, respectively, was also explored. METHODS: This was a pre-planned secondary analysis of nationwide cross-sectional survey data from the bereaved family caregivers of patients with cancer who died at 286 institutions. The major measurements were the eight-item family caregiver-perceived Burden scale (comprising specialist access, uncertainty, and prolonged diagnosis), Good Death Inventory, and Patient Health Questionnaire 9. RESULTS: Of 27,591 survey responses, we analyzed 97 and 717 responses from family caregivers of patients with CUP and common cancer, respectively. The families of CUP patients scored significantly higher on all three burden subscales than those of common cancer patients (effect sizes: specialist access subscale, 0.3; uncertainty subscale, 0.66; and prolonged diagnosis subscale, 0.69; adjusted P < 0.01). Greater family burden was significantly associated with lower patient QOL and higher family depression. Burden was significantly associated with being a spouse, second opinion consultation, and diagnosis period of > 1 month. CONCLUSION: The family caregivers of CUP patients experience poor specialist access, greater uncertainty, and a prolonged diagnosis. They should be cared for from the initial stages to establish access to specialists, obtain an early diagnosis, and reduce uncertainty.
Machine learning models to detect social distress, spiritual pain, and severe physical psychological symptoms in terminally ill patients with cancer from unstructured text data in electronic medical records. International-journal

Kento Masukawa, Maho Aoyama, Shinichiroh Yokota, Jyunya Nakamura, Ryoka Ishida, Masaharu Nakayama, Mitsunori Miyashita

Palliative medicine　2692163221105595-2692163221105595　2022/06/30

DOI： 10.1177/02692163221105595 　

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BACKGROUND: Few studies have developed automatic systems for identifying social distress, spiritual pain, and severe physical and phycological symptoms from text data in electronic medical records. AIM: To develop models to detect social distress, spiritual pain, and severe physical and psychological symptoms in terminally ill patients with cancer from unstructured text data contained in electronic medical records. DESIGN: A retrospective study of 1,554,736 narrative clinical records was analyzed 1 month before patients died. Supervised machine learning models were trained to detect comprehensive symptoms, and the performance of the models was tested using the area under the receiver operating characteristic curve (AUROC) and precision recall curve (AUPRC). SETTING/PARTICIPANTS: A total of 808 patients was included in the study using records obtained from a university hospital in Japan between January 1, 2018 and December 31, 2019. As training data, we used medical records labeled for detecting social distress (n = 10,000) and spiritual pain (n = 10,000), and records that could be combined with the Support Team Assessment Schedule (based on date) for detecting severe physical/psychological symptoms (n = 5409). RESULTS: Machine learning models for detecting social distress had AUROC and AUPRC values of 0.98 and 0.61, respectively; values for spiritual pain, were 0.90 and 0.58, respectively. The machine learning models accurately identified severe symptoms (pain, dyspnea, nausea, insomnia, and anxiety) with a high level of discrimination (AUROC > 0.8). CONCLUSION: The machine learning models could detect social distress, spiritual pain, and severe symptoms in terminally ill patients with cancer from text data contained in electronic medical records.
Cross-cultural conceptualization of a good end of life with dementia: A qualitative study Peer-reviewed

Mayumi Nishimura, Karen Harrison Dening, Elizabeth L. Sampson, Edison Iglesias de, Oliveira Vidal, Wilson Correia de Abreu, Sharon Kaasalainen, Yvonne Eisenmann, Laura Dempsey, Kirsten J. Moore, Nathan Davies, Sascha R. Bolt, Judith M.M. Meijers, Natashe Lemos Dekker, Mitsunori Miyashita, Miharu Nakanishi, Takeo Nakayama, Jenny T. van, der Steen

BMC Palliative Care　21　(1)　106　2022/06/08

DOI： 10.1186/s12904-022-00982-9 　
The impact of cachexia on dietary intakes, symptoms, and quality of life in advanced cancer

Koji Amano, Vickie E. Baracos, Tatsuya Morita, Tomofumi Miura, Naoharu Mori, Ryohei Tatara, Takaomi Kessoku, Akihiro Tokoro, Keita Tagami, Hiroyuki Otani, Masanori Mori, Tomohiko Taniyama, Nobuhisa Nakajima, Erika Nakanishi, Jun Kako, Daisuke Kiuchi, Hiroto Ishiki, Hiromichi Matsuoka, Eriko Satomi, Mitsunori Miyashita

JCSM Rapid Communications　2022/05/09
Publisher: Wiley
DOI： 10.1002/rco2.61 　

ISSN： 2617-1619

eISSN： 2617-1619
Long-term care nurses' perceptions of a good death for people with dementia: A qualitative descriptive study. International-journal

Katsumi Nasu, Hiroki Fukahori, Mitsunori Miyashita

International journal of older people nursing　17　(3)　e12443　2022/05

DOI： 10.1111/opn.12443 　

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INTRODUCTION: The number of people with dementia (PwD) dying in long-term care (LTC) settings is expected to increase. However, effective care strategies to promote a good death for PwD remain unclear. This study aimed to explore nurses' perceptions of a good death for PwD in LTC settings for older adults. METHODS: Interviews were conducted with 19 nurses providing end-of-life care in LTC settings for older adults in Japan. The transcribed texts were analysed using inductive content analysis. RESULTS: We identified two themes: (1) ambiguity and (2) preparedness. Participants perceived that there was ambiguity regarding a good death for PwD and emphasised the need for preparedness of those around PwD for a good death. Five categories represented preparedness: (a) reaffirming the original personality before dementia; (b) respecting that PwD change; (c) interpreting and fulfilling obscure desires, feelings, and sensations; (d) providing care consistent with an agreed-upon natural death process; and (e) maintaining relationships. CONCLUSION: Long-term care nurses should encourage families and multidisciplinary team members, including the nurses themselves, to prepare for a good death of the PwD. Future research should focus on healthcare professionals' perspectives on advance care planning in the early stages of dementia, as well as the perceptions of PwD, their family members and other healthcare professionals regarding the natural death process.
Comparison of the quality of death between primary malignant brain tumor patients and other cancer patients: results from a nationwide bereavement survey in Japan. International-journal

Maho Aoyama, Kento Masukawa, Ikuko Sugiyama, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

Journal of neuro-oncology　158　(1)　89-97　2022/05

DOI： 10.1007/s11060-022-04013-8 　

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PURPOSE: No studies have investigated the association between malignant brain tumor and the quality of dying, which is an important outcome in end-of-life care. This study aimed to clarify whether the quality of dying and related factors in patients with malignant brain tumor differ from those in patients with other malignant diseases. METHODS: This was a secondary analysis of data collected by two nationwide, multicenter, bereavement surveys of palliative care units in Japan. This analysis included 14,171 bereaved family members (160 patients with malignant brain tumors). The quality of dying was examined using the good death inventory (GDI), a validated tool widely used in palliative care settings. RESULTS: Patients with malignant brain tumors were younger (p < 0.0001) and had a longer palliative care unit stay during their end-of-life (p < 0.0001) than others. The total GDI score was significantly lower in patients with malignant brain tumors than others (p < 0.0001). Five GDI items were significantly lower in the malignant brain tumor group than other cancer group: "Being able to stay in one's favorite place" (p = 0.03); "Trusting the physician" (p = 0.003); "Not being a burden to others" (p = 0.01); "Being independent in daily activities" (p = 0.01); and "Feeling that one's life is worth living" (p = 0.001). CONCLUSION: This study showed that the quality of dying of patients with malignant brain tumors was lower compared to other cancers, suggesting the need to review care for patients with malignant brain tumors based on their characteristics.
Experience of the temporary discharge from the inpatient palliative care unit: A nationwide post-bereavement survey for end-of-life cancer patients. International-journal

Go Sekimoto, Sakiko Aso, Naoko Hayashi, Keiko Tamura, Chieko Yamamoto, Maho Aoyama, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

Asia-Pacific journal of oncology nursing　9　(5)　100058-100058　2022/05

DOI： 10.1016/j.apjon.2022.03.010 　

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Objective: Inpatient palliative care units (PCUs) have two roles: place of death and symptom control. In case of symptom control, most patients whose distressing symptoms could be relieved would be temporarily discharged back home. However, the experience of the patient and their family during temporary discharge is unclear. Methods: This study is a part of the Japan HOspice and Palliative Care Evaluation Study 3, a nationwide cross-sectional post-bereavement survey. We sent questionnaires to bereaved relatives of cancer patients who died in PCUs in 2018. Results: Among 968 questionnaires sent, 571 questionnaires were analyzed (59%). Sixteen percent of patients experienced temporary discharge from PCUs. Seventy-two percent of bereaved family members reported that patients said "I am happy to be discharged home." Overall, 22%-37% of participants reported improvement in the patient's condition after discharge. The caregiver's recognition of better patient's quality of life at home and the doctor's assurance of re-hospitalization, if necessary, were significantly associated with positive experience. Conclusions: Bereaved family members recognized temporal discharge as positive experiences for patients and families. Appropriate home palliative care and discharge planning would contribute to positive experience after discharge.
Family experience of palliative sedation therapy: proportional vs. continuous deep sedation. International-journal

Kengo Imai, Tatsuya Morita, Masanori Mori, Naosuke Yokomichi, Toshihiro Yamauchi, Satoru Miwa, Satoshi Inoue, Akemi Shirado Naito, Kento Masukawa, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Hiroyuki Otani, Mitsunori Miyashita

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer　30　(5)　3903-3915　2022/05

DOI： 10.1007/s00520-021-06745-1 　

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PURPOSE: Some patients experience intense symptoms refractory to intensive palliative care, and palliative sedation is sometimes used. Palliative sedation may be classified into proportional and continuous deep sedation (CDS). The primary aim of this study was to compare family experience between families of patients who received proportional or CDS. METHODS: A multicenter questionnaire survey was conducted involving bereaved families of cancer patients who received proportional or CDS based on a sedation protocol. Overall evaluation of sedation (satisfaction, family-perceived distress, appropriateness of timing, and patient distress) and 13-item family concerns, good death, satisfaction with care, depression, quality of care, unfinished business, and balance between symptom relief and maintaining communication were measured. RESULTS: Among the 2120 patients who died, 222 patients received a continuous infusion of midazolam. A sedation protocol was used in 147 patients, and questionnaires were sent to 124 families. A total of 78 responses were finally returned (proportional, 58 vs. CDS, 20). There were no significant differences in the overall evaluation, family concerns, total score of good death, satisfaction, depression, or balance between symptom relief and maintaining communication. On the other hand, some quality of care items, i.e., relationship with medical staff (P < 0.01), physical care by nurses (P = 0.04), and coordination and consistency (P = 0.04), were significantly better in the CDS group than in the proportional sedation group. Family-reported unfinished business was also better in the CDS group, with marginal significance. CONCLUSIONS: Family experience of CDS was not less favorable than proportional sedation, and actually rated more favorably for some elements of quality of care and unfinished business.
The impact of death rattle on bereaved families: not the sound itself, but the resonance with their feelings. International-journal

Takashi Yamaguchi, Masanori Mori, Isseki Maeda, Ryo Matsunuma, Yukako Tanaka-Yagi, Tomohiro Nishi, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Kento Masukawa, Mitsunori Miyashita

Japanese journal of clinical oncology　52　(7)　774-778　2022/04/22

DOI： 10.1093/jjco/hyac055 　

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BACKGROUND: This study aimed to explore (i) the consistency between physician-rated and bereaved family-perceived intensity of death rattle, (ii) the relationship between intensity of death rattle and the bereaved family's distress and (iii) the bereaved family's experience and feelings related to suctioning for death rattle. METHODS: We used matched data for deceased patients from a prospective cohort study of cancer patients admitted to a palliative care unit, and their bereaved families from a nationwide questionnaire survey in Japan. The intensity of death rattle using Back's score was evaluated prospectively by physicians and retrospectively by bereaved families. RESULTS: In total, 1122 bereaved families answered (response rate: 66.7%). Of these, 297 reported the development of death rattle. The maximum intensity of death rattle evaluated by physicians and perceived by bereaved families was poorly correlated (Spearman correlation coefficient 0.188, P = 0.082). The optimal cut-off point of Back's score for detecting high-level distress was 1/2, with a low accuracy of prediction (area under the curve 0.62). More than 70% of bereaved families indicated suctioning reduced the intensity of death rattle, made patients comfortable and themselves relieved, whereas a similar proportion felt patients were in distress during suctioning. Families who felt suctioning was gently performed and discussed well whether to do suctioning with health care providers felt less needs for improvement. CONCLUSIONS: Bereaved family-perceived intensity of death rattle did not correlate to physician-evaluated intensity, and the intensity of death rattle itself seemed to poorly correlate to family distress. Gently performed suctioning based on sufficient discussion with families can help reduce family-perceived patient discomfort.
Caregiver experience with decision-making difficulties in end-of-life care for patients with cardiovascular diseases. International-journal

Keitaro Shinada, Takashi Kohno, Keiichi Fukuda, Michiaki Higashitani, Naoto Kawamatsu, Takeshi Kitai, Tatsuhiro Shibata, Makoto Takei, Kotaro Nochioka, Gaku Nakazawa, Hiroki Shiomi, Mitsunori Miyashita, Atsushi Mizuno

Journal of cardiology　79　(4)　537-544　2022/04

DOI： 10.1016/j.jjcc.2021.11.001 　

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BACKGROUND: The decisional burden on caregivers in the end-of-life (EOL) care for patients with cardiovascular diseases (CVD) is unknown. We aimed to evaluate the frequency and circumstances of caregiver difficulties in decision-making during EOL care for CVD patients, its determinants, and associations with psychological distress in the bereaved caregivers. METHODS: We conducted a cross-sectional survey using a questionnaire for bereaved caregivers of CVD patients who had died in 10 tertiary care centers. We assessed their overall and situation-specific decision-making difficulties during EOL care. The questionnaire also covered the attitudes of patients, caregivers, and attending physicians during EOL care and the respondents' depression (Patient Health Questionnaire-9) and grief status (Brief Grief Questionnaire). RESULTS: We enrolled 266 bereaved caregivers [median age, 65 (57-72) years; 38.4% male] of CVD patients. Overall, 28.9% of them experienced difficulties in decision-making. The most difficult decision-making situations involved informing the patient of the prognosis (18.2%), life-prolonging treatment (17.9%), and discontinuation of hydration and artificial nutrition (15.6%). Difficulties were associated with patient and/or caregiver factors (poor understanding of disease status and the patient's wishes, caregiver's emotional inability), physician factors (poor understanding of the patient's and/or caregiver's values, inadequate support for decision-making), and both (insufficient communication, conflict of opinions and wishes). Decision-making difficulties were associated with subsequent depression (20.5% vs. 10.3%, p=0.029) and complicated grief (27.0% vs. 9.0%, p<0.001) among bereaved caregivers. CONCLUSIONS: Approximately 30% of bereaved caregivers experienced decisional burdens during EOL care of CVD patients. The caregiver's decisional burdens were associated with subsequent psychological distress.
肺がんによる死別が遺族に与える肯定的影響について

嶋田和貴, 恒藤暁, 坂口幸弘, 森田達也, 木澤義之, 志真泰夫, 升川研人, 宮下光令

日本呼吸器学会誌　11　(増刊)　214-214　2022/04
Publisher: (一社)日本呼吸器学会
ISSN： 2186-5876

eISSN： 2186-5884
Development and Validation of the Death Pronouncement Burden Scale for Oncology Practice

Yusuke Hiratsuka, Mitsunori Miyashita, Yu Uneno, Kiyohumi Oya, Soichiro Okamoto, Takaomi Kessoku, Hironori Mawatari, Shunsuke Oyamada, Junko Nozato, Keita Tagami, Akira Inoue

Palliative Medicine Reports　3　(1)　39-46　2022/04/01
Publisher: Mary Ann Liebert Inc
DOI： 10.1089/pmr.2021.0082 　

eISSN： 2689-2820
Current status of palliative care delivery and self-reported practice in ICUs in Japan: a nationwide cross-sectional survey of physician directors. International-journal

Yuko Igarashi, Yuta Tanaka, Kaori Ito, Mitsunori Miyashita, Satomi Kinoshita, Akane Kato, Yoshiyuki Kizawa

Journal of intensive care　10　(1)　18-18　2022/03/18

DOI： 10.1186/s40560-022-00605-8 　

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BACKGROUND: It is currently unknown how widespread is the practice of palliative care in intensive care units (ICUs) in Japan. This study aimed to determine evaluate the delivery and self-reported practice of palliative care in ICUs in Japan. METHODS: A self-administered questionnaire was sent to the physician directors of all 873 ICUs in Japan in August 2020. RESULTS: Of the 873 institutions, 439 responded the questionnaire (response rate: 50%) and 413 responses were included in the analysis. The responding physicians thought palliative care was appropriate for physical symptoms (36%, 95% Confidence Interval [CI] 32-41), the provision of information (32%, 95% CI: 28-37), psychological distress (25%, 95% CI: 21-29) and in Post Intensive Care Syndrome (PICS) prevention (20%, 95% CI: 17-24). Only 4% (95% CI: 2-6) of participants indicated that they always provided palliative care screening for the patients admitted to the ICU. The most common method to determine eligibility for palliative care was the "prediction of prognosis by clinician's experience" (54%, 95% CI: 50-59). Thirty-one percent (95% CI: 27-36) of participants responded that there was no clear method used to decide which patients need palliative care. Fifty-four percent of the participants answered they had no standardized protocols for symptom management at all. Less than 5% answered they had standardized protocols for end-of-life symptom management or terminal weaning off mechanical ventilation including extubation of endotracheal tubes. CONCLUSIONS: In Japan, the dissemination of palliative care and its integration into ICU care appears insufficient. To improve the quality of life of patients who are admitted to ICU, it may be useful to implement palliative care screening and multidisciplinary conferences, to develop standardized protocols for symptom management and withholding or withdrawing of life-sustaining treatment, and to educate primary palliative care for all ICU physicians.
Association between experiences of advanced cancer patients at the end of life and depression in their bereaved caregivers. International-journal

Yutaka Hatano, Tatsuya Morita, Masanori Mori, Maho Aoyama, Saran Yoshida, Koji Amano, Toru Terabayashi, Kiyofumi Oya, Hiroaki Tsukuura, Yusuke Hiratsuka, Isseki Maeda, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Kento Masukawa, Mitsunori Miyashita

Psycho-oncology　31　(7)　1243-1252　2022/03/07

DOI： 10.1002/pon.5915 　

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OBJECTIVE: Research on the association between circumstances of death in advanced cancer patients and depression in their bereaved caregivers is limited. METHODS: A longitudinal study was performed on patients admitted to 21 inpatient hospices/palliative care units (PCUs) in Japan. Patient symptoms were assessed at admission and in the last 3 days of life. Data on distressing events (unexpected death, bleeding) and received treatments (morphine prescriptions, continuous deep sedation, cardiopulmonary resuscitation) were also obtained. Bereaved caregiver depression was assessed 6 months or more after patient death via mail survey using the Patient Health Questionnaire-9 (PHQ-9). A multivariable logistic regression analysis was used to explore variables predicting bereaved caregiver depression. RESULTS: Of 1324 deceased patient-bereaved caregiver dyads, data were finally analyzed for 711 dyads. The proportion of probable depression (PHQ-9 scores ≥10) in bereaved caregivers was 13.6% (91/671; 95% confidence interval: 11.0-16.2). The multivariable logistic regression analysis showed that patient hyperactive delirium at PCU admission was significantly associated with the development of bereaved caregiver depression (odds ratio: 2.2, 95% CI: 1.2-3.8). Bereaved caregiver perceived low social support (OR: 4.7, 95% CI: 2.2-10.0) and low preparedness for death (OR: 4.5, 95% CI: 2.6-7.8) were also significantly associated with the development of depression. Other patient and bereaved caregiver variables had no association with depression. CONCLUSIONS: Hyperactive delirium in terminally ill cancer patients was associated with bereaved caregiver depression. The development of effective strategies to reduce delirium-related agitation and to provide educational interventions for caregivers may be needed.
Developing an Instrument to Assess the Readiness for Advance Care Planning. International-journal

Shima Sakai, Hiroko Nagae, Mitsunori Miyashita, Nozomi Harasawa, Takako Iwasaki, Yoko Katayama, Sayaka Takenouchi, Mari Ikeda, Mari Ito, Keiko Tamura

Journal of pain and symptom management　63　(3)　374-386　2022/03

DOI： 10.1016/j.jpainsymman.2021.10.009 　

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CONTEXT: In recent times, advance care planning for patients' end-of-life care preferences has attracted much attention worldwide. OBJECTIVES: To develop the Readiness for Advance Care Planning (RACP) Scale. METHODS: Participants included 624 Japanese citizens who were registered with a web-based survey company as of February 2019. Items regarding the process of advance care planning (ACP) were developed based on a literature review and expert panel discussions. The expert panel included nine experts and practitioners in the field of end-of-life care. Construct validity, concurrent validity, internal consistency, and test-retest reliability were evaluated. RESULTS: Initially, 37 items were collected. Examination of the floor effect, item-total, good-poor analysis, and exploratory factor analysis yielded a five-factor model with 28 items. The goodness of fit of the model was GFI = 0.80, CFI = 0.91, and RMSEA = 0.08. The concurrent validity was statistically significant (rs = 0.26-0.45, ps < 0.001). Cronbach's alpha for the overall scale was 0.95. The corresponding values for the subscales ranged from 0.90 to 0.97. The intraclass correlation coefficients indicating test-retest reliability was 0.66 (P < 0.001) for the total scale and ranged from 0.52-0.65 for the five subscales. CONCLUSIONS: The validity and reliability of the scale were generally acceptable. The RACP is an appropriate instrument to evaluate the level of readiness for ACP behaviors among people of various generations at every health stage. More studies are needed to examine the clinical utility of the RACP, both nationally and internationally.
Attitudes of Physicians toward Palliative Care in Intensive Care Units: A Nationwide Cross-Sectional Survey in Japan. International-journal

Yuta Tanaka, Akane Kato, Kaori Ito, Yuko Igarashi, Satomi Kinoshita, Yoshiyuki Kizawa, Mitsunori Miyashita

Journal of pain and symptom management　63　(3)　440-448　2022/03

DOI： 10.1016/j.jpainsymman.2021.09.015 　

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CONTEXT: Palliative care is an essential component of comprehensive care for patients with critical illnesses. In Japan, little is known about palliative care in intensive care units (ICUs), and palliative care approaches are not widespread. OBJECTIVE: This study aimed to better understand the attitudes of physicians toward palliative care and the utilization and needs of specialized palliative care consultations in ICUs in Japan. METHODS: A nationwide, self-administered questionnaire was distributed ICU physician directors in all hospitals with ICUs. RESULTS: Questionnaires were distributed to 873 ICU physician directors; valid responses were received from 436 ICU physician director (50% response rate). Among the respondents, 94% (n = 411) felt that primary palliative care should be strengthened in ICUs; 89% (n = 386) wanted ICU physicians to collaborate with specialists, such as palliative care teams (PCTs); and 71% (n = 311) indicated the need for specialized palliative care consultations; however, only 38% (n = 166) actually consulted, and only 6% (n = 28) consulted more than 10 patients in the past year. Physicians most commonly consulted PCT for patients with serious end-of-life illness (24%) (n = 107), intractable pain (21%) (n = 92), and providing psychological support to family members (43%, n = 187). The potential barriers in providing primary and specialized palliative care included being unable to understand the patients' intentions (54%, n = 235), lack of knowledge and skills in palliative care (53%, n = 230), and inability to consult with PCTs in a timely manner (46%, n = 201). CONCLUSIONS: These data suggest a need for primary palliative care education in ICUs and improved access to specialized palliative care consultations.
Association between temporary discharge from the inpatient palliative care unit and achievement of good death in end-of-life cancer patients: A nationwide survey of bereaved family members.

Sakiko Aso, Naoko Hayashi, Go Sekimoto, Naoko Nakayama, Keiko Tamura, Chieko Yamamoto, Maho Aoyama, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

Japan journal of nursing science : JJNS　19　(3)　e12474　2022/02/17

DOI： 10.1111/jjns.12474 　

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AIM: To explore the unclear association between temporary discharge home from the palliative care unit and achievement of good death, in the background of increases in discharge from the palliative care unit. Association between experiences and circumstances of patient and family and duration of temporary discharge was also examined. METHODS: This study was a secondary analysis of data from a nationwide post-bereavement survey. RESULTS: Among 571 patients, 16% experienced temporary discharge home from the palliative care unit. The total good death inventory score (p < .05) and sum of 10 core attributes (p < .05) were significantly higher in the temporarily discharged and stayed home ≥2 weeks group. Among all attributes, "Independent in daily activities" (p < .001) was significantly better in the temporarily discharged and stayed home ≥2 weeks group. Regarding the experience and circumstance of patient and family, improvement of patient's appetite (p < .05), and sleep (p < .05) and peacefulness (p < .05) of family caregivers, compared to the patient being hospitalized, were associated with longer stay at home after discharge. CONCLUSIONS: Patient's achievement of good death was better in the temporarily discharged and stayed home longer group, but this seemed to be affected by high levels of independence of the patient. Temporary discharge from the palliative care unit and staying home longer was associated with improvement of appetite of patients and better sleep and mental health status of family caregivers. Discharging home from palliative care unit is worth being considered even if it is temporary.
Are family relationships associated with family conflict in advanced cancer patients? International-journal

Jun Hamano, Kento Masukawa, Satoru Tsuneto, Yasuo Shima, Tatsuya Morita, Yoshiyuki Kizawa, Mitsunori Miyashita

Psycho-oncology　31　(2)　260-270　2022/02

DOI： 10.1002/pon.5801 　

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OBJECTIVES: Family conflict during end-of-life care is an important issue for advanced cancer patients and their families, although studies are lacking. We investigated the association between family relationships and family conflict in advanced cancer patients. METHODS: This study was a secondary analysis of a nationwide multicenter questionnaire survey targeting the bereaved family members of cancer patients who died in palliative care units, general wards, or at home to evaluate the quality of end-of-life care in Japan. RESULTS: A total of 1084 questionnaires (63.0%) were returned and we analyzed a total of 908 responses. In total, 38.0% of family members reported at least one family conflict during end-of-life care, and the most frequent family conflict was "about certain family members not pulling their weight" (23.5%). Multivariate linear analysis revealed family members who asserted their opinions (p < 0.001), family assessment device score (p < 0.001), worries about family finances during cancer treatment (p < 0.001), family members contacted after illness were helpful (p = 0.003), female patients (p = 0.03), and family with family relationship index ≤7 (p = 0.04) were positively associated with the outcome-family conflict (OFC) score. Proxy decision maker was selected by the patient (p = 0.003), people listened to families' worries or problems (p = 0.003), physician gave sufficient explanation (p = 0.003), living will before their illness (p = 0.038) and female bereaved family members (p = 0.046) were negatively associated with the OFC score. CONCLUSIONS: It may be important for health care providers to actively assess the possibility of family conflicts according to family relationships, such as a proxy decision maker having been selected by the patient.
The Farewell Prayer Gathering Held by the Chaplain after a Patients’ Death in Our Inpatient Hospice at the Japan Baptist Hospital: An Evaluation by Bereaved Families Using a Questionnaire Survey

Miyagawa Yumiko, Ito Satoko, Masukawa Kento, Miyashita Mitsunori, Yamagiwa Tetsuya

Palliative Care Research　17　(2)　59-64　2022
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.17.59 　

eISSN： 1880-5302

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Purpose: Our purpose is to report an actual performance of our farewell prayer gathering held by the chaplain in our inpatient hospice at the Japan Baptist Hospital, and to describe what impressions and thoughts the bereaved families had about our farewell prayer gathering. Method: The questionnaires were sent to 84 patients’ families asking about our farewell prayer gathering. We analyzed the content of their comments. Results: Among the 40 families that responded, 15 families experienced our farewell prayer gathering. The words such as “prayer” and “participation of the staff” were mentioned as the favored experiences. The bereaved families felt “an emotional closure”, “peace of mind”, and “healing of mind and body”. They also found the gathering as “an opportunity to look back” and “special memorable moment”. Discussion: Our farewell prayer gathering is likely to be helpful for the bereaved to give peace to their mind and to reduce feelings of loss. By sharing the voices of bereaved families, it will be helpful for the betterment of grief care to future bereaved families in hospice care. We would like to see further research in the future.
認知症患者の終末期における積極的治療の選好とその関連要因の探索遺族・医師・看護師・介護職を対象にしたインターネット・アンケート

林ゑり子, 高橋明里, 青山真帆, 升川研人, 宮下光令

Palliative Care Research　17　(3)　109-118　2022
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
Bathing in Terminal Care of Cancer Patients and Its Relation to Perceptions of a "Good Death": A Nationwide Bereavement Survey in Japan. International-journal

Eriko Hayashi, Maho Aoyama, Kento Masukawa, Mitsunori Miyashita, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima

Palliative medicine reports　3　(1)　55-64　2022

DOI： 10.1089/pmr.2021.0075 　

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Background: Bathing in a tub is integral to Japanese culture. It improves palliative care patients' symptoms and may improve quality of life. Objectives: This study aimed to determine the prevalence and impressions of bathing for terminally ill cancer patients and its relations to the evaluations of perceived end-of-life care and achievement of a good death. Design: This was a cross-sectional, anonymous, self-report questionnaire survey. Setting/Subjects: The questionnaire for this study was sent to bereaved family members who had lost loved ones in 14 general hospitals and 187 palliative care wards in Japan. Measurements: The bereaved family members of the patients who had actually bathed were asked about their impression of bathing. The short version of the Good Death Inventory (GDI) and the Care Evaluation Scale were used to evaluate "achievement of a good death." In total, 1819 surveys were sent between July and September 2018 to bereaved family members of patients who had died between February 2014 and January 2018 in 14 general hospitals and 187 palliative care wards in Japan. Overall 885 questionnaires (valid response rate 48%) returned by bereaved family members were analyzed. Results: Overall, 85% of bereaved family members of patients who bathed evaluated the experience positively, 86% reported that the patient's face seemed to become calm after the bath, and 28% of bereaved family members whose loved one had not bathed reported regretting it. The total GDI score for the bereaved family's desired death was 82.7 ± 13.0 for the bathing group and 75.4 ± 15.7 for the no bathing group, a significant difference (effect size = 0.52, p < 0.01). Conclusions: Bathing before death was evaluated positively and was associated with the achievement of a good death.
Factors related to specialized palliative care use and aggressive care at end of life in Japanese patients with advanced solid cancers: a cohort study. International-journal

Yusuke Hiratsuka, Takayuki Oishi, Mitsunori Miyashita, Tatsuya Morita, Jennifer W Mack, Yuko Sato, Masahiro Takahashi, Keigo Komine, Ken Saijo, Chikashi Ishioka, Akira Inoue

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer　29　(12)　7805-7813　2021/12

DOI： 10.1007/s00520-021-06364-w 　

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PURPOSE: This study aimed to (1) describe characteristics of aggressive care at the end of life (EOL) and (2) identify factors associated with specialized palliative care use (SPC) and aggressive care at the EOL among Japanese patients with advanced cancer. METHODS: This single-center, follow-up cohort study involved patients with advanced cancer who received chemotherapy at Tohoku University Hospital. Patients were surveyed at enrollment, and we followed clinical events for 5 years from enrollment in the study. We performed multivariate logistic regression analysis to identify independent factors related to SPC use and chemotherapy in the last month before death. RESULTS: We analyzed a total of 135 patients enrolled between January 2015 and January 2016. No patients were admitted to the intensive care unit, and few received resuscitation or ventilation. We identified no factors significantly associated with SPC use. Meanwhile, younger age (20-59 years, odds ratio [OR] 4.10; 95% confidence interval [CI] 1.30-12.91; p = 0.02) and no receipt of SPC (OR 4.32; 95% CI 1.07-17.37; p = 0.04) were associated with chemotherapy in the last month before death. CONCLUSION: Younger age and a lack of SPC were associated with chemotherapy at the EOL in patients with advanced cancer in Japan. These findings suggest that Japanese patients with advanced cancer may benefit from access to SPC.
ICU・救命センターにおける治療・ケアの目標についての話し合いの実施状況全国アンケート調査結果から

伊藤香, 五十嵐祐子, 木澤義之, 宮下光令

日本救急医学会雑誌　32　(12)　1630-1630　2021/11
Publisher: (一社)日本救急医学会
ISSN： 0915-924X

eISSN： 1883-3772
The degree of coincidence between medical staffs and bereaved families regarding the presence or absence of terminal delirium, and its related factors

Megumi Uchida, Tasuo Akechi, Tatsuya Morita, Kento Masukawa, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Masaki Mori, Mitsunori Miyashita

ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY　17　197-198　2021/11

ISSN： 1743-7555

eISSN： 1743-7563
Depression and complicated grief in bereaved caregivers in cardiovascular diseases: prevalence and determinants. International-journal

Keitaro Shinada, Takashi Kohno, Keiichi Fukuda, Michiaki Higashitani, Naoto Kawamatsu, Takeshi Kitai, Tatsuhiro Shibata, Makoto Takei, Kotaro Nochioka, Gaku Nakazawa, Hiroki Shiomi, Mitsunori Miyashita, Atsushi Mizuno

BMJ supportive & palliative care　2021/10/22

DOI： 10.1136/bmjspcare-2021-002998 　

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OBJECTIVES: Despite the recommendation that patients with cardiovascular disease (CVD) receive bereavement care, few studies have examined the psychological disturbances in bereaved caregivers. We examined the prevalence and determinants of depression and complicated grief among bereaved caregivers of patients with CVD. METHODS: We conducted a cross-sectional survey using a self-administered questionnaire for bereaved caregivers of patients with CVD who had died in the cardiology departments of nine Japanese tertiary care centres. We assessed caregiver depression and grief using the Patient Health Questionnaire-9 (PHQ-9) and Brief Grief Questionnaire (BGQ), respectively. The questionnaire also covered caregivers' perspectives toward end-of-life care and the quality of the deceased patient's death. RESULTS: A total of 269 bereaved caregivers (mean age: 66 (57-73) years; 37.5% male) of patients with CVD were enrolled. Overall, 13.4% of the bereaved caregivers had depression (PHQ-9 ≥10) and 14.1% had complicated grief (BGQ ≥8). Depression and complicated grief's determinants were similar (ie, spousal relationship, unpreparedness for the death, financial and decision-making burden and poor communication among medical staff). Patients and caregivers' positive attitudes toward life-prolonging treatment were associated with complicated grief. Notably, in caregivers with complicated grief, there was less discussion with physicians about end-of-life care. Caregivers who felt that the patients did not receive sufficient treatment suffered more frequently from depression and complicated grief. CONCLUSIONS: Approximately 15% of bereaved caregivers of patients with CVD suffered from depression and complicated grief. Cardiologists should pay particular attention to caregivers with high-risk factors to identify those likely to develop depression or complicated grief.
Care Associated With Satisfaction of Bereaved Family Members of Terminally Ill Cancer Patients With Dyspnea: A Cross-sectional Nationwide Survey. International-journal

Sena Yamamoto, Harue Arao, Miwa Aoki, Masanori Mori, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Kento Masukawa, Mitsunori Miyashita

Journal of pain and symptom management　62　(4)　796-804　2021/10

DOI： 10.1016/j.jpainsymman.2021.03.023 　

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CONTEXT: Terminal dyspnea in dying cancer patients is frequent and distressing, and the impact extends to their families. Families are often involved in providing care for terminal dyspnea. OBJECTIVES: This study aimed to describe various care strategies for terminal dyspnea in cancer patients hospitalized in palliative care units (PCUs), evaluate families' satisfaction with care for terminal dyspnea, and explore determinants contributing to families' satisfaction. METHODS: A nationwide, cross-sectional survey was conducted using a self-reported questionnaire among bereaved families of cancer patients who died in PCUs. The questionnaire consisted of questions on the perceptions of care offered to patients with terminal dyspnea and their families, satisfaction with care for terminal dyspnea, family-perceived intensity of terminal dyspnea, use of oxygen, and background data of patients and families. RESULTS: In total, 533 participants (response rate = 54%) returned the completed questionnaires, and 231 reported that their loved one had experienced terminal dyspnea. Dedicated and compassionate care was perceived by 60%-89% of the participants as the strategy provided for patients. Care for family members was perceived by 58%-69% of the participants. Perception of dedicated and compassionate care for patients and that of care for family members were significantly associated with high satisfaction (odds ratio, 95% confidence interval: 8.64, 3.85-19.36 and 15.37, 5.00-47.25, respectively). CONCLUSION: Dedicated and compassionate care may be the essential part of the care for terminal dyspnea. Dedicated and compassionate care for patients and care for family members have a potential of improving the care satisfaction among family caregivers.
Effects of Bathing in a Tub on Physical and Psychological Symptoms of End-of-Life Cancer Patients

Eriko Hayashi, Maho Aoyama, Fumiyasu Fukano, Junko Takano, Yoichi Shimizu, Mitsunori Miyashita

Journal of Hospice & Palliative Nursing　Publish Ahead of Print　2021/09/20
Publisher: Ovid Technologies (Wolters Kluwer Health)
DOI： 10.1097/njh.0000000000000803 　

ISSN： 1522-2179
Care needs level in long-term care insurance system and family caregivers’ self-perceived time-dependent burden in patients with home palliative care for cancer: a cross-sectional study

Naoko Otsuki, Ryohei Yamamoto, Yukihiro Sakaguchi, Kento Masukawa, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Sakiko Fukui, Mitsunori Miyashita

Supportive Care in Cancer　30　(2)　1587-1596　2021/09/20
Publisher: Springer Science and Business Media LLC
DOI： 10.1007/s00520-021-06579-x 　

ISSN： 0941-4355

eISSN： 1433-7339
Preliminary Effect and Acceptability of an Intervention to Improve End-of-Life Care in Long-Term-Care Facilities: A Feasibility Study. International-journal

Chihiro Yamagata, Sachiko Matsumoto, Mitsunori Miyashita, Yusuke Kanno, Atsuko Taguchi, Kana Sato, Hiroki Fukahori

Healthcare (Basel, Switzerland)　9　(9)　2021/09/10

DOI： 10.3390/healthcare9091194 　

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The number of deaths of older adults in long-term care settings will increase with the aging population. Nurses and care workers in these settings face various challenges in providing end-of-life care, and interventions for quality end-of-life care may be useful. This feasibility study aims to explore the preliminary effect and acceptability of an intervention named the EOL Care Tool to improve end-of-life care in long-term-care facilities. We conducted a single-arm quasi-experimental study using mixed methods. This tool consisted of multiple components: professionalized lectures, newly developed structured documents, regular conferences regarding end-of-life care, and educational support from administrators. Twenty-four nurses and fifty-five care workers employed in a long-term care facility participated. For nurses, improvement in attitudes toward end-of-life care (p < 0.05) and interdisciplinary collaboration (p < 0.05) were shown quantitatively. Regarding acceptability, nurses and care workers evaluated the tool positively except for the difficulty of using the new documents. However, qualitative results showed that care workers felt the reluctance to address the work regarding end-of-life care. Therefore, a good preliminary effect and acceptability for nurses were indicated, while acceptability for care workers was only moderate. Revision to address the mentioned issues and evaluation of the revised tool with a more robust research design are required.
Physician's Communication in Code Status Discussions for Terminally Ill Cancer Patients in Inpatient Hospice/Palliative Care Units in Japan: A Nationwide Post-Bereavement Survey. International-journal

Yoshiyuki Kizawa, Takashi Yamaguchi, Akihiro Sakashita, Maho Aoyama, Tatsuya Morita, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

Journal of pain and symptom management　62　(3)　e120-e129　2021/09

DOI： 10.1016/j.jpainsymman.2021.03.011 　

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CONTEXT: Cardiopulmonary resuscitation is one of the most important end-of-life care decisions. However, the experience of bereaved families during code status discussions is not well documented. OBJECTIVE: The aims of this study were to describe the degree of emotional distress of bereaved families when discussing code status, identify their perceived areas for improvement and determine associated factors. METHODS: This study is part of a nationwide post-bereavement survey, the Japan Hospice and Palliative care Evaluation 3 (J-HOPE3) study. Questionnaires were sent to the relatives of cancer patients who had died in palliative care units in Japan in 2014. RESULTS: From an analysis of 338 questionnaires, 37% of families reported high emotional distress during code status discussions and 32% reported a need for improvement. Multiple logistic regression analyses revealed the following were associated with high-level distress: the family had hoped for the miraculous and spontaneous recovery of the patient (odds ratio [OR] 2.4, 95% confidence interval [CI] 1.31-4.43, P = 0.0049), the family felt they could not voice their opinion about Cardiopulmonary resuscitation (OR 2.07, CI 1.12-3.81, P = 0.02), or the physician failed to adapt the explanation to the family's preparation level (OR 0.36, CI 0.18-0.68, P = 0.0015). Factors identified for improvement were: holding discussions in a relaxing atmosphere conducive to questioning (OR 0.36, CI 0.16-0.80, P = 0.012), and ensuring the physician adapted the explanation to the family's preparation level (OR 0.47, CI 0.23-0.96, P = 0.037). CONCLUSION: We recommend the development of educational programs for code status discussions to improve the experience of bereaved family members.
Are cancer patients living alone more or less likely to achieve a good death? Two cross-sectional surveys of bereaved families. International-journal

Naoko Igarashi, Maho Aoyama, Kento Masukawa, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

Journal of advanced nursing　77　(9)　3745-3758　2021/09

DOI： 10.1111/jan.14886 　

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This study examined differences in sociodemographic characteristics and the achievement of a good death between cancer patients who live alone and those who do not live alone prior to death in different settings. Secondary analysis of data collected across two cross-sectional self-reported questionnaire surveys was undertaken. The participants were bereaved family members of cancer patients who had died in palliative care units (PCUs), acute hospitals or homes. We stratified the data by the place of death and examined the differences in sociodemographic characteristics to determine the relationship between cancer patients achieving a "good death" and whether they were living alone. The data were collected through 15,949 surveys. On the Good Death Inventory, significantly higher total scores emerged for cancer patients who were living alone than for those who not living alone in PCUs (effect size [ES] = 0.11, Student's t-test: p < .0001), but not in acute hospitals (ES = -0.03, p = 0.74) or home care services (ES = 0.02, p = 0.86). Cancer patients who were living alone were more likely to have been female, been older and have earned a lower annual income than those who were not living alone. Thus, among those who had received specialized palliative care, there was no difference in the quality of palliative care between cancer patients who were or were not living alone.
Conditions, possibility and priority for admission into inpatient hospice/palliative care units in Japan: a nationwide survey. International-journal

Yoshiyuki Kizawa, Takashi Yamaguchi, Yukako Yagi, Mitsunori Miyashita, Yasuo Shima, Asao Ogawa

Japanese journal of clinical oncology　51　(9)　1437-1443　2021/08/30

DOI： 10.1093/jjco/hyab098 　

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BACKGROUND: Known barriers to admission into inpatient hospice/palliative care units (PCUs) include poor accessibility and stringent conditions for admission. However, the exact criteria are unclear. The aim of this study was to clarify the actual conditions, possibilities and priorities for admission to PCU in Japan. METHODS: We conducted a nationwide, anonymous, self-administered questionnaire survey to the responsible physicians of all 251 PCUs in 2014. RESULTS: Responses were received from 190 institutions (response rate 76%). The most frequent condition for admission was 'either the patient or the family knows the diagnosis' [86%, 95% confidence interval (CI): 80-90]. For the conditions for admission to PCU, 10-40% fewer facilities answered that the patient's consent or understanding was required compared with those that answered the patient or family's consent was sufficient. Seventy-one percent (95% CI: 64-77) of PCUs answered that either the patient or a family member needed to agree to a do-not-resuscitate (DNR) policy. The factors most likely to result in refusal of admission to a PCU varied greatly. Ninety-four percent (95% CI: 90-97) of PCUs answered that patients who had undergone a long waiting time after applying for admission would be given higher priority, and approximately 50% of PCUs answered they gave priority to their outpatients and inpatients. CONCLUSIONS: The findings of this study should be used to modify the system so that appropriate palliative care can be provided to patients who wish to be admitted to PCU.
Appropriate referral timing to specialized palliative care service: survey of bereaved families of cancer patients who died in palliative care units. International-journal

Keita Tagami, Kento Masukawa, Akira Inoue, Tatsuya Morita, Yusuke Hiratsuka, Mamiko Sato, Katsura Kohata, Noriaki Satake, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer　30　(1)　931-940　2021/08/21

DOI： 10.1007/s00520-021-06493-2 　

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Few studies have investigated appropriate referral timing of specialized palliative care (SPC) from the perspective of cancer patients' and families' experiences. We aimed to clarify appropriate SPC referral timing for patients with advanced cancer and their families. We used data from a nationwide bereaved family survey in Japan. We sent a questionnaire to 999 bereaved families of cancer patients who died in 164 palliative care units (PCUs) and analyzed the first SPC referral timing and how patients evaluated it. We defined SPC as outpatient or inpatient palliative care service comprising certified palliative care physicians, advanced-practice nurses, and multidisciplinary practitioners. Finally, 51.6% (n = 515) of all responses were analyzed. The SPC referral timing was evaluated as appropriate (26.1%), late or too late (20.2%), early or too early (1.2%), or none of these (52.5%). Of these, 32.3% reported that they were referred to an SPC when diagnosed with advanced or incurable cancer or during anti-cancer treatment, and 62.6% reported they were referred after anti-cancer treatment. Patient-perceived appropriateness of SPC referral timing was associated with their good death process. After excluding "none of these" responses, a significantly higher proportion of respondents who reported being referred to SPC at diagnosis and during anti-cancer treatment evaluated the response timing as appropriate, compared to those who reported being referred after anti-cancer treatment. Appropriate timing for SPC referrals relates to quality of death; findings suggest that appropriate timing is at the time of diagnosis or during anti-cancer treatment.
Palliative care physicians' recognition of patients after immune checkpoint inhibitors and immune-related adverse events. International-journal

Yuko Usui, Tomofumi Miura, Takashi Kawaguchi, Kazuhiro Kosugi, Yuko Uehara, Masashi Kato, Toshifumi Kosugi, Miyuki Sone, Naoki Nakamura, Akio Mizushima, Mitsunori Miyashita, Tatsuya Morita, Takuhiro Yamaguchi, Yoshihisa Matsumoto, Eriko Satomi

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer　30　(1)　775-784　2021/08/12

DOI： 10.1007/s00520-021-06482-5 　

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PURPOSE: This study investigated the experience of palliative care physicians (PCPs) and their knowledge and recognition of immune checkpoint inhibitors (ICIs) and immune-related adverse events (irAEs) in clinical practice as well as the need to provide palliative care services for patients after ICI treatments. METHODS: A cross-sectional survey with self-administered questionnaires was conducted between February and April 2020. A total of 759 questionnaires were sent to PCPs in Japan. The changes in the PCPs' knowledge and recognition of ICIs and irAEs due to the increased experiences of treating patients after ICI treatments were analyzed. RESULTS: Four hundred ninety-two responses (64.8%) were analyzed. Only 15.0% of respondents had no experience of patients after ICI treatments, while 53.9% had experience of more than six patients. On the other hand, 40% of respondents had no experience of patients with suspected irAEs, while only 13.4% had experience of more than six patients. Respondents with more experience of patients after ICI treatments or those with suspected irAEs had extensive knowledge of ICIs and irAEs, were more confident in treating these patients, and tended to consider irAEs as therapeutic indications. The majority of respondents required guidelines and efficient consultation systems with oncologists. CONCLUSION: This study demonstrated that PCPs with experience had extensive knowledge and confidence of ICIs and irAEs and tended to recognize irAEs as therapeutic indications. The establishment of a more intimate relationship between PCPs and oncologists is important for providing better treatment for these patients.
Changes in depressive symptoms among family caregivers of patients with cancer after bereavement and their association with resilience: A prospective cohort study. International-journal

Yoichi Shimizu, Akitoshi Hayashi, Isseki Maeda, Tomofumi Miura, Akira Inoue, Mayuko Takano, Maho Aoyama, Yutaka J Matsuoka, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Kento Masukawa, Mitsunori Miyashita

Psycho-oncology　31　(1)　86-97　2021/08/03

DOI： 10.1002/pon.5783 　

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OBJECTIVES: To elucidate changes in depressive symptoms after bereavement and the impact of pre-loss resilience on such changes and on the extent of complicated grief and posttraumatic growth. METHODS: Prospective cohort surveys were provided to family caregivers of patients with cancer in four palliative care units (PCUs) before and after bereavement. Pre-loss Connor-Davidson Resilience Scale scores, pre- and post-loss Patient Health Questionnaire-9 scores, post-loss Brief Grief Questionnaire scores, and the expanded Posttraumatic Growth Inventory scores were determined. RESULTS: Out of 186 bereaved family caregivers, 71 (38.2%) responses were analyzed, among which 47% pre-loss and 15% post-loss responses suggested to be a high risk for major depressive disorder (MDD). Approximately 90% of family caregivers at a high risk for post-loss MDD were already at a high risk for pre-loss MDD. Even after adjustment of the background variables as covariates, the interaction effect between family caregivers' pre-loss depressive symptoms and resilience on post-loss depressive symptoms was observed (F = 7.29; p < 0.01). Moreover, pre-loss resilience was not associated with other bereavement outcome measures. CONCLUSIONS: Among family caregivers of patients with cancer in PCUs, 47% and 15% had high risk for MDD before and after bereavement, respectively. Moreover, pre-loss resilience mitigated post-loss depressive symptoms among family caregivers who had high risk for MDD before bereavement. However, considering the study's small sample size, further research is needed.
Unmet need for palliative rehabilitation in inpatient hospices/palliative care units: a nationwide post-bereavement survey. International-journal

Takaaki Hasegawa, Tatsuo Akechi, Satoshi Osaga, Tetsuya Tsuji, Toru Okuyama, Haruka Sakurai, Kento Masukawa, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

Japanese journal of clinical oncology　51　(8)　1334-1338　2021/08/01

DOI： 10.1093/jjco/hyab093 　

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In end-of-life care, rehabilitation for terminally ill cancer patients is inconsistently provided and rarely discussed. We sought to clarify the prevalence of unmet rehabilitation need for patients admitted to inpatient hospice/palliative care units as perceived by bereaved family members. We conducted a nationwide questionnaire survey of 1001 family members of cancer patients who died at inpatient hospices/palliative care units. For cancer patients who did not receive rehabilitation, we asked if family members perceived that the patient would have wanted rehabilitation intervention. Data were obtained from 416 respondents. Of these, 281 (67.5%) cases received no rehabilitation. The need for physical modalities was the most frequently reported (27.8%; 95% CI: 22.6-33.4), followed by relief of dyspnea (25.6%; 95% CI: 20.6-31.1) and treatment of edema (23.8%; 95% CI: 19.0-29.3). A non-negligible proportion of bereaved families reported unmet need for rehabilitation related to symptom management in inpatient hospices/palliative care units.
Predicting models of depression or complicated grief among bereaved family members of patients with cancer. International-journal

Maho Aoyama, Mitsunori Miyashita, Kento Masukawa, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Tatsuo Akechi

Psycho-oncology　30　(7)　1151-1159　2021/07

DOI： 10.1002/pon.5630 　

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OBJECTIVE: To derive and validate a risk scoring system for predicting major depressive disorder (MDD) and complicated grief (CG) among bereaved family members of patients with cancer that is feasible for clinical use. METHODS: We conducted a secondary analysis of two cross-sectional nationwide bereavement surveys in Japan. From a total of 17,312 bereaved family members of patients with cancer, 8618 and 8619 were randomly assigned to a derivation and a validation group. The Patient Health Questionnaire 9 (PHQ-9) and the Brief Grief Questionnaire (BGQ) were used to assess MDD (PHQ-9 score ≥ 10) and CG (BGQ score ≥ 8), respectively. We compared five models with potential predictive variables that could be easily obtained in daily practice and were included in the bereavement survey (i.e., sociodemographic data). RESULTS: The model which included variables such as the families' physical/mental health status and preparedness toward bereavement, in addition to their sociodemographic data, was considered modest for predicting the risk of both MDD and CG. The areas around the curve for MDD and CG were 0.74 (95% CI: 0.73-0.76) and 0.74 (95% CI: 0.72-0.75) and 0.78 (95% CI: 0.76-0.79) and 0.77 (95% CI: 0.76-0.79) in the derivation and validation groups, respectively. CONCLUSIONS: We developed a clinical risk score for predicting MDD and CG among bereaved family members of patients with cancer. However, further research is needed for external validation and assessment regarding its implementation in actual practice.
The Association of Family Functioning With Possible Major Depressive Disorders and Complicated Grief Among Bereaved Family Members of Patients With Cancer: Results From the J-HOPE4 Study, a Nationwide Cross-Sectional Follow-Up Survey in Japan. International-journal

Ryoko Hiratsuka, Maho Aoyama, Kento Masukawa, Yoichi Shimizu, Jun Hamano, Yukihiro Sakaguchi, Miwa Watanabe, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

Journal of pain and symptom management　62　(6)　1154-1164　2021/06/10

DOI： 10.1016/j.jpainsymman.2021.06.006 　

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CONTEXT: Family functioning is a modifiable factor associated with major depressive disorder (MDD) and complicated grief (CG) among the bereaved families of patients with advanced cancer; however, the evidence regarding this association is limited. OBJECTIVES: We aimed to explore the association of family functioning with possible MDD and CG among the bereaved families of patients with advanced cancer who died in palliative care units. METHODS: This study is a part of the J-HOPE4 study, a nationwide cross-sectional multi-purpose questionnaire survey conducted in 2018. We recruited potential participants from 164 inpatient palliative care units in Japan and assessed family functioning with the Family Relations Index (FRI). Family functioning was classified into three categories (Well-functioning: FRI ≥ 10, Intermediate: FRI = 8〜9, Dysfunctioning ≤ 7). The Patient Health Questionnaire 9 (PHQ-9) and the Brief Grief Questionnaire (BGQ) were used to assess depression (PHQ-9 score ≥ 10) and complicated grief (BGQ score ≥ 8), respectively. Multinomial logistic regression analysis was performed with possible MDD and CG and factors the family functioning. RESULTS: A total of 615 questionnaires were returned, of which 54.0 % (n = 510) age of questionnaires could be used. Although family functioning was associated with possible MDD (21.1% in Dysfunctional; 9.3% in Well-functional, P = 0.016), it was not associated with possible CG (14.8% in Dysfunctional; 9.9% in Well-functional, P = 0.929). Possible MDD and CG were significantly associated with deteriorated family relationships (OR:8.29; P = 0.004 and OR:34.00; P < 0.001, respectively), and consulting with health care providers about their concerns (OR:0.23; P = 0.003 and OR:0.23; P = 0.003, respectively). CONCLUSIONS: Family function was affected by post-bereavement possible MDD and not by CG. Our findings suggest that health care providers can identify risk factors for MDD among bereaved, dysfunctional family members.
看取りの場に関する家族内葛藤に関連する因子

浜野淳, 升川研人, 宮下光令

Palliative Care Research　16　(Suppl.)　S304-S304　2021/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
専門的な緩和ケアサービスの適切な受診・相談時期に関する遺族調査(J-HOPE4研究)

田上恵太, 升川研人, 井上彰, 森田達也, 平塚裕介, 佐藤麻美子, 木幡桂, 佐竹宣明, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research　16　(Suppl.)　S362-S362　2021/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
がんで近親者を亡くした遺族の遺族ケア利用の実態

渡邉美和, 眞嶋朋子, 増島麻里子, 長坂育代, 坂口幸弘, 宮下光令

Palliative Care Research　16　(Suppl.)　S298-S298　2021/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
Development and validation of the Terminal Delirium-Related Distress Scale to assess irreversible terminal delirium. International-journal

Megumi Uchida, Tatsuo Akechi, Tatsuya Morita, Yasuo Shima, Naoko Igarashi, Mitsunori Miyashita

Palliative & supportive care　19　(3)　287-293　2021/06

DOI： 10.1017/S1478951520001340 　

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OBJECTIVE: There is no tool to appropriately assess terminal delirium, including the natural terminal course. The objective of this study was to develop an evaluation scale to assess distress from irreversible terminal delirium and to examine the validity of the scale. METHOD: Based on previous qualitative analysis and systematic literature searches, we carried out a survey regarding the views of bereaved families and developed a questionnaire. We extracted items that bereaved families regarded as important and constructed an evaluation scale of terminal delirium. Then, we applied the questionnaire in a cross-sectional questionnaire survey of bereaved relatives of cancer patients who were admitted to a hospice or a palliative care unit. RESULTS: We developed the Terminal Delirium-Related Distress Scale (TDDS), a 24 item questionnaire consisting of five subscales (support for families and respect for a patient, ability to communicate, hallucinations and delusions, adequate information about the treatment of delirium, and agitation and restlessness). Two hundred and eighty-one bereaved relatives participated in the validation phase. The construct validity was shown to be good by repeated factor analysis. Convergent validity, confirmed by the correlation between the TDDS and the Care Evaluation Scale (r = 0.651, P < 0.001), was also good. The TDDS had good internal consistency (Cronbach's alpha coefficient for all 24 items = 0.84). SIGNIFICANCE OF RESULTS: This study showed that the TDDS is a valid and feasible measure of irreversible terminal delirium.
日本緩和医療学会緩和ケアの質評価WPGによる専門的緩和ケアの質評価のための患者登録システムの開発状況

宮下光令, 平山英幸, 中條庸子, 金澤麻衣子, 田上恵太, 井上彰, 加藤雅志

Palliative Care Research　16　(Suppl.)　S167-S167　2021/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
専門的な緩和ケアサービスの適切な受診・相談時期に関する遺族調査(J-HOPE4研究)

田上恵太, 升川研人, 井上彰, 森田達也, 平塚裕介, 佐藤麻美子, 木幡桂, 佐竹宣明, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research　16　(Suppl.)　S362-S362　2021/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
苦痛スクリーニングは入院時のみで良いのか?東北大学病院のSTAS-Jを用いた苦痛スクリーニングデータの分析

宮下光令, 斎木花称子, 佐藤祐里, 金澤麻衣子, 中條庸子, 齋藤明美, 田上恵太, 井上彰

Palliative Care Research　16　(Suppl.)　S362-S362　2021/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
がん患者の遺族の死別後の生活に関連した社会的苦痛の実態とその関連因子(J-HOPE4)

清水陽一, 升川研人, 青山真帆, 志真泰夫, 恒藤暁, 木澤義之, 森田達也, 宮下光令

Palliative Care Research　16　(Suppl.)　S296-S296　2021/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
Growth and Challenges in Hospital Palliative Cancer Care Services: An Analysis of Nationwide Surveys Over a Decade in Japan. International-journal

Yoko Nakazawa, Masahi Kato, Mitsunori Miyashita, Tatsuya Morita, Asao Ogawa, Yoshiyuki Kizawa

Journal of pain and symptom management　61　(6)　1155-1164　2021/06

DOI： 10.1016/j.jpainsymman.2020.10.023 　

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CONTEXT: The development of palliative care services is a public health priority. The Japanese Cancer Control Act has been promoting palliative care services nationwide for over 10 years. OBJECTIVES: To evaluate long-term changes in the structure and processes of hospital palliative cancer care services nationwide. METHODS: This was an observational study using three representative questionnaire surveys between 2008 and 2018. The questionnaire consisted of domains on the structure and process regarding hospital palliative cancer care services. The changes over time were assessed using the MacNemar test. The differences between groups, namely community hospitals and designated cancer hospitals, were determined using χ2 tests. RESULTS: We analyzed changes over time from 281 designated cancer hospitals and compared the services between 1395 community hospitals and 380 designated cancer hospitals. The development of the structure and processes for designated cancer hospital's palliative cancer care services was greater for 10 years including the number of Palliative Care Consultation Teams (PCTs) with more than 50 patient referrals annually (from 2010 to 2018: 76.2% to 85.4%, P < 0.001). The palliative cancer care services of community hospitals were poorly prepared compared with designated cancer hospitals in 2018, such as the "direct medical care by any member of the Palliative Care Consultation Team at least 3 times a week (41.7% vs. 81.3%; P < 0.001). CONCLUSION: Hospital palliative cancer care services in designated cancer hospitals have developed significantly from 2008 to 2018. Building a system to promote palliative care services in community hospitals is a challenge for the next decade.
Effects of financial status on major depressive disorder and complicated grief among bereaved family members of patients with cancer. International-journal

Maho Aoyama, Yukihiro Sakaguchi, Naoko Igarashi, Tatsuya Morita, Yasuo Shima, Mitsunori Miyashita

Psycho-oncology　30　(6)　844-852　2021/06

DOI： 10.1002/pon.5642 　

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OBJECTIVE: To examine current financial status, changes before and after bereavement, and their effects on possible major depressive disorder (MDD) and complicated grief (CG) among bereaved family members of patients with cancer. METHODS: We conducted a nationwide cross-sectional questionnaire survey on 787 bereaved family members of patients with cancer in 71 palliative care institutions in Japan from May to July 2016. The survey assessed perceived level of concern regarding current financial status and whether it changed after bereavement. We also collected information on demographic factors and assessed the possible MDD and CG using the Patient Health Questionnaire-9 and Brief Grief Questionnaire, respectively. We then conducted bivariate analysis to examine the relationship between these factors and financial status. RESULTS: A total of 491 (62%) questionnaires were returned. The majority of the participants (n = 382, 78%) reported having no or mild concerns about their livelihood, whereas 19% (n = 95) had moderate to severe concerns. Regarding the change in financial status after bereavement, 7% (n = 35) reported improvement, 28% (n = 131) reported worsening, and 65% (n = 308) reported no change. The prevalences of possible MDD and CG were 22% (n = 108) and 9% (n = 41), respectively, and were significantly lower among participants with less concern regarding their livelihood and whose financial status had not changed after bereavement (both p < 0.05). CONCLUSIONS: About one-fifth of the bereaved family members reported financial difficulties to some extent; these were significantly associated with MDD and CG. These findings provide evidence of the need for psychosocial support including financial consultation for bereaved family members.
Differences in aggressive treatments during the actively dying phase in patients with cancer and heart disease: an exploratory study using the sampling dataset of the National Database of Health Insurance Claims.

Atsushi Mizuno, Mitsunori Miyashita, Sachiko Ohde, Osamu Takahashi, Sayoko Yamauchi, Hitonari Nakazawa, Nobuyuki Komiyama

Heart and vessels　36　(5)　724-730　2021/05

DOI： 10.1007/s00380-020-01734-6 　

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Despite the recent attention given to palliative care for patients with heart disease, data about the treatments in their actively dying phase are not sufficiently elaborated. In this study, we used the sampling dataset of a national database to compare the aggressive treatments performed in patients with cancer and those with heart disease. We only included patients deceased in January or July from 2011 to 2015, using the Diagnosis Procedure Combination sampling dataset of the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB). Patients who were discharged within the first 10 days of each month were excluded. We explored and compared aggressive treatments such as cardiopulmonary resuscitation and intensive care utilization, performed within seven days before death in cancer patients. We used 10,637 (0.4% of the dataset) deceased target population (40.0% female), with 7844 (73.7%) and 2793 (26.3%) being the proportion of cancer and heart disease patients, respectively. Aggressive treatments and procedures such as cardiopulmonary resuscitation (18.4%), intensive care utilization (5.4%), use of inotropes (43.4%), use of respirators (29.1%), and dialysis (4.5%) were frequently observed in heart disease patients. These associations remained after adjusting for age, sex, and disease severity. This study indicates the possible use of an NDB sampling dataset to evaluate the aggressive treatments and procedures in the actively dying phase in both heart disease and cancer patients. Our results showed the differences in aggressive treatment strategies in the actively dying phase between patients with cancer and those with heart disease.
Comparison between patient-reported and clinician-reported outcomes: Validation of the Japanese version of the Integrated Palliative care Outcome Scale for staff. International-journal

Hiroki Sakurai, Mitsunori Miyashita, Tatsuya Morita, Akemi Shirado Naito, Shingo Miyamoto, Hiroyuki Otani, Junko Nozato, Naosuke Yokomichi, Kengo Imai, Ai Oishi, Yoshiyuki Kizawa, Eisuke Matsushima

Palliative & supportive care　1-7　2021/03/05

DOI： 10.1017/S1478951521000018 　

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OBJECTIVES: The goal of palliative and supportive care is to improve patients' quality of life (QoL). Patient-reported outcome measures (PROMs) are the gold standard for the assessment of QoL and symptoms; however, when self-reporting is complicated, PROMs are often substituted with proxy-reported outcome measures, such as clinician-reported outcome measures. The objective of this study was to assess the validity and reliability of the Japanese version of the Integrated Palliative care Outcome Scale (IPOS) for staff (IPOS-Staff). METHODS: This multicenter, cross-sectional observational study was conducted concurrently with the validation of the IPOS for patients (IPOS-Patient). Japanese adult patients with cancer and their staff were recruited. We assessed the characteristics of the patients and staff members, missing values, prevalence, and total IPOS scores. For the analysis of criterion validity, intra-rater, and inter-rater reliability, we calculated intraclass correlations (ICCs). RESULTS: One hundred and forty-three patients completed the IPOS-Patient, and 79 medical staff members completed the IPOS-Staff. The most common missing values from IPOS-Staff were Family Anxiety (3.5%) and Sharing Feelings (3.5%). Over half of the patients scored themselves moderate or worse for Poor Mobility, Anxiety, and Family Anxiety, while staff members scored patients moderate or worse for Weakness, Anxiety, and Family Anxiety. For criterion validity (patient-staff agreement) as well as intra-rater and inter-rater reliability, ICCs ranged from 0.114 (Sharing Feelings) to 0.826 (Nausea), 0.720 (Anxiety) to 0.933 (Nausea), and -0.038 (Practical Problems) to 0.830 (Nausea), respectively. SIGNIFICANCE OF RESULTS: The IPOS-Staff is easy to respond to; it has fair validity and reliability for physical items but poor for psycho-social items. By defining the context and objectives of its use and interpretation, the IPOS-Staff can be a useful tool for measuring outcomes in adult patients with cancer who cannot complete self-evaluations.
Patients' understanding of communication about palliative care and health condition in Japanese patients with unresectable or recurrent cancer: a cross-sectional survey. International-journal

Yusuke Hiratsuka, Takayuki Oishi, Mitsunori Miyashita, Tatsuya Morita, Jennifer W Mack, Masahiro Takahashi, Hidekazu Shirota, Kazunori Otsuka, Chikashi Ishioka, Akira Inoue

Annals of palliative medicine　10　(3)　2650-2661　2021/03

DOI： 10.21037/apm-20-2045 　

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BACKGROUND: Understanding treatment goal is essential for decision-making among patients with unresectable/recurrent solid cancers. However, no previous studies in Japan have examined the association between patients' understanding and physicians' explanations. We aimed to examine agreement between patients' and physicians' reports of communication about palliative care and current health condition among patients with unresectable/recurrent cancer and explore factors associated with optimistic understanding in Japan. METHODS: In this cross-sectional, multicenter, observational survey in Japan, 178 patients with unresectable/ recurrent solid cancers and 16 physicians responded to questionnaires. The primary outcome was agreement between patients' and physicians' reports of communication about palliative care and current health condition. RESULTS: Of 56 patients who reported their communication about palliative care, 25/56 (44.6%) agreed with physician reports, and 31/56 (55.4%) were more optimistic than their physicians. Regarding current overall health condition, 45/122 (36.9%) patients gave reports that agreed with physicians' reports, and 77/122 (63.1%) were optimistic relative to physicians. Physicians' general approach about disclosure were not associated with patients' understanding. CONCLUSIONS: Fewer than 50% of Japanese patients with unresectable/recurrent cancer agreed with their physicians, whereas most others were more optimistic about palliative care communication and their health condition as compared to physicians. Effective communication is essential to ensure informed decisionmaking.
緩和ケア病棟における呼吸困難のケア遺族からみた呼吸困難の強さとケアの実践状況

山本瀬奈, 荒尾晴惠, 青木美和, 森雅紀, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 升川研人, 宮下光令

日本がん看護学会学術集会　35回　P9-151　2021/02
Publisher: (一社)日本がん看護学会
Bereaved Family Members' Perceived Care at the End of Life for Patients with Noncancerous Respiratory Diseases. International-journal

Ryosuke Imai, Atsushi Mizuno, Mitsunori Miyashita, Kohei Okafuji, Atsushi Kitamura, Yutaka Tomishima, Torahiko Jinta, Naoki Nishimura, Tomohide Tamura

Palliative medicine reports　2　(1)　265-271　2021

DOI： 10.1089/pmr.2021.0034 　

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Background: Data regarding the quality of end-of-life care for patients with noncancerous illnesses are lacking. Objective: This study aimed to evaluate end-of-life care for patients with noncancerous respiratory disease from the perspective of bereaved family members and explore the factors associated with the quality of patient death and care. Design: This cross-sectional study included patients who had died of noncancerous respiratory disease in general wards of pulmonary department in Japan between 2014 and 2016 and conducted an anonymous self-report questionnaire survey for the patients' bereaved family members. Measurements: We evaluated overall satisfaction with care and the quality of death and end-of-life care using the Good Death Inventory (GDI) and Care Evaluation Scale (CES), respectively. A multiple linear regression analysis was performed to explore the factors associated with these outcomes. Results: In total, 130 questionnaires were distributed, and the effective response rate was 38% and 50 patients were included (median age: 82 [range 58-101] years; 37 men [74%]). Primary diagnoses at death included 29 cases of pneumonia (58%), 15 interstitial lung disease (30%), and 3 chronic obstructive pulmonary disease (6%). Of the bereaved family members, 26 (52%) were spouses, and 19 (38%) were children (median age [range]: 68 [33-102] years, 15 men [30%]). The overall CES and GDI scores (mean ± standard deviation) were 77 ± 15 and 79 ± 15, respectively. The presence of dementia was an independent factor associated with high CES and GDI scores in the multiple linear regression analysis. Conclusions: In patients who died of noncancerous respiratory disease, the presence of dementia could be associated with the higher quality of patient death and care. In dementia, an understanding of the terminal nature of this condition may lead to an appropriate end-of-life care.
Spiritual Care Training Program’s Effects on Physicians’ Confidence, Self-reported Practice, and Attitudes in Caring for Terminally Ill Cancer Patients Who Express Meaninglessness

Yasunori Matoba, Hisayuki Murata, Tatsuya Morita, Mitsunori Miyashita

Palliative Care Research　16　(1)　45-54　2021
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.16.45 　

eISSN： 1880-5302
Cancer Care Evaluation Scale (CCES): measuring the quality of the structure and process of cancer care from the perspective of patients with cancer. International-journal

Kento Masukawa, Kazuki Sato, Megumi Shimizu, Tatsuya Morita, Mitsunori Miyashita

Japanese journal of clinical oncology　51　(1)　92-99　2021/01/01

DOI： 10.1093/jjco/hyaa165 　

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OBJECTIVE: To evaluate the quality of the structure and process of cancer care from the perspective of patients with cancer, we developed a Cancer Care Evaluation Scale. METHODS: Two anonymous online surveys of patients with cancer in Japan were conducted using a convenience sample of 400 adult cancer outpatients. RESULTS: In total, 162 patients participated in the online surveys. Factor analysis revealed that the Cancer Care Evaluation Scale had the following 12 domains: (i) relationship with physician, (ii) relationship with nurse, (iii) physical care by physician, (iv) physical care by nurse, (v) psycho-existential care, (vi) help with decision-making for patients, (vii) coordination and consistency, (viii) environment, (ix) cost, (x) availability, (xi) care for the side effects of cancer treatment by a physician, and (xii) care for the side effects of cancer treatment by a nurse. The Cancer Care Evaluation Scale was correlated with overall care satisfaction (r = 0.75), but not with the quality of life (r = 0.40). In regard to rest-retest reliability, most items showed an intraclass correlation coefficient of 0.7 or higher. CONCLUSION: The validity and reliability of the Cancer Care Evaluation Scale were confirmed, suggesting that this tool is useful for evaluating the quality of cancer care from the perspective of patients with cancer.
緩和ケア医が苦痛の評価を行う上で知っておくことが必要と考える方言緩和医療専門医・認定医に対する質問紙調査

三輪聖, 森田達也, 松本禎久, 上原優子, 加藤雅志, 小杉寿文, 曽根美雪, 中村直樹, 水嶋章郎, 宮下光令, 山口拓洋, 里見絵理子

Palliative Care Research　16　(4)　281-287　2021
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
High Feasibility and Safety, but Negligible Efficacy of Acupressure for Treating Nausea in Cancer Patients Admitted to the Palliative Care Unit: A Pilot Study.

Hiroyuki Tsugita, Maho Aoyama, Noriaki Satake, Makoto Saito, Yusuke Hiratsuka, Akira Inoue, Shin Takayama, Mitsunori Miyashita

The Tohoku journal of experimental medicine　254　(3)　155-161　2021

DOI： 10.1620/tjem.254.155 　

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Management of nausea is an important dimension of palliative care. The first choice for treating nausea is antiemetics, but their efficacy is inadequate. Acupressure intervention for nausea in cancer patients has been studied as a non-pharmacological therapy, and appears to have had some effect. However, such a therapy has not been well reviewed in patients with terminal cancer. The purpose of this study was to clarify the feasibility of acupressure intervention and examine its safety and preliminary efficacy. We recruited cancer patients that fulfilled the eligibility criteria and were admitted to the palliative care unit, from August 2018 to February 2019, in Tohoku University Hospital, Japan. We conducted a longitudinal assessment of acupressure intervention in a single arm. We identified the patient's research accomplishments and evaluated possible fainting due to the vagal reflex and symptom severity. Descriptive statistics were used to calculate the completion rate for the feasibility and Wilcoxon signed-rank tests to compare the average of continuous variables for the safety and efficacy. Twelve patients participated in this study and completed the procedure. Their average age was 70 years (SD = 9.3), and the most common primary cancer sites were the rectum and pancreas. The blood pressure and pulse rate did not drop sharply. Four patients exhibited decreased nausea but there was no statistically significant difference (P = 0.5). We suggested that acupressure has high feasibility and safety, as an intervention for patients with terminal cancer. However, no significant differences were observed regarding its effect on nausea.
NDB特別抽出データを用いたがん患者の死亡場所と死亡前30日の療養場所の推移

勝梨沙子, 田辺公一, 佐藤一樹, 宮下光令, 石川ベンジャミン光一, 森田達也, 内富庸介, 酒井隆全, 大津史子

日本薬剤師会学術大会講演要旨集　53回　0292-0293　2020/10
Publisher: (公社)日本薬剤師会
Insomnia and changes in alcohol consumption: Relation between possible complicated grief and depression among bereaved family caregivers. International-journal Peer-reviewed

Maho Aoyama, Yukihiro Sakaguchi, Daisuke Fujisawa, Tatsuya Morita, Asao Ogawa, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

Journal of affective disorders　275　1-6　2020/10/01

DOI： 10.1016/j.jad.2020.06.023 　

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BACKGROUND: Bereaved individuals are known to have greater health risks, such as insomnia, excessive alcohol intake, and depression. However, few studies have investigated the relation between these risks and bereavement outcomes, namely complicated grief (CG) and major depressive disorder (MDD). This study aimed to assess the relation between insomnia, changes in alcohol consumption, and CG or MDD. METHODS: A cross-sectional, self-report questionnaire survey was conducted between May and July 2014 on 20 acute hospitals, 133 inpatient palliative care units (PCUs), and 22 home hospice services. Questionnaires were sent to the bereaved family members identified by each institution. RESULTS: Data were obtained from 814, 7,291, and 1,018 family members from acute hospitals, PCUs, and home hospice services, respectively. Significant associations were found between CG or MDD and all sleep condition symptoms (OR: 1.48-12.88; all p<0.0001) and between changes in alcohol intake (OR: 1.63-3.55; all p<0.0001). LIMITATIONS: The majority were family members who had lost a loved one to cancer in a PCU, the psychological health of nonresponders was unavailable, the results were based on self-report data, and no clinical assessment interviews were done; this could limit the generalizability of the findings. CONCLUSIONS: Overall, 14% and 17% of the respondents reported increased and decreased alcohol consumption, respectively, and 46-61% reported experiencing insomnia. Interestingly, both increase and decrease in alcohol intake after bereavement were risk factors of possible CG or MDD. These results suggest that assessing sleep conditions and alcohol consumption might help prevent severe psychological impairments in bereaved individuals.
The association of family functioning and psychological distress in the bereaved families of patients with advanced cancer: A nationwide survey of bereaved family members Peer-reviewed

Hamano, Jun, Morita, Tatsuya, Igarashi, Naoko, Shima, Yasuo, Miyashita, Mitsunori

Psycho-oncology　Epub　2020/09
Publisher: WILEY
DOI： 10.1002/pon.5539 　

ISSN： 1099-1611

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[OBJECTIVES] Family conflict and family functioning were regarded as changeable factors associated with complicated grief (CG) and major depressive disorder (MDD) in the bereaved families of patients with advanced cancer, although the evidence is limited. We explored the family functioning associated with CG and MDD developing either independently or co-morbidly in the bereaved families of patients with advanced cancer who died in palliative care units (PCUs). [METHODS] This study comprised a nationwide cross-sectional questionnaire survey of bereaved family members of cancer patients who died in Japanese PCUs participating in evaluation of the quality of end-of-life care. [RESULTS] A total of 529 questionnaires (69.2%) were returned, and we analyzed a total of 458 responses. A total of 14.2% of participants were considered as having CG, 22.5% as having moderate to severe depression, and 9.6% as having co-morbid symptoms. Multivariate logistic regression analysis revealed that many family members insulted or yelled at one another (odd ratio (OR): 2.99, p=0.046; OR:2.57, p=0.033), and conflict regarding what is meant by a good death (OR:3.60, p=0.026; OR:4.06, p=0.004) was significa
Prevalence and associated factors of perceived cancer-related stigma in Japanese cancer survivors. International-journal Peer-reviewed

Daisuke Fujisawa, Shino Umezawa, Maiko Fujimori, Mitsunori Miyashita

Japanese journal of clinical oncology　50　(11)　1325-1329　2020/08/08

DOI： 10.1093/jjco/hyaa135 　

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This study aimed to examine the prevalence and associated factors of perceived cancer-related stigma among Japanese cancer survivors. In this web-based survey involving 628 Japanese cancer survivors, perceived cancer-related stigma, quality of life (Quality of Life-Cancer Survivors Instrument), psychological distress (K6) and perceived social support (multidimensional scale of perceived social support) were evaluated. Perceived cancer-related stigma was endorsed by 61.2% of the participants. Perceived cancer-related stigma was significantly associated with quality of life (R = 0.35-0.37), psychological distress (R = 0.35) and perceived social support (R = 0.10). Logistic regression analysis demonstrated that cancer survivors at younger ages (odds ratio = 0.96), with low income (odds ratio = 2.49), with poorer performance status (odds ratio = 2.33), and with breast, urinary or gynecological cancers (odds ratio = 4.27, 4.01, 4.01, respectively) were at higher risk for perceived cancer-related stigma.
がん患者におけるがんの治癒や進行抑制のための補完代替医療の使用実態及び遺族の抑うつや悲嘆との関連についての調査

鈴木梢, 森田達也, 田中桂子, 大宜見由奈, 高橋幸江, 木澤義之, 恒藤暁, 志真泰夫, 升川研人, 宮下光令

Palliative Care Research　15　(Suppl.)　S231-S231　2020/08
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
がん患者の遺族のアドバンス・ケア・プランニング(ACP)が他者との関係性や死生観に与える影響

宮地由佳, 塩崎麻里子, 恒藤暁, 森田達也, 木澤義之, 升川研人, 宮下光令, 志真泰夫

Palliative Care Research　15　(Suppl.)　S242-S242　2020/08
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
緩和ケア病棟入院中の進行がん患者に行った肺炎治療や死亡前1週間に生じた発熱への対応に関する遺族の考えを明らかにする質問紙研究 EASED-JHOPE4連結研究

小田切拓也, 西智弘, 小杉和博, 川島夏希, 浜野淳, 前田一石, 森雅紀, 森田達也, 木澤義之, 志真泰夫, 升川研人, 宮下光令

Palliative Care Research　15　(Suppl.)　S470-S470　2020/08
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
臨死期の心電図モニター使用の有無が遺族の看取る心理に及ぼす影響に関する研究

佐藤香, 馬場美華, 森田達也, 升川研人, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research　15　(Suppl.)　S272-S272　2020/08
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
ホスピス・緩和ケア病棟患者におけるリハビリテーションの実施とGood Deathとの関連:J-HOPE3・J-HOPE4付帯研究の統合解析

長谷川貴昭, 関根龍一, 明智龍男, 大佐賀智, 辻哲也, 奥山徹, 桜井春香, 升川研人, 青山真帆, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research　15　(Suppl.)　S275-S275　2020/08
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
遺族からみたホスピス・緩和ケア病棟による望ましい遺族ケアの提供に関する研究

北得美佐子, 角甲純, 小林成光, 森川みはる, 月山淑, 川俣知之, 森田達也, 木澤義之, 恒藤暁, 志摩泰夫, 升川研人, 宮下光令

Palliative Care Research　15　(Suppl.)　S276-S276　2020/08
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
プロトコルに基づく調節型鎮静と持続的深い鎮静を受けた遺族の体験の違い

今井堅吾, 森田達也, 森雅紀, 横道直佑, 山内敏宏, 三輪聖, 井上聡, 木澤義之, 恒藤暁, 志真泰夫, 升川研人, 宮下光令

Palliative Care Research　15　(Suppl.)　S278-S278　2020/08
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
緩和ケア病棟で終末期がん患者にみられる「故人やあの世をみた体験」などの終末期体験および遺族の抑うつや悲嘆との関連についての調査

鈴木梢, 森田達也, 田中桂子, 大宜見由奈, 高橋幸江, 木澤義之, 恒藤暁, 志真泰夫, 升川研人, 宮下光令

Palliative Care Research　15　(Suppl.)　S281-S281　2020/08
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
一般病院で死亡したがん患者の家族が経験した意思決定困難感に関する遺族調査

高野みなみ, 清水恵, 青山真帆, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 升川研人, 宮下光令

Palliative Care Research　15　(Suppl.)　S627-S627　2020/08
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
死別が遺族に与える肯定的影響

嶋田和貴, 坂口幸弘, 恒藤暁, 森田達也, 木澤義之, 升川研人, 宮下光令, 志真泰夫

Palliative Care Research　15　(Suppl.)　S646-S646　2020/08
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
がん患者の介護者の介護中の離職および死亡

宮地由佳, 塩崎麻里子, 恒藤暁, 森田達也, 木澤義之, 升川研人, 宮下光令, 志真泰夫

Palliative Care Research　15　(Suppl.)　S687-S687　2020/08
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
診断期にある原発不明がん患者の家族の体験に関する検討膵がんとの比較から

石田京子, 安藤詳子, 小松弘和, 森田達也, 佐藤一樹, 内田恵, 明智龍男, 古川陽介, 佐橋朋代, 升川研人, 五十嵐尚子, 志真泰夫, 木澤義之, 恒藤暁, 宮下光令

Palliative Care Research　15　(Suppl.)　S1049-S1049　2020/08
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
死亡直前期の病状説明が「不十分」と感じることと関連する因子の検討 J-HOPE4付帯研究

前田一石, 升川研人, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research　15　(Suppl.)　S1114-S1114　2020/08
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
死亡直前期の病状説明に対する遺族の満足度と医療者の取るべき態度 J-HOPE4付帯研究

前田一石, 升川研人, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research　15　(Suppl.)　S1115-S1115　2020/08
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
終末期せん妄の治療とケアの質は遺族のうつ病と関連する

内田恵, 明智龍男, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 升川研人, 宮下光令

Palliative Care Research　15　(Suppl.)　S1160-S1160　2020/08
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
終末期せん妄評価尺度短縮版の開発

内田恵, 明智龍男, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 升川研人, 宮下光令

Palliative Care Research　15　(Suppl.)　S1161-S1161　2020/08
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
認知症のGood Deathとは何か? 遺族・医師・看護師・介護職の認識に関するWeb調査

野中瑞穂, 青山真帆, 中西三春, 山川みやえ, 深堀浩樹, 佐藤一樹, 高橋在也, 長江弘子, 森田達也, 坂井志麻, 宮下光令

Palliative Care Research　15　(Suppl.)　S208-S208　2020/08
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
終末期がん患者の悪心嘔吐に対する指圧の実施可能性・安全性に関する検討

継田浩之, 青山真帆, 宮下光令, 高山真, 佐竹宜明

Palliative Care Research　15　(Suppl.)　S403-S403　2020/08
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
がん患者の遺族の家族機能とうつ・複雑性悲嘆との関連全国調査(J-HOPE4付帯研究)

平塚良子, 青山真帆, 升川研人, 清水陽一, 浜野淳, 坂口幸弘, 渡邉美和, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research　15　(Suppl.)　S237-S237　2020/08
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
がん患者の家族介護者のレジリエンスと死別後の抑うつとの関連(J-HOPE4付帯研究)

清水陽一, 前田一石, 林章敏, 三浦智史, 井上彰, 志真泰夫, 恒藤暁, 木澤義之, 森田達也, 升川研人, 石垣和美, 高野真優子, 宮下光令

Palliative Care Research　15　(Suppl.)　S645-S645　2020/08
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
遺族が評価した患者・家族間のEnd of Life Discussion実施の実態(第2報)

辰巳有紀子, 荒尾晴惠, 升川研人, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research　15　(Suppl.)　S240-S240　2020/08
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
遺族が評価した患者・家族間のEnd-of-Life Discussion実施の実態(第1報)

辰巳有紀子, 荒尾晴惠, 升川研人, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research　15　(Suppl.)　S648-S648　2020/08
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
緩和ケア病棟における認知機能低下を有する終末期がん患者の家族の体験

高尾鮎美, 荒尾晴惠, 青木美和, 升川研人, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research　15　(Suppl.)　S266-S266　2020/08
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
終末期がん患者に対する機械浴の症状緩和に対する有効性

林ゑり子, 宮下光令, 青山真帆, 深野史靖, 佐藤晶子, 高野純子

Palliative Care Research　15　(Suppl.)　S782-S782　2020/08
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
遺族からみたホスピス・緩和ケア病棟による望ましい遺族ケアの提供に関する研究

北得美佐子, 角甲純, 小林成光, 森川みはる, 月山淑, 川俣知之, 森田達也, 木澤義之, 恒藤暁, 志摩泰夫, 升川研人, 宮下光令

Palliative Care Research　15　(Suppl.)　S276-S276　2020/08
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
Beliefs and Perceptions About Parenteral Nutrition and Hydration by Family Members of Patients With Advanced Cancer Admitted to Palliative Care Units: A Nationwide Survey of Bereaved Family Members in Japan. International-journal Peer-reviewed

Koji Amano, Isseki Maeda, Tatsuya Morita, Kento Masukawa, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

Journal of pain and symptom management　60　(2)　355-361　2020/08

DOI： 10.1016/j.jpainsymman.2020.03.006 　

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CONTEXT: There has been a growing consensus that parenteral nutrition and hydration is to be forgone in terminally ill patients with cancer. However, it remains unclear what the beliefs and perceptions of parenteral nutrition and hydration by the family members are. OBJECTIVES: To clarify their beliefs and perceptions and examine the relationships between the factors of family members, their beliefs and perceptions, and their overall satisfaction with the care the patient received at the place of death. METHODS: This study was performed as a part of the cross-sectional anonymous nationwide survey of the bereaved family members of patients with cancer in Japan. RESULTS: In total, 1001 questionnaires were sent, and 610 questionnaires were returned. Among these, 499 were analyzed. Regarding the prevalence of beliefs and perceptions about parenteral nutrition and hydration, when a patient cannot eat enough, parenteral hydration is needed was the highest (87.7%), followed by the opinions of medical staff are important in the issue of parenteral nutrition and hydration, parenteral hydration serves as a substitute for oral hydration, and if I were a patient and could not eat enough, parenteral hydration would be needed (85.1%, 81.0%, and 80.0%, respectively). We extracted two concepts as follows: belief that parenteral nutrition and hydration are beneficial and perceived need for parenteral nutrition and hydration. They were not identified as independent determinants of overall care satisfaction. CONCLUSION: This study showed that beliefs and perceptions about parenteral nutrition and hydration were important in the family members in palliative care.
Rehabilitation for Cancer Patients in Inpatient Hospices/Palliative Care Units and Achievement of a Good Death: Analyses of Combined Data From Nationwide Surveys Among Bereaved Family Members. International-journal Peer-reviewed

Takaaki Hasegawa, Ryuichi Sekine, Tatsuo Akechi, Satoshi Osaga, Tetsuya Tsuji, Toru Okuyama, Haruka Sakurai, Kento Masukawa, Maho Aoyama, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

Journal of pain and symptom management　60　(6)　1163-1169　2020/06/29

DOI： 10.1016/j.jpainsymman.2020.06.031 　

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CONTEXT: In end-of-life care, rehabilitation for patients with cancer is considered to be an important means for improving patients' quality of death and dying. OBJECTIVES: To determine whether the provision of rehabilitation for patients with cancer in palliative care units is associated with the achievement of a good death. METHODS: This study involved a cross-sectional, anonymous, and self-report questionnaire survey of families of patients with cancer who died in palliative care units in Japan. We evaluated the short version of Good Death Inventory (GDI) on a seven-point scale. A logistic regression model was used to calculate the propensity score. Covariates included in this model were survey year, patients' characteristics, and families' characteristics. The associations between rehabilitation and GDI were tested using trend tests after propensity score matching adjustment. RESULTS: Of the 1965 family caregivers who received the questionnaires, available data were obtained from 1008 respondents (51.2%). Among them, 285 (28.2%) cases received rehabilitation in palliative care units. There was no difference in total GDI score between the groups with and without rehabilitation. In exploratory analyses, patients receiving rehabilitation were significantly more likely to feel maintaining hope and pleasure (mean 4.50 [SE 0.10] vs. 4.05 [0.11], respectively; effect size [ES] 0.31; P = 0.003), good relationships with medical staff (mean 5.67 [SE 0.07] vs. 5.43 [0.09], respectively; ES 0.22; P = 0.035), and being respected as an individual (mean 6.08 [SE 0.06] vs. 5.90 [0.07], respectively; ES 0.19; P = 0.049) compared with patients not receiving rehabilitation. CONCLUSION: Rehabilitation in palliative care units may contribute to several domains of quality of death and dying, particularly maintaining hope and pleasure. Further research is needed to investigate whether palliative rehabilitation contributes to the achievement of a good death.
Impressions of Interfaith Chaplain's Activities among Patients in a Palliative Care Unit: A Semi-Structured Interview-Based Qualitative Study.

Yusuke Hiratsuka, Maho Aoyama, Taiko Kaneta, Kento Masukawa, Keita Tagami, Mitsunori Miyashita, Akira Inoue

The Tohoku journal of experimental medicine　251　(2)　91-96　2020/06

DOI： 10.1620/tjem.251.91 　

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Providing spiritual care in light of a patient's religious and/or spiritual background can help improve the quality of end-of-life care. Rinsho-shukyo-shi is a Japanese interfaith chaplain who provides religious and spiritual care to patients. In this study, we qualitatively explore the impressions of patients in a palliative care unit of the activities of an interfaith chaplain in a hospital in Japan. The authors used semi-structured interviews carried out by a male nurse experienced in qualitative and quantitative research in palliative care. The male nurse asked only a few predetermined questions in the interviews, which were conducted from January 19 to December 26, 2018. The interviewees were 15 patients diagnosed with advanced cancer (five men and 10 women; aged 53-81 years), and they were admitted to the palliative care unit of Tohoku University Hospital (the hospital has no religious affiliation). Patients who had spoken to the interfaith chaplain at the hospital at least twice were included in the study. The interviews were digitally audio-recorded, transcribed verbatim, and analyzed. Three main themes were identified through thematic analysis. Resistance varied across patients; no patient felt resistance to the intervention by, or to the presence of, the interfaith chaplain once he/she had spoken with him. Opinions about the interfaith chaplain also varied, with 10 patients claiming that his role was necessary for end-of-life care and beneficial for the chaplain himself. Finally, the patients' religious beliefs varied widely. In conclusion, the interfaith chaplain is deemed helpful by the interviewed patients in relieving their anxieties.
Palliative care knowledge test for nurses and physicians: validation and cross-cultural adaptation

Monica Lopez-Garcia, Leticia Rubio, Rafael Gomez-Garcia, Fuensanta Sanchez-Sanchez, Mitsunori Miyashita, Maria Dolores Medina-Abellan, Maria D. Perez-Carceles

BMJ Supportive & Palliative Care　bmjspcare-2019　2020/04/22
Publisher: BMJ
DOI： 10.1136/bmjspcare-2019-002182 　

ISSN： 2045-435X

eISSN： 2045-4368

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<sec><title>Background</title>Palliative care knowledge is essential in primary healthcare due to the increasing number of patients who require attention in the final stage of their life. Health professionals (physicians and nurses) need to acquire specific knowledge and abilities to provide high-quality palliative care. The development of education programmes in palliative care is necessary. The Palliative Care Knowledge Test (PCKT) is a questionnaire that evaluates the basic knowledge about palliative care, but it has not been adapted into Spanish, and its effectiveness and utility for Spanish culture have not been analysed. </sec><sec><title>Objective</title>The aim of this study was to report the translation into Spanish and a psychometric analysis of the PCKT. </sec><sec><title>Methods</title>The questionnaire survey was validated with a group of 561 physicians and nurses. The PCKT Spanish Version (PCKT-SV) was obtained from a process, including translation, back translation and revision by experts and a pilot study. The content validity and reliability of the questionnaire were analysed. </sec><sec><title>Results</title>The results showed internal consistency and reliability indexes similar to those obtained by the original version of PCKT. </sec><sec><title>Conclusion</title>The PCKT-SV is a useful instrument for measuring Spanish-speaking physician and nurse knowledge of palliative care, and it is suitable to evaluate the effectiveness of training activities in palliative care. </sec>
Potential Measurement Properties of a Questionnaire for Eating-Related Distress Among Advanced Cancer Patients With Cachexia: Preliminary Findings of Reliability and Validity Analysis

Koji Amano, Tatsuya Morita, Mitsunori Miyashita

Journal of Palliative Care　2020
Publisher: SAGE Publications Ltd
DOI： 10.1177/0825859720951356 　

ISSN： 0825-8597
Validation of the Japanese Version of the Functional Assessment of Cancer Therapy-Cognitive Function Version 3. Peer-reviewed

Miyashita M, Tsukamoto N, Hashimoto M, Kajiwara K, Kako J, Okamura H

Journal of pain and symptom management　59　(1)　139-146.e3　2020/01

DOI： 10.1016/j.jpainsymman.2019.09.027 　

ISSN： 0885-3924
終末期にある小児がん患者のQOLと関連要因看護師によるQOL代理評価尺度を用いて

名古屋祐子, 宮下光令, 入江亘, 余谷暢之, 塩飽仁

Palliative Care Research　15　(2)　53-64　2020
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
The Bereaved Families' Preferences for Individualized Goals of Care for Terminal Dyspnea: What Is an Acceptable Balance between Dyspnea Intensity and Communication Capacity? International-journal

Masanori Mori, Tatsuya Morita, Kengo Imai, Naosuke Yokomichi, Takashi Yamaguchi, Kento Masukawa, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

Palliative medicine reports　1　(1)　42-49　2020

DOI： 10.1089/pmr.2020.0035 　

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Background: Toward the individualized care of terminally ill patients with dyspnea ("terminal dyspnea"), it is essential to identify individualized goals of care (GOC) to achieve an acceptable balance between dyspnea intensity and communication capacity. Objective: To explore preferences for individualized GOC for terminal dyspnea, and factors associated with the preferences. Design: A nationwide cross-sectional survey. Setting/Subjects: In total, 1055 bereaved families of cancer patients admitted to 167 inpatient hospices in Japan. Measurements: Preferences for individualized GOC for terminal dyspnea to achieve an acceptable balance between dyspnea intensity and communication capacity, should individuals experience continuous moderate or severe/overwhelming dyspnea despite optimal palliative care, and perceptions about a good death. Results: Among 548 participants (response rate = 52%), we analyzed responses of 477 families whose loved one suffered dyspnea in the last week of life. In total, 167 (45%; 95% confidence interval [CI] = 40%-50%) and 272 (80%; 95% CI = 75%-84%) participants would prioritize dyspnea relief over communication capacity, should they continuously suffer moderate or severe/overwhelming dyspnea, respectively. In multivariate analyses, the determinants of the prioritization of dyspnea relief were perceiving physical comfort as important for a good death (odds ratio [OR] = 1.389; 95% CI = 1.062-1.818; p = 0.017) in moderate dyspnea, and perceiving physical comfort (OR = 2.505; 95% CI = 1.718-3.651; p < 0.001) and not perceiving mental awareness (OR = 0.695; 95% CI = 0.529-0.913; p = 0.009) as important in severe/overwhelming dyspnea. Conclusions: Preferences for individualized GOC for terminal dyspnea can vary among individuals and with different symptom intensity, and may be influenced by perceptions about a good death. Outcome measurements incorporating an acceptable balance between dyspnea intensity and communication capacity should be developed.
慢性心不全患者とその家族と行うアドバンス・ケア・プランニングの必要性に関する循環器病棟に勤務する看護師の認識

渡邉梨紗, 落合亮太, 徳永友里, 三條真紀子, 眞茅みゆき, 宮下光令, 石川利之, 渡部節子

Palliative Care Research　15　(4)　265-276　2020
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
宗教的背景をもたない緩和ケア病棟における臨床宗教師の活動 -「臨床宗教師活動記録」の分析を通した一考察-

金田諦晃, 青山真帆, 平塚裕介, 田上恵太, 升川研人, 宮下光令, 井上彰

スピリチュアルケア研究　4　45-59　2020
Publisher: (一社)日本スピリチュアルケア学会
ISSN： 2433-1627
How Cardiovascular Nurses Perceive the Need for Advanced Care Planning for Chronic Heart Failure with Patients and Their Families

Risa Watanabe, Ryota Ochiai, Yuri Tokunaga-Nakawatase, Makiko Sanjo, Miyuki Makaya, Mitsunori Miyashita, Toshiyuki Ishikawa, Setsuko Watabe

Palliative Care Research　15　(4)　265-276　2020
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.15.265 　

eISSN： 1880-5302
日本の一般市民を対象に受療行動調査の質問項目によって測定したQOLの性質とその関連要因

伊藤怜子, 清水恵, 佐藤一樹, 加藤雅志, 藤澤大介, 内藤明美, 森田達也, 宮下光令

Palliat Care Res　15　(2)　135-146　2020
Quality-of-life of Pediatric Cancer Patients Receiving End-of-life Care and Related Factors: Using a Proxy QOL Rating Scale from the Nurse’s Perspective Peer-reviewed

Yuko Nagoya, Mitsunori Miyashita, Wataru Irie, Nobuyuki Yotani, Hitoshi Shiwaku

Palliative Care Research　15　(2)　53-64　2020
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.15.53 　

eISSN： 1880-5302
Development of a Proxy Quality-of-Life Rating Scale for the End-of-Life Care of Pediatric Cancer Patients Evaluated from a Nurse's Perspective. International-journal Peer-reviewed

Yuko Nagoya, Mitsunori Miyashita, Wataru Irie, Nobuyuki Yotani, Hitoshi Shiwaku

Journal of palliative medicine　23　(1)　82-89　2020/01

DOI： 10.1089/jpm.2018.0598 　

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Background: Assessing the quality of life (QoL) of children receiving end-of-life (EoL) care through evaluations by the children and their bereaved families is challenging; presently, there is no QoL assessment measure that is appropriate for use in pediatric EoL and/or palliative care. Objective: To develop and test a proxy rating scale (the "Good Death Inventory for Pediatrics," GDI-P) for the QoL of pediatric cancer patients receiving EoL care, evaluated from the nurse's perspective, as well as a short version of the scale. Design, Setting, and Measurements: The GDI-P was developed based on previous studies. After initial testing, it was distributed to hospitals across Japan, where nurses in charge of patients with childhood cancer receiving EoL care used the scale to evaluate a patient retrospectively. To examine inter-rater reliability, we encouraged two nurses to evaluate one patient. The GDI-P was modified on the basis of the responses, and the validity and reliability were measured. Results: In total, 85 questionnaires were completed, including 32 pairs of responses from two nurses evaluating one patient. In addition, 47 retest questionnaires were returned. The final, modified GDI-P comprised eight factors with 22 items and showed high convergent and discriminant validity, scaling success rates for each item and factor, and Cronbach's α values. A short version of GDI-P was prepared, comprising eight representative items. Conclusions: The final GDI-P was confirmed to have adequate reliability and validity. The QoL scale developed in this study should provide useful outcome evaluation criteria for assessing the EoL care of pediatric cancer patients.
Perceptions of Physicians and Nurses Concerning Advanced Care Planning for Patients with Heart Failure in Japan Peer-reviewed

Annals of Palliative Medicine　2020
看取りケアエビデンスとプラクティス

宮下光令, 林ゑり子

死の臨床　42　(2)　266-266　2019/10
Publisher: 日本死の臨床研究会
ISSN： 0912-4292
がん患者に対する死亡前1年間の漢方薬処方 DPCデータを用いた全国実態調査

松居千夏, 田辺公一, 佐藤一樹, 宮下光令, 石川ベンジャミン光一, 森田達也, 伏見清秀, 内冨庸介, 酒井隆全, 大津史子

日本薬剤師会学術大会講演要旨集　52回　P-365　2019/10
Publisher: (公社)日本薬剤師会
がん患者家族の死別に対する心の準備の関連要因 Peer-reviewed

大庭秋穂, 青山真帆, 升川研人, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research　14　(Suppl.)　S227-S227　2019/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
望ましい死の達成度尺度Good Death Inventoryは全般的なGood Deathをどの程度捉えることができているのか? 全国遺族調査より Peer-reviewed

升川研人, 青山真帆, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research　14　(Suppl.)　S300-S300　2019/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
Investigating associations between pain and complicated grief symptoms in bereaved Japanese older adults. Peer-reviewed

Ghesquiere A, Bagaajav A, Ito M, Sakaguchi Y, Miyashita M

Aging & mental health　1-7　2019/04

DOI： 10.1080/13607863.2019.1594166 　

ISSN： 1360-7863
Achievement of a good death among young adult patients with cancer: analyses of combined data from three nationwide surveys among bereaved family members. International-journal Peer-reviewed

Masanori Mori, Tomoyo Sasahara, Tatsuya Morita, Maho Aoyama, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer　27　(4)　1519-1527　2019/04

DOI： 10.1007/s00520-018-4539-9 　

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PURPOSE: Although little improvement has been made in the survival rate among young cancer patients over recent decades, whether they have achieved a good death has never been systematically explored. We aimed to clarify whether young cancer patients (aged 20-39 years) have achieved a good death, and compare their achievement with that of middle-aged patients (aged 40-64 years). METHODS: We analyzed combined data of three nationwide, cross-sectional surveys of families of cancer patients who died at inpatient hospices in Japan (2007-2014). We measured 10 core items of the Good Death Inventory (GDI) short-version on a 7-point scale, and calculated rates of "agree/absolutely agree" and the mean scores. RESULTS: We analyzed 245 and 5140 responses of families of young and middle-aged patients, respectively. Less than 60% of families of young patients reported "agree/absolutely agree" regarding 9 items, which included "feeling that one's life was completed" in 44 (18%; 95% confidence interval (CI) = 14-23%), "being independent in daily life" in 48 (20%; 95% CI = 15-25%), and "being free from physical distress" in 103 (42%; 95% CI = 36-48%) young patients. Young patients were significantly less likely to feel "one's life was completed" (mean = 3.3 (standard deviation = 2.0) vs. 3.8 (1.9), respectively; effect size (ES) = 0.29; adjusted p value = 0.000) and "not being a burden to others" (3.1 (1.5) vs. 3.5 (1.6), respectively; ES = 0.24; adjusted p value = 0.010) than the middle-aged. CONCLUSIONS: Overall, young cancer patients did not achieve a good death. Future efforts are needed to improve the quality of palliative care for young patients, focusing on psychosocial/spiritual suffering.
Difference in Opinions About Continuous Deep Sedation Among Cancer Patients, Bereaved Families, and Physicians. International-journal Peer-reviewed

Tatsuya Morita, Daisuke Kiuchi, Masayuki Ikenaga, Hirofumi Abo, Sayaka Maeda, Maho Aoyama, Takuya Shinjo, Yoshiyuki Kizawa, Satoru Tsuneto, Mitsunori Miyashita

Journal of pain and symptom management　57　(3)　e5-e9-e9　2019/03

DOI： 10.1016/j.jpainsymman.2018.11.025 　
Effectiveness of spiritual care using spiritual pain assessment sheet for advanced cancer patients: A pilot non-randomized controlled trial. International-journal Peer-reviewed

Kaori Ichihara, Sayako Ouchi, Sachiko Okayama, Fukiko Kinoshita, Mitsunori Miyashita, Tatsuya Morita, Keiko Tamura

Palliative & supportive care　17　(1)　46-53　2019/02

DOI： 10.1017/S1478951518000901 　

ISSN： 1478-9515
End-of-life Care and Good Death of Dying Non-cancer Patients from the Perspective of Bereaved Family Members

Akiko Unesoko, Kazuki Sato, Yuka Onishi, Mitsunori Miyashita, Tatsuya Morita, Masahiro Iwabuchi, Yuna Goto, Hiroya Kinoshita

Palliative Care Research　14　(3)　177-185　2019
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.14.177 　

eISSN： 1880-5302
高齢者ケア施設におけるエンド・オブ・ライフケアのIntegrated Care Pathwayに関する介入・実装研究スコーピングレビュー

山縣千尋, 廣岡佳代, 菅野雄介, 田口敦子, 松本佐知子, 宮下光令, 深堀浩樹

Palliative Care Research　13　(4)　313-327　2018/12
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
A Booklet for Families of Children Dying with Incurable Cancer: Development and Feasibility Study by Opinions of Pediatric Oncology Specialists

入江亘, 名古屋祐子, 名古屋祐子, 羽鳥裕子, 吉田沙蘭, 尾形明子, 松岡真里, 多田羅竜平, 永山淳, 宮下光令, 塩飽仁

Palliative Care Research (Web)　13　(4)　383-391　2018/12
Publisher:
DOI： 10.2512/jspm.13.383 　

ISSN： 1880-5302

eISSN： 1880-5302
緩和ケア病棟のケアの質および遺族の悲嘆・うつの地域差全国遺族調査の結果から Peer-reviewed

米永裕紀, 青山真帆, 森谷優香, 五十嵐尚子, 升川研人, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research　13　(3)　235-243　2018/09
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
がんサバイバーの就業状況、収入の変化に関する経験の実態とQOL・心の健康との関連 Peer-reviewed

清水佐智子, 高橋都, 藤澤大介, 藤森麻衣子, 宮下光令

Palliative Care Research　13　(3)　209-218　2018/09
Publisher:
eISSN： 1880-5302
Families' Sense of Abandonment When Patients Are Referred to Hospice. International-journal Peer-reviewed

Takuya Odagiri, Tatsuya Morita, Maho Aoyama, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

The oncologist　23　(9)　1109-1115　2018/09

DOI： 10.1634/theoncologist.2017-0547 　

ISSN： 1083-7159

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BACKGROUND: Terminally ill patients with cancer and their families may have a sense of abandonment when they are referred to hospice. This study aimed to clarify the prevalence of families' sense of abandonment, explore the association between the sense of abandonment and the oncologists' behaviors, and investigate the association between the sense of abandonment and the families' depression and complicated grief. PATIENTS AND METHODS: This was part of a nationwide self-reported questionnaire survey of bereaved families of patients with cancer who died in inpatient hospices. We sent questionnaires to 947 bereaved families of patients with cancer who died in 133 certified hospices between May 2012 and January 2014. RESULTS: Among 707 responses obtained, a total of 189 (26.7%) families felt abandoned. The factors significantly associated with a greater sense of abandonment were that the oncologists said there was nothing more to do for the patient, the patient's age of less than 60 years, and being the patient's spouse. The factors significantly associated with a lower sense of abandonment were that the oncologists reassured the patients that they had received the best anticancer treatment, that the oncologists recommended hospices as one potential choice rather than mandatory, and that a palliative care team provided care. Families with a sense of abandonment had higher scores on the Patient Health Questionnaire-9 (p = .096) and Brief Grief Questionnaire (p < .001). CONCLUSION: Approximately a quarter of bereaved families had a sense of abandonment, which was associated with a higher rate of complicated grief. Oncologists may reduce the sense of abandonment by reassuring that the patients received the best anticancer treatment, recommending hospices as a potential choice rather than as mandatory, and by not saying there is nothing that can be done for the patients. IMPLICATIONS FOR PRACTICE: This self-reported questionnaire study investigated the prevalence of families' feelings of abandonment when they were referred to hospice care, focusing on the association of sense of abandonment and the behavior of their physicians. Nearly a quarter of families felt abandoned by the referral to hospice, and the behavior of some oncologists was associated with the sense of abandonment.
Patient perceptions of curability and physician-reported disclosures of incurability in Japanese patients with unresectable/recurrent cancer: a cross-sectional survey. Peer-reviewed

Oishi T, Sato K, Morita T, Mack JW, Shimodaira H, Takahashi M, Takahashi S, Inoue A, Murakawa Y, Kawahara M, Ishioka C, Miyashita M

Japanese journal of clinical oncology　48　(10)　913-919　2018/08

DOI： 10.1093/jjco/hyy112 　

ISSN： 0368-2811

eISSN： 1465-3621
Bereaved Family Members' Perceptions of the Distressing Symptoms of Terminal Patients With Cancer. International-journal Peer-reviewed

Yoshiaki Okamoto, Tatsuya Morita, Satoru Tsuneto, Maho Aoyama, Yoshiyuki Kizawa, Yasuo Shima, Mitsunori Miyashita

The American journal of hospice & palliative care　35　(7)　972-977　2018/07

DOI： 10.1177/1049909118765409 　

ISSN： 1049-9091
Editorial Special Issue: Pain Management. Peer-reviewed

Miyashita M

Asia-Pacific journal of oncology nursing　5　(3)　245-247　2018/07

DOI： 10.4103/apjon.apjon_22_18 　

ISSN： 2347-5625
Development and Validity of the Nursing Care Scale and Nurse's Difficulty Scale in Caring for Dying Patients With Cancer and Their Families in General Hospitals in Japan. International-journal Peer-reviewed

Kanno Y, Sato K, Shimizu M, Funamizu Y, Andoh H, Kishino M, Senaga T, Takahashi T, Miyashita M

Journal of hospice and palliative nursing : JHPN : the official journal of the Hospice and Palliative Nurses Association　21　(2)　174-182　2018/07

DOI： 10.1097/NJH.0000000000000482 　

ISSN： 1522-2179

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This study develops and examines the validity and reliability of 2 scales, respectively, for evaluating nursing care and the experience of difficulties providing nursing care for dying patients with cancer and their families. A cross-sectional anonymous questionnaire was administered to nursing staff caring for dying patients with cancer and their families in 4 general hospitals and a university hospital in Japan. The instruments assessed were the Nursing Care Scale for Dying Patients and Their Families (NCD) and the Nurse's Difficulty Scale for Dying Patients and Their Families (NDD). Of the 497 questionnaires sent to nurses, 401 responses (80%) were analyzed. Factor analyses revealed that the NCD and NDD consisted of 12 items with 4 subscales: "symptom management," "reassessment of current treatment and nursing care," "explanation to family," and "respect for the patient and family's dignity before and after death." These scales had sufficient convergent and discriminative validity, sufficient internal consistency (α of subscales: NCD, 0.71-0.87; NDD, 0.74-0.93), and sufficient test-retest reliability (intraclass correlation coefficient of subscales: NCD, 0.59-0.81; NDD, 0.67-0.82) to be used as self-assessments and evaluation tools in education programs to improve the quality of nursing care for the dying patients and their families.
がん薬物療法の効果の認識による看取り場所の希望と実際

佐藤悠子, 大石隆之, 高橋昌宏, 宮下光令, 石岡千加史

Palliative Care Research　13　(Suppl.)　S421-S421　2018/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
認知症患者における望ましい人生の最終段階のあり方についてのインタビュー調査

田村菜津子, 青山真帆, 五十嵐尚子, 山川みやえ, 坂井志麻, 深堀浩樹, 中西三春, 佐藤一樹, 長江弘子, 高橋在也, 宮下光令

Palliative Care Research　13　(Suppl.)　S441-S441　2018/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
緩和ケア病棟におけるケアの質および遺族の悲嘆・抑うつの地域差全国調査の結果から Peer-reviewed

米永裕紀, 青山真帆, 森谷優香, 五十嵐尚子, 升川研人, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research　13　(Suppl.)　S263-S263　2018/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
高齢者ケア施設におけるエンド・オブ・ライフ・ケアのIntegrated Care Pathwaysに関する介入・実装研究スコーピングレビュー

山縣千尋, 深堀浩樹, 廣岡佳代, 菅野雄介, 田口敦子, 松本佐知子, 宮下光令

Palliative Care Research　13　(Suppl.)　S440-S440　2018/06
Publisher: (NPO)日本緩和医療学会
緩和ケア病棟におけるケアの質および遺族の悲嘆・抑うつの地域差全国調査の結果から

米永裕紀, 青山真帆, 森谷優香, 五十嵐尚子, 升川研人, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research　13　(Suppl.)　S263-S263　2018/06
Publisher: (NPO)日本緩和医療学会
ISSN： 1880-5302
Communication about the impending death of patients with cancer to the family: a nationwide survey. Peer-reviewed

Mori M, Morita T, Igarashi N, Shima Y, Miyashita M

BMJ supportive & palliative care　8　(2)　221-228　2018/06

DOI： 10.1136/bmjspcare-2017-001460 　

ISSN： 2045-435X
Advance care planning for heart failure

Yuri Nishikawa, Hiroki Fukahori, Erika Ota, Atsushi Mizuno, Natsuko Hiroyama, Mitsunori Miyashita, Daisuke Yoneoka, Joey S.W. Kwong

Cochrane Database of Systematic Reviews　2018　(5)　2018/05/04
Publisher: John Wiley and Sons Ltd
DOI： 10.1002/14651858.CD013022 　

ISSN： 1469-493X
The Japan hospice and palliative evaluation study 4: a cross-sectional questionnaire survey. International-journal Peer-reviewed

Kento Masukawa, Maho Aoyama, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

BMC palliative care　17　(1)　66-66　2018/04/20

DOI： 10.1186/s12904-018-0319-z 　

ISSN： 1472-684X
Communication Disparity Between the Bereaved and Others: What Hurts Them and What Is Unhelpful? A Nationwide Study of the Cancer Bereaved. International-journal Peer-reviewed

Mayumi Ishida, Hideki Onishi, Tatsuya Morita, Yosuke Uchitomi, Megumi Shimizu, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

Journal of pain and symptom management　55　(4)　1061-1067　2018/04

DOI： 10.1016/j.jpainsymman.2017.12.493 　

ISSN： 0885-3924
Intensive Care Unit 版 Quality of Dying and Death (ICU-QODD) 看護師評価用日本語版の作成に関する研究 Peer-reviewed

木下里美, 宮下光令, 佐藤一樹

Palliative Care Research　13　(1)　121-128　2018/03/29

DOI： 10.2512/jspm.13.121 　

ISSN： 1880-5302
Physician Behavior toward Death Pronouncement in Palliative Care Units Peer-reviewed

Yutaka Hatano, Tatsuya Morita, Hiroyuki Otani, Naoko Igarashi, Yasuo Shima, Mitsunori Miyashita

Journal of Palliative Medicine　21　(3)　368-372　2018/03/01

DOI： 10.1089/jpm.2017.0239 　

ISSN： 1557-7740 1096-6218
Factors associated with possible complicated grief and major depressive disorders. International-journal Peer-reviewed

Maho Aoyama, Yukihiro Sakaguchi, Tatsuya Morita, Asao Ogawa, Daisuke Fujisawa, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

Psycho-oncology　27　(3)　915-921　2018/03

DOI： 10.1002/pon.4610 　

ISSN： 1057-9249
Are Bereaved Family Members Satisfied With Information Provision About Palliative Care Units in Japan? Peer-reviewed

Makiko Sanjo, Tatsuya Morita, Mitsunori Miyashita, Kazuki Sato, Kiyoko Kamibeppu, Satoru Tsuneto, Yasuo Shima

American Journal of Hospice and Palliative Medicine　35　(2)　275-283　2018/02/01

DOI： 10.1177/1049909117729805 　

ISSN： 1938-2715 1049-9091
Changes in Nurses' Knowledge, Difficulties, and Self-reported Practices Toward Palliative Care for Cancer Patients in Japan: An Analysis of Two Nationwide Representative Surveys in 2008 and 2015. International-journal Peer-reviewed

Nakazawa Y, Kato M, Miyashita M, Morita T, Kizawa Y

Journal of pain and symptom management　55　(2)　402-412　2018/02

DOI： 10.1016/j.jpainsymman.2017.08.034 　

ISSN： 0885-3924
Which Research Questions Are Important for the Bereaved Families of Palliative Care Cancer Patients? A Nationwide Survey. International-journal Peer-reviewed

Akihiro Sakashita, Tatsuya Morita, Megumi Kishino, Maho Aoyama, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

Journal of pain and symptom management　55　(2)　379-386　2018/02

DOI： 10.1016/j.jpainsymman.2017.09.012 　

ISSN： 0885-3924
Development of an Instrument for Evaluating Nurses' Knowledge and Attitude Toward End-of-Life Care: End-of-Life Nursing Education Consortium-Japan Core Quiz. International-journal Peer-reviewed

Tomoko Arahata, Mitsunori Miyashita, Sayaka Takenouchi, Keiko Tamura, Yoshiyuki Kizawa

Journal of hospice and palliative nursing : JHPN : the official journal of the Hospice and Palliative Nurses Association　20　(1)　55-62　2018/02

DOI： 10.1097/NJH.0000000000000393 　

ISSN： 1522-2179
The Current Situation and Issues of Cancer Treatment Selection, Influence on Life of Cancer Patients, and Support for Cancer Patients: Survey of Members of Miyagi Cancer Patient Association Network

五十嵐尚子, 青山真帆, 吉田久美子, 田村久美子, 阿部佐智子, 小野寺幸枝, 高橋修子, 高橋まどか, 兼平麻衣子, 志田彩佳, 宮下光令

東北大学医学部保健学科紀要　27　(1)　31‐42　2018/01/31

ISSN： 1348-8899
日本のがん疼痛とオピオイド量の真実第3回日本のがん患者の疼痛の頻度とPain Management Indexに関するメタ分析

高橋理智, 高橋理智, 森田達也, 野里洵子, 服部政治, 上野博司, 岡本禎晃, 伊勢雄也, 佐藤一樹, 宮下光令, 細川豊史

緩和ケア　28　(1)　042‐049　2018/01/15

ISSN： 1349-7138
Medical Staff’s Support for Family Members Who Verbally Communicate Feelings to Patients in Palliative Care Units: A Survey of Bereaved Family Members

Kazuhiro Nakazato, Mariko Shiozaki, Kei Hirai, Tatsuya Morita, Ryuhei Tatara, Kaori Ichihara, Shinichi Sato, Megumi Shimizu, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

Palliative Care Research　13　(3)　263-271　2018
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.13.263 　

eISSN： 1880-5302

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Objectives: This study aimed to clarify the presence and evaluation of eight types of support by medical staff for family members that aid the verbal communication of feelings to patients (i.e., verbal communication support for family members) in palliative care units. Further, the relationship between the presence of "verbal communication support for family members" and the variables of a "good relationship between patient and family," and "overall care satisfaction" was assessed. Methods: A questionnaire was administered to 968 bereaved family members of patients who died in 103 palliative care units in Japan. Results: A total of 536 responses were analyzed. Although the proportion of the families who received support differed depending on the content, the evaluation of the support received by the families was positive overall. Multiple regression analysis showed a significant positive association (p<0.05) for all eight types of support and those family members who reported a good relationship between patient and family. The results also showed a significant positive association (p<0.05) between four support types (concrete proposal of families' verbalization to the patients, telling to the patients the feelings that families want to convey, ensuring that the patients can hear, and words to families that imply the patient's feelings toward his/her family) and overall care satisfaction. Conclusion: Identifying methods to improve medical staff's "verbal communication support for families" in daily care may ultimately strengthen the relationship between patients and their families as well as lead to their increased satisfaction with care.
The Job Types and Related Factors That Physicians and Nurses Feel Easy to Consult about Pediatric Cancer Patients' and Their Families' End of Life Care

名古屋祐子, 名古屋祐子, 宮下光令, 塩飽仁

Palliative Care Research (Web)　13　(1)　89‐98(J‐STAGE)　2018

DOI： 10.2512/jspm.13.89 　

ISSN： 1880-5302
Development of a Scale for the Japanese Version of the Quality of Dying and Death in the Intensive Care Unit Instrument for Use by Nurses

木下里美, 宮下光令, 佐藤一樹

Palliative Care Research (Web)　13　(1)　121‐128(J‐STAGE)　2018

DOI： 10.2512/jspm.13.121 　

ISSN： 1880-5302
End-of-life experiences of family caregivers of deceased patients with cancer: A nation-wide survey Peer-reviewed

Kayo Hirooka, Hiroyuki Otani, Tatsuya Morita, Tomofumi Miura, Hiroki Fukahori, Maho Aoyama, Yoshiyuki Kizawa, Yasuo Shima, Satoru Tsuneto, Mitsunori Miyashita

Psycho-Oncology　27　(1)　272-278　2018/01/01

DOI： 10.1002/pon.4504 　

ISSN： 1099-1611 1057-9249
Prevalence and predictors of conflict in the families of patients with advanced cancer: A nationwide survey of bereaved family members Peer-reviewed

Jun Hamano, Tatsuya Morita, Masanori Mori, Naoko Igarashi, Yasuo Shima, Mitsunori Miyashita

Psycho-Oncology　27　(1)　302-308　2018/01/01

DOI： 10.1002/pon.4508 　

ISSN： 1099-1611 1057-9249
Acculturation and Perceptions of a Good Death Among Japanese Americans and Japanese Living in the U.S. Peer-reviewed

Masanori Mori, Yuichiro Kuwama, Takamaru Ashikaga, Henrique A. Parsons, Mitsunori Miyashita

Journal of Pain and Symptom Management　55　(1)　31-38　2018/01/01

DOI： 10.1016/j.jpainsymman.2017.08.010 　

ISSN： 1873-6513 0885-3924
Validity and Reliability of the Dying Care Process and Outcome Scales Before and After Death From the Bereaved Family Members' Perspective. Peer-reviewed

Kanno Y, Sato K, Shimizu M, Funamizu Y, Andoh H, Kishino M, Senaga T, Takahashi T, Miyashita M

The American journal of hospice & palliative care　36　(2)　1049909118785178-137　2018/01

DOI： 10.1177/1049909118785178 　

ISSN： 1049-9091

eISSN： 1938-2715
Empowering Nurses Through Translating the End-of-Life Nursing Education Consortium: The End-of-Life Nursing Education Consortium-Japan Core Curriculum Project Peer-reviewed

Sayaka Takenouchi, Tomoyo Sasahara, Mitsunori Miyashita, Masako Kawa, Megumi Umeda, Miyoko Kuwata, Tomoko Arahata, Yoshiyuki Kizawa, Keiko Tamura

JOURNAL OF HOSPICE & PALLIATIVE NURSING　19　(6)　539-549　2017/12

DOI： 10.1097/NJH.0000000000000385 　

ISSN： 1522-2179

eISSN： 1539-0705
Talking About Death With Terminally-Ill Cancer Patients: What Contributes to the Regret of Bereaved Family Members? Peer-reviewed

Masanori Mori, Saran Yoshida, Mariko Shiozaki, Mika Baba, Tatsuya Morita, Maho Aoyama, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　54　(6)　853-+　2017/12

DOI： 10.1016/j.jpainsymman.2017.02.021 　

ISSN： 0885-3924

eISSN： 1873-6513
Unfinished Business in Families of Terminally Ill With Cancer Patients Peer-reviewed

Ryoko Yamashita, Harue Arao, Ayumi Takao, Eiko Masutani, Tatsuya Morita, Yasuo Shima, Yoshiyuki Kizawa, Satoru Tsuneto, Maho Aoyama, Mitsunori Miyashita

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　54　(6)　861-869　2017/12

DOI： 10.1016/j.jpainsymman.2017.04.013 　

ISSN： 0885-3924

eISSN： 1873-6513
Psychological and psychiatric symptoms of terminally ill patients with cancer and their family caregivers in the home-care setting: A nation-wide survey from the perspective of bereaved family members in Japan Peer-reviewed

Makoto Kobayakawa, Asao Ogawa, Michiko Konno, Akiko Kurata, Jun Hamano, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Maho Aoyama, Mitsunori Miyashita

JOURNAL OF PSYCHOSOMATIC RESEARCH　103　127-132　2017/12

DOI： 10.1016/j.jpsychores.2017.10.012 　

ISSN： 0022-3999

eISSN： 1879-1360
Development and Validation of the Terminal Delirium Scale, A Scale for Assessment of Irreversible Terminal Delirium Peer-reviewed

Megumi Uchida, Tatsuo Akechi, Tatsuya Morita, Yasuo Shima, Naoko Igarashi, Mitsunori Miyashita

ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY　13　223-223　2017/11

ISSN： 1743-7555

eISSN： 1743-7563
The relationship between cancer patients' place of death and bereaved caregivers' mental health status Peer-reviewed

Yutaka Hatano, Maho Aoyama, Tatsuya Morita, Takuhiro Yamaguchi, Isseki Maeda, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

PSYCHO-ONCOLOGY　26　(11)　1959-1964　2017/11

DOI： 10.1002/pon.4412 　

ISSN： 1057-9249

eISSN： 1099-1611
Trust in Physicians, Continuity and Coordination of Care, and Quality of Death in Patients with Advanced Cancer Peer-reviewed

Jun Hamano, Tatsuya Morita, Sakiko Fukui, Yoshiyuki Kizawa, Satoru Tunetou, Yasuo Shima, Makoto Kobayakawa, Maho Aoyama, Mitsunori Miyashita

JOURNAL OF PALLIATIVE MEDICINE　20　(11)　1252-1259　2017/11

DOI： 10.1089/jpm.2017.0049 　

ISSN： 1096-6218

eISSN： 1557-7740
Variations in Denominators and Cut-off Points of Pain Intensity in the Pain Management Index: A Methodological Systematic Review Peer-reviewed

Richi Takahashi, Tatsuya Morita, Mitsunori Miyashita

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　54　(5)　E1-E4　2017/11

DOI： 10.1016/j.jpainsymman.2017.08.026 　

ISSN： 0885-3924

eISSN： 1873-6513
"What I Did for My Loved One Is More Important than Whether We Talked About Death": A Nationwide Survey of Bereaved Family Members Peer-reviewed

Masanori Mori, Saran Yoshida, Mariko Shiozaki, Tatsuya Morita, Mika Baba, Maho Aoyama, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

JOURNAL OF PALLIATIVE MEDICINE　21　(3)　335-341　2017/11

DOI： 10.1089/jpm.2017.0267 　

ISSN： 1096-6218

eISSN： 1557-7740
Exploratory Qualitative Study of Regret Stemming from Ending Terminal Treatment and Psychological Coping among the Bereaved Family Members of Cancer Patients: What Does the Family Regret about Terminal Treatment Choices and Why?

塩崎麻里子, 三條真紀子, 吉田沙蘭, 平井啓, 宮下光令, 森田達也, 恒藤暁, 志真泰夫

Palliative Care Research (Web)　12　(4)　753-760　2017/10
Publisher:
DOI： 10.2512/jspm.12.753 　

ISSN： 1880-5302

eISSN： 1880-5302
Symptom Prevalence, Severity, and Distress Assessed by Memorial Symptom Assessment Scale (MSAS) in the General Population in Japan

伊藤怜子, 清水恵, 内藤明美, 佐藤一樹, 藤澤大介, 恒藤暁, 森田達也, 宮下光令

Palliative Care Research (Web)　12　(4)　761-770　2017/10
Publisher:
DOI： 10.2512/jspm.12.761 　

ISSN： 1880-5302

eISSN： 1880-5302
Potential palliative care quality indicators in heart disease patients: A review of the literature Peer-reviewed

Atsushi Mizuno, Mitsunori Miyashita, Akitoshi Hayashi, Fujimi Kawai, Koichiro Niwa, Akemi Utsunomiya, Shun Kohsaka, Takashi Kohno, Takeshi Yamamoto, Morimasa Takayama, Toshihisa Anzai

JOURNAL OF CARDIOLOGY　70　(3-4)　335-341　2017/09

DOI： 10.1016/j.jjcc.2017.02.010 　

ISSN： 0914-5087

eISSN： 1876-4738
Meaningful Communication Before Death, but Not Present at the Time of Death Itself, Is Associated With Better Outcomes on Measures of Depression and Complicated Grief Among Bereaved Family Members of Cancer Patients Peer-reviewed

Hiroyuki Otani, Saran Yoshida, Tatsuya Morita, Maho Aoyama, Yoshiyuki Kizawa, Yasuo Shima, Satoru Tsuneto, Mitsunori Miyashita

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　54　(3)　273-279　2017/09

DOI： 10.1016/j.jpainsymman.2017.07.010 　

ISSN： 0885-3924

eISSN： 1873-6513
The Japan HOspice and Palliative Care Evaluation Study 3: Study Design, Characteristics of Participants and Participating Institutions, and Response Rates Peer-reviewed

Maho Aoyama, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE　34　(7)　654-664　2017/08

DOI： 10.1177/1049909116646336 　

ISSN： 1049-9091

eISSN： 1938-2715
Validation Study for the Brief Measure of Quality of Life and Quality of Care: A Questionnaire for the National Random Sampling Hospital Survey Peer-reviewed

Megumi Shimizu, Daisuke Fujisawa, Miho Kurihara, Kazuki Sato, Tatsuya Morita, Masashi Kato, Mitsunori Miyashita

AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE　34　(7)　622-631　2017/08

DOI： 10.1177/1049909117693576 　

ISSN： 1049-9091

eISSN： 1938-2715
J‐HOPE3研究の概要と療養場所がケアの質・遺族の精神的健康状態にあたえる影響について

青山真帆, 羽多野裕, 宮下光令

がん看護　22　(5)　534‐538　2017/07/20

DOI： 10.15106/J03022.2017336681 　

ISSN： 1342-0569
Effects of End-of-Life Discussions on the Mental Health of Bereaved Family Members and Quality of Patient Death and Care Peer-reviewed

Takashi Yamaguchi, Isseki Maeda, Yutaka Hatano, Masanori Mori, Yasuo Shima, Satoru Tsuneto, Yoshiyuki Kizawa, Tatsuya Morita, Takuhiro Yamaguchi, Maho Aoyama, Mitsunori Miyashita

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　54　(1)　17-+　2017/07

DOI： 10.1016/j.jpainsymman.2017.03.008 　

ISSN： 0885-3924

eISSN： 1873-6513
全国大規模遺族調査に基づく緩和ケア病棟入院後1週間未満で死亡した患者の特徴 Peer-reviewed

赤堀初音, 齊藤英一, 青山真帆, 佐藤一樹, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research　12　(Suppl.)　S338-S338　2017/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
Pediatric Cancer Patients' Important End-of-Life Issues, Including Quality of Life: A Survey of Pediatric Oncologists and Nurses in Japan Peer-reviewed

Yuko Nagoya, Mitsunori Miyashita, Hitoshi Shiwaku

JOURNAL OF PALLIATIVE MEDICINE　20　(5)　487-493　2017/05

DOI： 10.1089/jpm.2016.0242 　

ISSN： 1096-6218

eISSN： 1557-7740
Decision Making Regarding the Place of End-of-Life Cancer Care: The Burden on Bereaved Families and Related Peer-reviewed

Sena Yamamoto, Harue Arao, Eiko Masutani, Miwa Aoki, Megumi Kishino, Tatsuya Morita, Yasuo Shima, Yoshiyuki Kizawa, Satoru Tsuneto, Maho Aoyama, Mitsunori Miyashita

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　53　(5)　862-870　2017/05

DOI： 10.1016/j.jpainsymman.2016.12.348 　

ISSN： 0885-3924

eISSN： 1873-6513
Views on life and death of physicians, nurses, cancer patients and general population in Japan Peer-reviewed

Noriyasu Sekiya, Yujiro Kuroda, Kasumi Nakajima, Yumi Iwamitsu, Yoshiaki Kanai, Mitsunori Miyashita, Midori Kotani, Yutaka Kitazawa, Hideomi Yamashita, Keiichi Nakagawa

PLOS ONE　12　(5)　e0176648　2017/05

DOI： 10.1371/journal.pone.0176648 　

ISSN： 1932-6203
Why Patients in Institutions with Religious Background Achieve 'Good Death' ? : Findings from National Bereavement Survey of 127 Hospice and Palliative Care Units

青山真帆, 斎藤愛, 菅井真理, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research (Web)　12　(2)　211-220　2017/04
Publisher:
DOI： 10.2512/jspm.12.211 　

ISSN： 1880-5302

eISSN： 1880-5302
Desirable Information of Opioids for Families of Patients With Terminal Cancer: The Bereaved Family Members' Experiences and Recommendations Peer-reviewed

Yoshiaki Okamoto, Satoru Tsuneto, Tatsuya Morita, Tatsuya Takagi, Megumi Shimizu, Mitsunori Miyashita, Etsuko Uejima, Yasuo Shima

AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE　34　(3)　248-253　2017/04

DOI： 10.1177/1049909115626701 　

ISSN： 1049-9091

eISSN： 1938-2715
Collaborative care intervention for the perceived care needs of women with breast cancer undergoing adjuvant therapy after surgery: a feasibility study Peer-reviewed

Kanae Momino, Miyashita Mitsunori, Hiroko Yamashita, Tatsuya Toyama, Hiroshi Sugiura, Nobuyasu Yoshimoto, Kei Hirai, Tatsuo Akechi

JAPANESE JOURNAL OF CLINICAL ONCOLOGY　47　(3)　213-220　2017/03

DOI： 10.1093/jjco/hyw189 　

ISSN： 0368-2811

eISSN： 1465-3621
東北大学病院の看護師のがん疼痛ケアの実践状況

平山英幸, 中條庸子, 齋藤明美, 畠山里恵, 飯沼由紀恵, 大桐規子, 志田智子, 庄子由美, 門間典子, 宮下光令

東北大学医学部保健学科紀要　26　(1)　35‐45　2017/01/31

ISSN： 1348-8899
グリーフケアを考える遺族研究にみる「望ましい終末期ケア」と「望ましい看取り」

青山真帆, 宮下光令

訪問看護と介護　22　(1)　20‐25　2017/01/15

DOI： 10.11477/mf.1688200610 　

ISSN： 1341-7045
原発性悪性脳腫瘍患者における終末期ケアの質の評価ホスピス・緩和ケア病棟での多施設遺族調査 Peer-reviewed

杉山育子, 青山真帆, 佐藤一樹, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

日本がん看護学会誌　31　(Suppl.)　202-202　2017/01
Publisher: (一社)日本がん看護学会
ISSN： 0914-6423

eISSN： 2189-7565
全国のがん診療連携拠点病院における認知症ケア提供体制に関する実態 Peer-reviewed

菅野雄介, 野畑宏之, 岩田愛雄, 比嘉謙介, 佐山七生, 内村泰子, 大谷清子, 山中弘子, 豊永香奈, 宮下光令, 小川朝生

Palliat Care Res　12　(1)　116-24　2017
Verbal communication of families with cancer patients at end of life: A questionnaire survey with bereaved family members Peer-reviewed

中里和弘, 塩崎麻里子, 平井啓, 森田達也, 多田羅竜平, 市原香織, 佐藤眞一, 清水恵, 恒藤暁, 志真泰夫, 宮下光令

27　(1)　155-162　2017/01
遺族によるホスピス・緩和ケアの質の評価に関する多施設遺族調査における結果のフィードバックの活用状況

五十嵐尚子, 青山真帆, 佐藤一樹, 佐藤一樹, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research (Web)　12　(1)　131-139　2017/01
Publisher:
DOI： 10.2512/jspm.12.131 　

ISSN： 1880-5302

eISSN： 1880-5302
がん診療連携拠点病院における認知症の整備体制に関する実態調査

菅野雄介, 菅野雄介, 野畑宏之, 岩田愛雄, 比嘉謙介, 佐山七生, 内村泰子, 大谷清子, 豊永香奈, 宮下光令, 小川朝生, 小川朝生

Palliative Care Research (Web)　12　(1)　116‐124(J‐STAGE)-124　2017
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.12.116 　

ISSN： 1880-5302

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The aim of this study was to investigate the dementia provision for elderly cancer patients in designated regional cancer centers. A survey was mailed to 389 designated regional cancer centers from February to June, 2015. A total of 188 facilities responded (response rate: 48.3%). 5.3% of the respondents used two manuals (on basic dementia care and the behavioral and psychological symptoms of dementia) to check whether these centers were following appropriate measures. About 50% of the respondents performed dementia assessments by the primary care team. 29.3% of the respondents maintained the system of the education and training of dementia care. Therefore, dementia provision for elderly cancer patients in designated regional cancer centers needs to improve the education of dementia care.
Nationwide Survey on Complementary and Alternative Medicine (CAM) in Cancer Patients Who Died at Palliative Care Units in Japan: Prevalence of CAM and Family Experience

鈴木梢, 森田達也, 田中桂子, 鄭陽, 東有佳里, 五十嵐尚子, 志真泰夫, 宮下光令

Palliative Care Research (Web)　12　(4)　731‐737(J‐STAGE)-737　2017
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.12.731 　

ISSN： 1880-5302

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The aim of this study was to understand the use of complementary and alternative medicine (CAM) in cancer patients in Japan. This study was part of the Japan Hospice and Palliative care Evaluation 2016 (J-HOPE2016) Study. A multicenter questionnaire survey was conducted on a sample of bereaved family members of cancer patients who died at palliative care units. Data suggest that 54% of cancer patients use CAM. In comparison with a previous study in 2005 in Japan, categories of CAM vary widely; CAM previously included supplements mostly, but now exercise and mind and body therapy are also used. Most cancer patients use CAM without any harmful influence on their household economy and cancer treatment; however, in some patients, CAM incurs a large expense and a delay in starting cancer treatment. Therefore, it is important for medical staff and patients to have an opportunity to discuss CAM use. Multiple logistic regression analysis shows that CAM use is significantly associated with younger patients and highly educated families; moreover, there is a possibility that family members who use CAM have a high level of psychological distress. We must pay attention to the physical and the psychological aspects of cancer patients who use CAM and their families. Further studies are needed to investigate the use of each category of CAM, and to understand patients who use CAM and who die at home or in hospitals other than palliative care units.
遺族による終末期高齢患者の介護体験評価:認知症併存の有無での比較と関連要因

佐藤一樹, 佐藤一樹, 芹澤未有, 宮下光令, 木下寛也, 木下寛也

Palliative Care Research (Web)　12　(1)　159‐168(J‐STAGE)-168　2017
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.12.159 　

ISSN： 1880-5302

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Objectives: This study aimed to evaluate the consequences of caring for end-of-life elderly patients from the bereaved family's perspective. Methods: We conducted a cross-sectional, anonymous, self-report questionnaire survey for bereaved family members by web survey. Outcomes were caregiving consequences (Caregiving Consequences Inventory). We compared the outcomes between with and without dementia. Results: 163 and 224 dying elderly patients with and without comorbid dementia were analyzed from bereaved family members' responses. The outcomes were not significantly different (burden, 5.24±1.12, 5.32±1.24, p=0.487; fulfillment, 4.53±1.06, 4.59±1.29, p=0.627; growth, 4.94±0.93, 5.00±1.04, p=0.523). Fulfillment was significantly associated with spouse, family visitation, and mental health. Growth was significantly associated with age, spouse, end-of-life discussion, and family preference of treatments. Conclusion: The evaluation of the consequences of caring for end-of-life elderly patients from the bereaved family's perspective were not significantly between the informal caregivers of those with and without comorbid dementia.
Factors Affecting Quality of Life of Family Caregivers of Cancer Patients: Study Using the Japanese Version CQOLC (The Caregiver Quality of Life Index-Cancer)

杉山育子, 庄司春菜, 五十嵐尚子, 佐藤一樹, 佐藤一樹, 高橋都, 宮下光令

Palliative Care Research (Web)　12　(3)　259‐269(J‐STAGE)-269　2017
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.12.259 　

ISSN： 1880-5302

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Purpose: To clarify the factors that affect the family caregiver's quality of life (QOL) of cancer patients. Methods: We conducted an internet survey including 21 items of the Japanese version CQOLC for 400 families of cancer patients in March 2012. Results: Factors that increased psychological burden were that caregivers were women, other family needed long-term care, and the patient had higher need for care. Factors that increased the family caregiver's difficulty in their daily activities due to long-term care were caregivers are women, other family needed long-term care, caregivers did not think they had a good relationship with the patient, and the patient had higher need for care. Factors that increased financial burden were that the age of caregivers was less than 60 years, decreased of income after the patient's diagnosis, and patients were men. Factors that increase the positive feeling for caregiving were that caregivers thought they had good relationship with the patient, and the patient's need for care was higher. Conclusions: To reduce the burden in family caregiver of cancer patients without losing the positive feeling for caregiving would be important for both improving the family caregiver's QOL, and to continue the care for patient in long term.
The Predictive Risk Factors for Bedsores of Terminal Cancer Patients Receiving Home-based Care

西崎久純, 石川奈津江, 平山英幸, 宮下光令, 中島信久

Palliative Care Research (Web)　12　(3)　271‐276(J‐STAGE)-276　2017
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.12.271 　

ISSN： 1880-5302

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Aim: To clarify the predictive risk factors for bedsores of terminal cancer patients receiving home-based care. Methods: A retrospective study was conducted involving 95 terminal cancer patients receiving home-based care, including people using services provided by home-visit care providers until death. Results: The numbers of patients with and without bedsores were 31 and 64, respectively. Bivariate analyses revealed that significant variables were the Ohura-Hotta scale (P=0.02), hyperactive delirium (P=0.005), contracture (P=0.008), and anemia (P=0.02). According to multivariable logistic analysis, significant variables were contracture (OR=16.55, P=0.0002) and hyperactive delirium (OR=4.22, P=0.008) as independent risk factors for bedsores. Discussion: For terminal cancer patients receiving home-based care, hyperactive delirium should also be considered as a predictive risk factor for bedsores.
終末期高齢者の望ましい死の達成の遺族による評価:認知症併存の有無での比較と関連要因

佐藤一樹, 佐藤一樹, 菊地亜里沙, 宮下光令, 木下寛也, 木下寛也

Palliative Care Research (Web)　12　(1)　149‐158(J‐STAGE)-158　2017
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.12.149 　

ISSN： 1880-5302

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Objectives: This study aimed to evaluate good death (end-of-life quality of life) from the perspective of bereaved family members. Methods: We conducted a cross-sectional, anonymous, self-report questionnaire survey for bereaved family members by web survey. Outcomes were achievement of a good death (Good Death Inventory, GDI). We compared the outcomes between with and without dementia. Results: 163 and 224 dying elderly patients with and without comorbid dementia were analyzed from bereaved family members' responses. The achievement of good death were significantly different (GDI scores, 4.2±1.0, 4.4±0.9, Adj P=0.053) as regards "maintaining hope and pleasure," "good relationship with family," and "independence." Conclusion: The achievement of good death was not significantly different between the dying elderly patients with and without comorbid dementia. Psychosocial care for informal caregivers would be important for better quality of dying in the terminally ill elderly patients with dementia.
がん患者が答えやすい痛みの尺度―鎮痛水準測定方法開発のための予備調査―

岸野恵, 木澤義之, 佐藤悠子, 宮下光令, 森田達也, 細川豊史

ペインクリニック　38　(1)　93‐98-98　2017/01/01
Publisher:
ISSN： 0388-4171
Does Negative PMI Indicate a Need for Further Pain Treatment? Concordance Between PMI and Other Indicators Peer-reviewed

Megumi Kishino, Yoshiyuki Kizawa, Yuko Sato, Mitsunori Miyashita, Tatsuya Morita, Toyoshi Hosokawa

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　52　(6)　E117-E118　2016/12

DOI： 10.1016/j.jpainsymman.2016.10.254 　

ISSN： 0885-3924

eISSN： 1873-6513
Eating-related distress and need for nutritional support of families of advanced cancer patients: a nationwide survey of bereaved family members Peer-reviewed

Koji Amano, Isseki Maeda, Tatsuya Morita, Yoshiro Okajima, Takashi Hama, Maho Aoyama, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

JOURNAL OF CACHEXIA SARCOPENIA AND MUSCLE　7　(5)　527-534　2016/12

DOI： 10.1002/jcsm.12102 　

ISSN： 2190-5991

eISSN： 2190-6009
日本のがん疼痛とオ伸オイド量の真実第2回世界各国と日本のオピオイド消費量に関する研究日本のがん患者に使用されているオピオイドは本当に少ないのか?

高橋理智, 森田達也, 服部政治, 上野博司, 岡本禎晃, 伊勢雄也, 宮下光令, 細川豊史

緩和ケア　26　(6)　445‐451　2016/11/15

ISSN： 1349-7138
The Burden of Decision Making Regarding the Place of End-of-Life Cancer Care on Bereaved Families Peer-reviewed

Sena Yamamoto, Harue Arao, Miwa Aoki, Megumi Kishino, Eiko Masutani, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Maho Aoyama, Mitsunori Miyashita

CANCER NURSING　39　S8-S9　2016/11

ISSN： 0162-220X

eISSN： 1538-9804
End-of-Life Medical Treatments in the Last Two Weeks of Life in Palliative Care Units in Japan, 2005-2006: A Nationwide Retrospective Cohort Survey Peer-reviewed

Kazuki Sato, Mitsunori Miyashita, Tatsuya Morita, Satoru Tsuneto, Yasuo Shima

JOURNAL OF PALLIATIVE MEDICINE　19　(11)　1188-1196　2016/11

DOI： 10.1089/jpm.2016.0108 　

ISSN： 1096-6218

eISSN： 1557-7740
A simple home-based self-monitoring tool for early detection of hand-foot syndrome in cancer patients Peer-reviewed

Naoko Mikoshiba, Noriko Yamamoto-Mitani, Takamasa Ohki, Yoshinari Asaoka, Hironori Yamaguchi, Shuntaro Obi, Kazuki Sato, Kazuhiko Koike, Mitsunori Miyashita

JAPANESE JOURNAL OF CLINICAL ONCOLOGY　46　(11)　979-985　2016/11

DOI： 10.1093/jjco/hyw112 　

ISSN： 0368-2811

eISSN： 1465-3621
Guidelines for parenteral fluid management for terminal cancer patients Peer-reviewed

Takashi Higashiguchi, Junichi Ikegaki, Kazuya Sobue, Yoichiro Tamura, Nobuhisa Nakajima, Akihiko Futamura, Mitsunori Miyashita, Naoharu Mori, Akio Inui, Keiichiro Ohta, Toyoshi Hosokawa

JAPANESE JOURNAL OF CLINICAL ONCOLOGY　46　(11)　986-992　2016/11

DOI： 10.1093/jjco/hyw105 　

ISSN： 0368-2811

eISSN： 1465-3621
Nationwide Japanese Survey About Deathbed Visions: "My Deceased Mother Took Me to Heaven'' Peer-reviewed

Tatsuya Morita, Akemi Shirado Naito, Maho Aoyama, Asao Ogawa, Izuru Aizawa, Ryosuke Morooka, Masanori Kawahara, Yoshiyuki Kizawa, Yasuo Shima, Satoru Tsuneto, Mitsunori Miyashita

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　52　(5)　646-+　2016/11

DOI： 10.1016/j.jpainsymman.2016.04.013 　

ISSN： 0885-3924

eISSN： 1873-6513
Changes in Relatives' Perspectives on Quality of Death, Quality of Care, Pain Relief, and Caregiving Burden Before and After a Region-Based Palliative Care Intervention Peer-reviewed

Isseki Maeda, Mitsunori Miyashita, Akemi Yamagishi, Hiroya Kinoshita, Yutaka Shirahige, Noriko Izumi, Takuhiro Yamaguchi, Miyuki Igarashi, Masashi Kato, Tatsuya Morita

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　52　(5)　637-645　2016/11

DOI： 10.1016/j.jpainsymman.2016.03.022 　

ISSN： 0885-3924

eISSN： 1873-6513
End-of-life discussions with advanced cancer patients and their effects on bereaved families' mental health.

Takashi Yamaguchi, Isseki Maeda, Yutaka Hatano, Masanori Mori, Yasuo Shima, Satoru Tsuneto, Yoshiyuki Kizawa, Tatsuya Morita, Takuhiro Yamaguchi, Maho Aoyama, Mitsunori Miyashita

JOURNAL OF CLINICAL ONCOLOGY　34　(26)　2016/10

DOI： 10.1200/jco.2016.34.26_suppl.3 　

ISSN： 0732-183X

eISSN： 1527-7755
遺族による終末期がん患者への緩和ケアの質の評価のための全国調査 the Japan Hospice and Palliative Care Evaluation 2 study(J-HOPE2 study)

清水恵, 青山真帆, 森田達也, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research　11　(4)　254-264　2016/10
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
Family caregivers require mental health specialists for end-of-life psychosocial problems: A nation-wide survey from the Japan Hospice and Palliative care Evaluation study (JHOPE2) Peer-reviewed

Makoto Kobayakawa, Hitoshi Okamura, Akemi Yamagishi, Tatsuya Morita, Shohei Kawagoe, Megumi Shimizu, Taketoshi Ozawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

PSYCHO-ONCOLOGY　25　(SP. S3)　51-51　2016/10

DOI： 10.1002/pon.3982 　

ISSN： 1057-9249

eISSN： 1099-1611
日本のがん疼痛とオピオイド量の真実第1回日本と世界のオピオイド消費量

高橋理智, 森田達也, 服部政治, 上野博司, 岡本禎晃, 伊勢雄也, 宮下光令, 細川豊史

緩和ケア　26　(5)　367‐374　2016/09/15

ISSN： 1349-7138
The Association Between Pain and Quality of Life for Patients With Cancer in an Outpatient Clinic, an Inpatient Oncology Ward, and Inpatient Palliative Care Units Peer-reviewed

Fukiko Mikan, Makoto Wada, Michiko Yamada, Ayaka Takahashi, Hideki Onishi, Mayumi Ishida, Kazuki Sato, Sachiko Shimizu, Motohiro Matoba, Mitsunori Miyashita

AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE　33　(8)　782-790　2016/09

DOI： 10.1177/1049909116630266 　

ISSN： 1049-9091

eISSN： 1938-2715
Evaluation of care for leukemia and lymphoma patients during their last hospitalization from the perspective of the bereaved family Peer-reviewed

Yuki Shirai, Mitsunori Miyashita, Masako Kawa, Toru Motokura, Fumiaki Sano, Tetsuya Fukuda, Kazuo Oshimi, Keiko Kazuma

LEUKEMIA RESEARCH　47　93-99　2016/08

DOI： 10.1016/j.leukres.2016.05.016 　

ISSN： 0145-2126

eISSN： 1873-5835
遺族調査の回収率の向上を目指した2×2×2ランダム化要因デザイン試験

宮下光令, 青山真帆, 佐藤一樹, 安部睦美, 首藤真理子, 岡本禎晃, 白土明美, 柳原一広, 山田祐司, 浜野淳, 森田達也, J-HOPE3パイロット調査研究グループ

Palliative Care Research　11　(Suppl.)　S297-S297　2016/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
がん医療に携わる医療者の緩和ケアに関する知識・態度・困難感の変化に関する研究がん対策基本計画策定前後比較結果

中澤葉宇子, 加藤雅志, 宮下光令, 森田達也, 木澤義之

Palliative Care Research　11　(Suppl.)　S276-S276　2016/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
大学病院入院中のがん患者のがんによる痛みの実態調査

岸野恵, 木澤義之, 佐藤悠子, 宮下光令, 森田達也, 細川豊史

Palliative Care Research　11　(Suppl.)　S310-S310　2016/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
日本人におけるがん疼痛治療の個別化された目標Personalized Pain Goalの検討

重野朋子, 舘田綾子, 森田達也, 岸野恵, 木澤義之, 佐藤悠子, 佐藤一樹, 細川豊史, 宮下光令

Palliative Care Research　11　(Suppl.)　S323-S323　2016/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
がん診療連携拠点の緩和ケアチームの年間新規診療症例数の規定要因

宮下光令, 今井涼生, 佐藤一樹, 中澤葉宇子, 木澤義之, 森田達也

Palliative Care Research　11　(Suppl.)　S478-S478　2016/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
遺族によるホスピス・緩和ケアの質の評価に関する研究3(J-HOPE3) 遺族からみた研究プライオリティに関する研究 Peer-reviewed

坂下明大, 森田達也, 青山真帆, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令, J-HOPE3研究グループ

Palliative Care Research　11　(Suppl.)　S275-S275　2016/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
遺族によるホスピス・緩和ケアの質の評価に関する研究(J-HOPE3研究)の調査報告書の活用状況の実態 Peer-reviewed

五十嵐尚子, 青山真帆, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令, J-HOPE3研究グループ

Palliative Care Research　11　(Suppl.)　S275-S275　2016/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
ホスピス・緩和ケア病棟の遺族ケアに関する研究 Peer-reviewed

北得美佐子, 水雲京, 石井京子, 月山淑, 川股知之, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 青山真帆, 宮下光令, J-HOPE3研究グループ

Palliative Care Research　11　(Suppl.)　S280-S280　2016/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
ホスピス・緩和ケア病棟の遺族ケアの改善点に関する研究 Peer-reviewed

北得美佐子, 水雲京, 石井京子, 月山淑, 川股知之, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 青山真帆, 宮下光令, J-HOPE3研究グループ

Palliative Care Research　11　(Suppl.)　S281-S281　2016/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
がん患者遺族の複雑性悲嘆とうつの混合とその関連要因 Peer-reviewed

青山真帆, 坂口幸弘, 小川朝生, 藤澤大介, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令, J-HOPE3研究グループ

Palliative Care Research　11　(Suppl.)　S281-S281　2016/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
がん患者遺族の睡眠・飲酒の実態と悲嘆や抑うつとの関連 Peer-reviewed

青山真帆, 坂口幸弘, 小川朝生, 藤澤大介, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令, J-HOPE3研究グループ

Palliative Care Research　11　(Suppl.)　S281-S281　2016/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
J-HOPE3研究の回収率に関わる要因 Peer-reviewed

宮下光令, 青山真帆, 塚田成美, 新山裕仁, 升川研人, 山田瀬奈, 渡部夏織, 佐藤一樹, 森田達也, 恒藤暁, 志真泰夫

Palliative Care Research　11　(Suppl.)　S297-S297　2016/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
未成年の子どもを持つがん患者の遺族の体験とサポートニーズに関する調査 J-HOPE3 Peer-reviewed

廣岡佳代, 大谷弘行, 三浦智史, 森田達也, 木澤義之, 恒藤暁, 志真康夫, 青山真帆, 宮下光令, J-HOPE3研究グループ

Palliative Care Research　11　(Suppl.)　S308-S308　2016/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
緩和ケア病棟紹介時の家族の見捨てられ感の研究(J-HOPE 3) Peer-reviewed

小田切拓也, 森田達也, 青山真帆, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research　11　(Suppl.)　S308-S308　2016/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
最期の療養場所を決定するときに重要視した要因 Peer-reviewed

首藤真理子, 森田達也, 青山真帆, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令, J-HOPE3研究グループ

Palliative Care Research　11　(Suppl.)　S313-S313　2016/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
日本人遺族における死後観と悲嘆、抑うつとの関連 Peer-reviewed

坂口幸弘, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 青山真帆, 宮下光令

Palliative Care Research　11　(Suppl.)　S316-S316　2016/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
宗教的背景のある施設において患者の望ましい死の達成度が高い理由 Peer-reviewed

青山真帆, 齊藤愛, 菅井真理, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令, J-HOPE3研究グループ

Palliative Care Research　11　(Suppl.)　S318-S318　2016/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
家族が患者の臨終に間に合わないことは、その後の複雑性悲嘆につながるか? J-HOPE3 Peer-reviewed

大谷弘行, 森田達也, 吉田沙蘭, 木澤義之, 恒藤暁, 志真泰夫, 青山真帆, 宮下光令, J-HOPE3研究グループ

Palliative Care Research　11　(Suppl.)　S321-S321　2016/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
在宅がん患者のQOLに影響を与える医療者の関わり J-HOPE3附帯研究 Peer-reviewed

浜野淳, 森田達也, 福井小紀子, 木澤義之, 恒藤暁, 志真泰夫, 青山真帆, 宮下光令, J-HOPE3研究グループ

Palliative Care Research　11　(Suppl.)　S324-S324　2016/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
終末期がん患者の家族が「もっと話しておけばよかった」「もっとあれをしておけばよかった」と思う原因は何か?

森雅紀, 吉田沙蘭, 塩崎麻里子, 馬場美華, 森田達也, 青山真帆, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research　11　(Suppl.)　S308-S308　2016/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
終末期がん患者の家族が患者の死を前提として行いたい事に関する研究緩和ケア病棟を利用した遺族に対する調査より Peer-reviewed

山下亮子, 荒尾晴惠, 高尾鮎美, 升谷英子, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 青山真帆, 宮下光令, J-HOPE, 研究グループ

Palliative Care Research　11　(Suppl.)　S282-S282　2016/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
Japanese Bereaved Family Members' Perspectives of Palliative Care Units and Palliative Care: J-HOPE Study Results Peer-reviewed

Satomi Kinoshita, Mitsunori Miyashita, Tatsuya Morita, Kazuki Sato, Ayaka Shoji, Yurika Chiba, Tamana Miyazaki, Satoru Tsuneto, Yasuo Shima

AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE　33　(5)　425-430　2016/06

DOI： 10.1177/1049909115578385 　

ISSN： 1049-9091

eISSN： 1938-2715
Changes in Perceptions of Opioids Before and After Admission to Palliative Care Units in Japan: Results of a Nationwide Bereaved Family Member Survey Peer-reviewed

Satomi Kinoshita, Mitsunori Miyashita, Tatsuya Morita, Kazuki Sato, Tamana Miyazaki, Ayaka Shoji, Yurika Chiba, Satoru Tsuneto, Yasuo Shima

AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE　33　(5)　431-438　2016/06

DOI： 10.1177/1049909115579407 　

ISSN： 1049-9091

eISSN： 1938-2715
Family caregivers require mental health specialists for end-of-life psychosocial problems at home: a nationwide survey in Japan Peer-reviewed

Makoto Kobayakawa, Hitoshi Okamura, Akemi Yamagishi, Tatsuya Morita, Shohei Kawagoe, Megumi Shimizu, Taketoshi Ozawa, Emi An, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

PSYCHO-ONCOLOGY　25　(6)　641-647　2016/06

DOI： 10.1002/pon.3982 　

ISSN： 1057-9249

eISSN： 1099-1611
Development and validation of scales for attitudes, self-reported practices, difficulties and knowledge among home care nurses providing palliative care Peer-reviewed

Megumi Shimizu, Misako Nishimura, Yoko Ishii, Masayo Kuramochi, Naoe Kakuta, Mitsunori Miyashita

EUROPEAN JOURNAL OF ONCOLOGY NURSING　22　8-22　2016/06

DOI： 10.1016/j.ejon.2016.02.009 　

ISSN： 1462-3889

eISSN： 1532-2122
Anxiety and depression in patients after surgery for head and neck cancer in Japan Peer-reviewed

Miho Suzuki, Minako Deno, Mie Myers, Takahiro Asakage, Koji Takahashi, Kenichi Saito, Yoshiyuki Mori, Hiroto Saito, Yuji Ichikawa, Noriko Yamamoto-Mitani, Mitsunori Miyashita

PALLIATIVE & SUPPORTIVE CARE　14　(3)　269-277　2016/06

DOI： 10.1017/S1478951515000930 　

ISSN： 1478-9515

eISSN： 1478-9523
Association Between Bereaved Families' Sense of Security and Their Experience of Death in Cancer Patients: Cross-Sectional Population-Based Study Peer-reviewed

Ayumi Igarashi, Mitsunori Miyashita, Tatsuya Morita, Nobuya Akizuki, Miki Akiyama, Yutaka Shirahige, Kazuki Sato, Noriko Yamamoto-Mitani, Kenji Eguchi

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　51　(5)　926-932　2016/05

DOI： 10.1016/j.jpainsymman.2015.11.015 　

ISSN： 0885-3924

eISSN： 1873-6513
Relationship between self-care and hand foot syndrome specific quality of life in cancer patients Peer-reviewed

Mikoshiba N, Yamamoto-Mitani N, Sato K, Yaju Y, Miyashita M

Open J Nursing　6　(2)　100-9　2016/02
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

Miki Akiyama, Kei Hirai, Toru Takebayashi, Tatsuya Morita, Mitsunori Miyashita, Ayano Takeuchi, Akemi Yamagishi, Hiroya Kinoshita, Yutaka Shirahige, Kenji Eguchi

Supportive Care in Cancer　24　(1)　347-356　2016/01/01
Publisher: Springer Verlag
DOI： 10.1007/s00520-015-2788-4 　

ISSN： 1433-7339 0941-4355
緩和ケア認定看護師の職務満足度およびバーンアウトの実態と関連要因

舩水裕子, 安藤秀明, 宮下光令

Palliative Care Research (Web)　11　(4)　274‐281(J‐STAGE)-281　2016
Publisher:
DOI： 10.2512/jspm.11.274 　

ISSN： 1880-5302

eISSN： 1880-5302
ナショナルデータベースを用いた,がん患者の死亡2週間前の終末期医療の質の評価:サンプリングデータセットの活用とその限界

佐藤悠子, 藤森研司, 石川光一, 佐藤一樹, 石岡千加史, 宮下光令

Palliative Care Research (Web)　11　(2)　156‐165(J‐STAGE)　2016

DOI： 10.2512/jspm.11.156 　

ISSN： 1880-5302
終末期医療を患者・家族・医師の誰が主体となって決定したかについての関連要因と主体の違いによる受ける医療やQuality of Lifeへの影響の検討

岩淵正博, 佐藤一樹, 宮下光令, 森田達也, 木下寛也

Palliative Care Research (Web)　11　(2)　189‐200(J‐STAGE)-200　2016
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.11.189 　

ISSN： 1880-5302

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Objectives: To determine the factors that influence the decision maker regarding end-of-life (EOL) care and to disclose how aggressive care in the last week before death, place of death, and quality-of-life (QOL) affected the decisions made. Methods: The subjects were 409 bereaved family members (cause of death included cancer, stroke, heart disease, and pneumonia) that registered with an internet research agency. Decision-making was controlled either by the patient, family, or physician or shared by the patient, family, and physician. Results: The results of a multinomial logistic regression analysis demonstrated that when a family controlled decision-making, they were less likely to report patient-family EOL discussion [odds ratio (OR)=0.52], and that the patient had good communication with the physician (OR=0.77); they were also likely to report that the patient had dementia (OR=1.94). Families who reported physician-controlled decision-making (vs patient controlled) were less likely to report that the patient had good communication with the physician (OR=0.62). Cardiopulmonary resuscitation in the last week and place of death were not associated with the decision maker. EOL QOL was associated with EOL care of the decision maker. When a physician controlled decision-making, patient EOL QOL was at its lowest. Conclusion: To improve patient-controlled decision-making, it is critical that patients, families, and physicians have more communication regarding EOL care.
Quality Evaluation and Improvement for End-of-life Care toward Residents in Long Term Care Facilities in Japan: A Literature Review

大河原啓文, 深堀浩樹, 廣岡佳代, 宮下光令

Palliative Care Research (Web)　11　(1)　401-412 (J-STAGE)-412　2016
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.11.401 　

ISSN： 1880-5302

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Long-term care facilities have important roles providing end-of-life-care in Japan. The purpose of this literature review was to examine the current research trend regarding quality evaluation and improvement for end-of-life-care in Japanese long-term care facilities. From a search of key medical databases, potential articles regarding end of life at long-term care facilities were retrieved. We classified retrieved 23 literatures into four research types; four intervention studies, three surveys for development educational / quality improvement tool, thirteen cross-sectional surveys, three qualitative studies. Despite the current increment of the literatures, intervention studies were a few. Related factors of the death in the facilities included administrators' policy regarding end of life care, and collaboration with the medical institutions, and clear family decision making regarding end of life care. Some research indicated that staffs in long-term care facilities felt difficulty in collaborating with medical institutions, conducting interdisciplinary work, and confirming residents' intention regarding end-of-life. The results indicate that conducting quality intervention study, supporting administrators of long-term care facilities, promoting residents and family decision making and education for the staffs in long-term care facilities might be effective to improve quality of end-of-life care in long-term care facilities.
The perception for good death of community dwelling Japanese and Thailand respondents

Michiyo Ando, Supawadee Somchit, Mitsunori Miyashita, Laiad Jamjan

Asian Pacific Island Nursing Journal　1　(3)　91-96　2016
Publisher: UNLV School of Nursing
DOI： 10.9741/23736658.1042 　

ISSN： 2373-6658
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 Peer-reviewed

Miki Akiyama, Kei Hirai, Toru Takebayashi, Tatsuya Morita, Mitsunori Miyashita, Ayano Takeuchi, Akemi Yamagishi, Hiroya Kinoshita, Yutaka Shirahige, Kenji Eguchi

SUPPORTIVE CARE IN CANCER　24　(1)　347-356　2016/01

DOI： 10.1007/s00520-015-2788-4 　

ISSN： 0941-4355

eISSN： 1433-7339
Changes in and Associations Among Functional Status and Perceived Quality of Life of Patients With Metastatic/Locally Advanced Cancer Receiving Rehabilitation for General Disability Peer-reviewed

Ryuichi Sekine, Masami Ogata, Ikuyo Uchiyama, Koichi Miyakoshi, Megumi Uruma, Mitsunori Miyashita, Tatsuya Morita

AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE　32　(7)　695-702　2015/11

DOI： 10.1177/1049909114537871 　

ISSN： 1049-9091

eISSN： 1938-2715
Anxiety in disease-free breast cancer patients might be alleviated by provision of psychological support, not of information Peer-reviewed

Tatsuo Akechi, Kanae Momino, Mitsunori Miyashita, Nobuhiro Sakamoto, Hiroko Yamashita, Tatsuya Toyama

JAPANESE JOURNAL OF CLINICAL ONCOLOGY　45　(10)　929-933　2015/10

DOI： 10.1093/jjco/hyv112 　

ISSN： 0368-2811

eISSN： 1465-3621
Family experience and evaluation about caring the body of deceased patient in Japanese inpatient hospices: a content analysis of free comments in questionnaire survey

山脇道晴, 森田達也, 清原恵美, 清水恵, 恒藤暁, 志真泰夫, 宮下光令

Palliat Care Res (Web)　10　(3)　209-216　2015/09
Publisher:
DOI： 10.2512/jspm.10.209 　

ISSN： 1880-5302

eISSN： 1880-5302
Strategies for Development of Palliative Care From the Perspectives of General Population and Health Care Professionals: A Japanese Outreach Palliative Care Trial of Integrated Regional Model Study Peer-reviewed

Saran Yoshida, Mitsunori Miyashita, Tatsuya Morita, Nobuya Akizuki, Miki Akiyama, Yutaka Shirahige, Takayuki Ichikawa, Kenji Eguchi

AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE　32　(6)　604-610　2015/09

DOI： 10.1177/1049909114532341 　

ISSN： 1049-9091

eISSN： 1938-2715
Validation of the Japanese version of HFS-14, a disease-specific quality of life scale for patients suffering from hand-foot syndrome Peer-reviewed

Naoko Mikoshiba, Noriko Yamamoto-Mitani, Kazuki Sato, Yoshinari Asaoka, Takamasa Ohki, Misato Ohata, Mitsunori Miyashita

SUPPORTIVE CARE IN CANCER　23　(9)　2739-2745　2015/09

DOI： 10.1007/s00520-015-2638-4 　

ISSN： 0941-4355

eISSN： 1433-7339
Views on death with regard to end-of-life care preferences among cancer patients at a Japanese university hospital Peer-reviewed

Yujiro Kuroda, Yumi Iwamitsu, Mitsunori Miyashita, Kei Hirai, Yoshiaki Kanai, Sachiko Kawakami, Kimiko Nakano, Keiichi Nakagawa

PALLIATIVE & SUPPORTIVE CARE　13　(4)　969-979　2015/08

DOI： 10.1017/S147895151400056X 　

ISSN： 1478-9515

eISSN： 1478-9523
Improvements in Physicians' Knowledge, Difficulties, and Self-Reported Practice After a Regional Palliative Care Program Peer-reviewed

Yoshiyuki Kizawa, Tatsuya Morita, Mitsunori Miyashita, Takuya Shinjo, Akemi Yamagishi, Satoshi Suzuki, Hiroya Kinoshita, Yutaka Shirahige, Takuhiro Yamaguchi, Kenji Eguchi

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　50　(2)　232-240　2015/08

DOI： 10.1016/j.jpainsymman.2015.02.025 　

ISSN： 0885-3924

eISSN： 1873-6513
Association between depressive symptoms and changes in sleep condition in the grieving process Peer-reviewed

Hitoshi Tanimukai, Hiroyoshi Adachi, Kei Hirai, Tomoko Matsui, Megumi Shimizu, Mitsunori Miyashita, Satoru Tsuneto, Yasuo Shima

SUPPORTIVE CARE IN CANCER　23　(7)　1925-1931　2015/07

DOI： 10.1007/s00520-014-2548-x 　

ISSN： 0941-4355

eISSN： 1433-7339
緩和ケア施策の達成度を評価するための指標の開発に関する研究

中澤葉宇子, 加藤雅志, 吉田沙蘭, 宮下光令, 森田達也, 木澤義之

日本緩和医療学会学術大会プログラム・抄録集　20回　454-454　2015/06
Publisher: (NPO)日本緩和医療学会
Family evaluation about caring the body of deceased patient by nurses in Japanese inpatient hospices

山脇道晴, 森田達也, 清原恵美, 清水恵, 恒藤暁, 志真泰夫, 宮下光令

Palliat Care Res (Web)　10　(2)　101-107　2015/06
Publisher:
DOI： 10.2512/jspm.10.101 　

ISSN： 1880-5302

eISSN： 1880-5302
Prevalence, associated factors and source of support concerning supportive care needs among Japanese cancer survivors Peer-reviewed

Shino Umezawa, Daisuke Fujisawa, Maiko Fujimori, Asao Ogawa, Eisuke Matsushima, Mitsunori Miyashita

PSYCHO-ONCOLOGY　24　(6)　635-642　2015/06

DOI： 10.1002/pon.3702 　

ISSN： 1057-9249

eISSN： 1099-1611
遺族の声を臨床に生かす~J‐HOPE2研究(多施設遺族調査)からの学び~遺族による緩和ケアの質評価/在宅療養に移行した時期とコミュニケーション

宮下光令

がん看護　20　(4)　468-472　2015/05/20
Publisher:
ISSN： 1342-0569
訪問看護師が認識する終末期がん患者の在宅療養継続の障害

大園康文, 石井容子, 宮下光令

日本がん看護学会誌　29　(1)　44-53　2015/05
Publisher: Japanese Society of Cancer Nursing
DOI： 10.11477/mf.7007200602 　

ISSN： 0914-6423

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AbstractPurpose : The purpose of this study was to clarify visiting nurses' awareness of obstacles to continued home care for terminal cancer patients. Method : Questionnaires on the 90 potential obstacles grouped into 12 domains were conducted for full-time visiting nurses who worked for 24-hour home nursing stations in the Kanto region, and the percentage of nurses who recognized each of the potential obstacles to be an actual obstacle was calculated. Result : Obstacles identified as actual obstacles by high percentages of the nurses included a lack of understanding of home care for terminal cancer patients by physicians and care managers, problems in the home nursing systems, and the financial burden on patients and their families. The results of the study indicated that the following were important for continued home care for terminal cancer patients. Discussion : Physicians, care managers, and visiting nurses must understand the characteristics of home care for terminal cancer patients and improve knowledge and skills in alleviating symptoms. Moreover,visiting nurses must coordinate closely with physicians and care managers. The financial burden on patients and their families must be eased.
Talking about home hospices with terminally III cancer patients-a multicenter survey of bereaved families Peer-reviewed

Akemi Yamagishi, Tatsuya Morita, Shohei Kawagoe, Megumi Shimizu, Taketoshi Ozawa, Emi An, Makoto Kobayakawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

Japanese Journal of Cancer and Chemotherapy　42　(3)　327-333　2015/03/01
Publisher: Japanese Journal of Cancer and Chemotherapy Publishers Inc.
ISSN： 0385-0684
Length of home hospice care, family-perceived timing of referrals, perceived quality of care, and quality of death and dying in terminally ill cancer patients who died at home Peer-reviewed

Akemi Yamagishi, Tatsuya Morita, Shohei Kawagoe, Megumi Shimizu, Taketoshi Ozawa, Emi An, Makoto Kobayakawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita

SUPPORTIVE CARE IN CANCER　23　(2)　491-499　2015/02

DOI： 10.1007/s00520-014-2397-7 　

ISSN： 0941-4355

eISSN： 1433-7339
Place of Death and the Differences in Patient Quality of Death and Dying and Caregiver Burden Peer-reviewed

Hiroya Kinoshita, Isseki Maeda, Tatsuya Morita, Mitsunori Miyashita, Akemi Yamagishi, Yutaka Shirahige, Toru Takebayashi, Takuhiro Yamaguchi, Ayumi Igarashi, Kenji Eguchi

JOURNAL OF CLINICAL ONCOLOGY　33　(4)　357-U105　2015/02

DOI： 10.1200/JCO.2014.55.7355 　

ISSN： 0732-183X

eISSN： 1527-7755
Factors Related to Perceived Barriers to Conducting Research and Expected Support from the Japan Academy of Nursing Science among Young Japanese Nursing Researchers

Fukahori Hiroki, Miyashita Mitsunori, Oyama Yumiko, Atogami Fumi, Okaya Keiko, Kashiwagi Masayo, Kono Ayumi, Takamizawa Emiko, Narama Miho, Yoshizawa Toyoko

Journal of Japan Academy of Nursing Science　35　(0)　203-214　2015
Publisher: 公益社団法人日本看護科学学会
DOI： 10.5630/jans.35.203 　

ISSN： 0287-5330

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Aim: The aims of this study were 1) to understand the perceived barriers to conducting research experienced by young Japanese nursing researchers, 2) to understand the support expected from the Japan Academy of Nursing Science, and 3) to examine factors associated with the barriers and support. Method: We conducted a web-based survey targeting members of the Japan Academy of Nursing Science younger than 40 years old. We conducted multiple regression analyses predicting scores on subscales of questionnaires assessing perceived barriers and expected support. Results: 648 young nursing researchers were analyzed. Regarding analyses on perceived barriers, "Difficulty in work–life balance" was related to positively raising children (β=0.36). "Workload of education and management" was negatively related to being assistant professor or research/education associate (β=0.31). Regarding expected support, "Improvement of environment/system for research activity" was negatively related to some subscales of perceived barriers including "Lack of research competency," "Lack of research resources," "Non-establishment of identity as researcher," and "Workload of education and management" (β=0.15–0.20). Conclusion: Young Japanese researcher had various perceived barriers and expected supports according to their own situation. Japan Academy of Nursing Science should develop strategies 1) to encourage networking among researcher, 2) to nurture young nursing scholars' growth in research competency, 3) to improve the research environment.
Factors influencing death or the cessation of palliative care in home-based setting among patients with cancer

佐藤一樹, 橋本孝太郎, 内海純子, 出水明, 藤本肇, 森井正智, 長沢譲, 宮下光令, 鈴木雅夫

Palliat Care Res (Web)　10　(2)　116-123 (J-STAGE)　2015

DOI： 10.2512/jspm.10.116 　

ISSN： 1880-5302
Current home palliative care for terminally ill cancer patients in Japan

橋本孝太郎, 佐藤一樹, 内海純子, 出水明, 藤本肇, 森井正智, 佐々木琴美, 宮下光令, 鈴木雅夫

Palliat Care Res (Web)　10　(1)　153-161 (J-STAGE)-161　2015
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.10.153 　

ISSN： 1880-5302

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Purpose：This study investigated the current state of medical care and home palliative care for terminally ill cancer patients in Japan. Methods：We conducted a retrospective questionnaire study of 352 cancer patients who received home palliative care from 6 specialized home care clinics and discontinued home care or died from January to June in 2012. Results：The questionnaire was answered by 290 patients〔165 men（57％）, mean age：72±13 years〕who started home palliative care after completing cancer treatment. Home visits from nurses were used by 238 patients（98％）and 95 patients（39％）used home care workers. Within a month before discontinuation of home care or death, 72 patients（30％）received fluid therapy and 127 patients（52％）received strong opioids. The outcome of home palliative care was death at home in 242 patients（83％）and discontinuation of home care in 48 patients（17％）. The reason for discontinuation was family physical and mental problems or physical problems of the patient. Conclusion：This study demonstrated the current state of home palliative care by specialized home care clinics.
The burden of introducing the Japanese language version of the Liverpool Care Pathway(LCP-J)for dying patients in general wards and their families:experience of health care professionals in a university hospital

菅野雄介, 佐藤一樹, 早川陽子, 瀧田好恵, 我妻崇史, 千葉友子, 本田和子, 柴田弘子, 山内かず子, 高橋信, 井上彰, 宮下光令

Palliat Care Res (Web)　10　(1)　318-323 (J-STAGE)-323　2015
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.10.318 　

ISSN： 1880-5302

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The purpose of this study was to explore the burden of introducing LCP-J in two wards（medical oncology and respiratory medicine）in Tohoku University Hospital. We administered audit evaluations about dying cancer patients and interviewed 2 doctors and 8 nurses regarding LCP-J intervention. LCP-J was used for 22 patients（38％）, and no significant difference in infusion, potent opioid analgesic and sedative medication within last 48 hours were seen between users and nonusers. Responses were categorized into［confirm directions about dying care among health care professionals］, and［training in dying care in a structured way］as usefulness facets of the LCP-J, and［difficulty in assessment of dying］,［burden of health care professionals］, and［difficulty using LCP-J without knowledge and training in dying care］as burdens of the LCP-J. We explored the burden of LCP-J in general wards, and found that use of the LCP-J could need education in dying care and backup of the palliative care team.
Preliminary study for the brief measure of quality of life and quality of care for the national random sampling hospital survey: content validity and interpretability

清水恵, 佐藤一樹, 加藤雅志, 藤澤大介, 森田達也, 宮下光令

Palliat Care Res (Web)　10　(4)　223-237 (J-STAGE)-237　2015
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.10.223 　

ISSN： 1880-5302

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To monitor the quality of life （QOL）of cancer patients through the Patient Behavior Survey, a large population-based survey, we developed a short QOL and quality of care （QOC）questionnaire. In order to help evaluate QOL in cancer patients, we also conducted a web–based survey designed to evaluate the content validity and interpretability of the questionnaire. In total, 630 cancer patients completed the survey. For each item, the result that more than 90% responses determined the item was of importance indicated that the item was important for living with cancer. Regarding items related to QOC, satisfaction with care, we consolidated responses; for example, the answer of "neutral" could also be interpreted as "almost satisfied" and patients who answered "other" may also mean that the item does not apply to them. We found that this questionnaire accurately evaluated the QOL of cancer patients and the responses were interpretable and presentable.
Prevalence and characteristics of breakthrough pain in cancer patients: a pilot study

岸野恵, 木澤義之, 佐藤悠子, 宮下光令, 森田達也, 細川豊史

Palliat Care Res (Web)　10　(3)　155-160 (J-STAGE)-160　2015
Publisher:
DOI： 10.2512/jspm.10.155 　

ISSN： 1880-5302

eISSN： 1880-5302
Analysis of administrative data to investigate end-of-life cancer care in a Japanese university hospital: development of methodology

佐藤悠子, 宮下光令, 藤森研司, 中谷純, 藤本容子, 栗原誠, 佐藤一樹, 石岡千加史

Palliat Care Res (Web)　10　(3)　177-185 (J-STAGE)-185　2015
Publisher:
DOI： 10.2512/jspm.10.177 　

ISSN： 1880-5302

eISSN： 1880-5302
気管挿管患者における鎮痛評価スケールを用いた痛みの評価

鈴木友里恵, 上野千晶, 阿部結, 原理恵, 工藤淳, 須東光江, 星邦彦, 吾妻俊弘, 宮下光令

日本集中治療医学会学術集会(Web)　42nd　NP10-2 (WEB ONLY)　2015
Why People Accept Opioids: Role of General Attitudes Toward Drugs, Experience as a Bereaved Family, Information From Medical Professionals, and Personal Beliefs Regarding a Good Death Peer-reviewed

Takuya Shinjo, Tatsuya Morita, Kei Hirai, Mitsunori Miyashita, Megumi Shimizu, Satoru Tsuneto, Yasuo Shima

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　49　(1)　45-54　2015/01

DOI： 10.1016/j.jpainsymman.2014.04.015 　

ISSN： 0885-3924

eISSN： 1873-6513
Outcome Evaluation of the Palliative Care Emphasis Program on Symptom Management and Assessment for Continuous Medical Education: Nationwide Physician Education Project for Primary Palliative Care in Japan Peer-reviewed

Ryo Yamamoto, Yoshiyuki Kizawa, Yoko Nakazawa, Sachiko Ohde, Sato Tetsumi, Mitsunori Miyashita

JOURNAL OF PALLIATIVE MEDICINE　18　(1)　45-49　2015/01

DOI： 10.1089/jpm.2014.0122 　

ISSN： 1096-6218

eISSN： 1557-7740
Smoking status, service use and associated factors among Japanese cancer survivors-a web-based survey Peer-reviewed

Daisuke Fujisawa, Shino Umezawa, Ado Basaki-Tange, Maiko Fujimori, Mitsunori Miyashita

SUPPORTIVE CARE IN CANCER　22　(12)　3125-3134　2014/12

DOI： 10.1007/s00520-014-2284-2 　

ISSN： 0941-4355

eISSN： 1433-7339
Which quality of life instruments are preferred by cancer patients in Japan? Comparison of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 and the Functional Assessment of Cancer Therapy-General Peer-reviewed

Kazuki Sato, Megumi Shimizu, Mitsunori Miyashita

SUPPORTIVE CARE IN CANCER　22　(12)　3135-3141　2014/12

DOI： 10.1007/s00520-014-2287-z 　

ISSN： 0941-4355

eISSN： 1433-7339
Nurse Education Program on Meaninglessness in Terminally Ill Cancer Patients: A Randomized Controlled Study of a Novel Two-Day Workshop Peer-reviewed

Tatsuya Morita, Keiko Tamura, Etsuko Kusajima, Sayuri Sakai, Masako Kawa, Chizuru Imura, Kaori Ichihara, Mitsunori Miyashita, Takuhiro Yamaguchi, Yosuke Uchitomi

JOURNAL OF PALLIATIVE MEDICINE　17　(12)　1298-1305　2014/12

DOI： 10.1089/jpm.2013.0559 　

ISSN： 1096-6218

eISSN： 1557-7740
がん治療に伴う変化をとらえる~実践に活きるアセスメントツール~全体からみる包括的なケア評価尺度およびQuality of Life尺度

宮下光令

がん看護　19　(7)　634-639　2014/11/20

ISSN： 1342-0569
Who Are at Risk for Cancer-Related Stigma? Peer-reviewed

Daisuke Fujisawa, Shino Umezawa, Maiko Fujimori, Mitsunori Miyashita

PSYCHO-ONCOLOGY　23　349-350　2014/10

ISSN： 1057-9249

eISSN： 1099-1611
A SURVEY OF THE INFLUENCE OF PATIENTS' RESIDENTIAL AREAS ON SATISFACTION LEVELS IN CANCER CARE AT DESIGNATED HOSPITALS Peer-reviewed

Shoko Akiyama, Kanako Kumasaka, Mitsunori Miyashita, Makio Gamoh, Seiichi Kobayashi, Seiji Chubachi, Hiroshi Ishii, Yuko Sato, Takahiro Mori, Chikashi Ishioka

ANNALS OF ONCOLOGY　25　2014/10

DOI： 10.1093/annonc/mdu435.97 　

ISSN： 0923-7534

eISSN： 1569-8041
Changes in Quality of Care and Quality of Life of Outpatients With Advanced Cancer After a Regional Palliative Care Intervention Program Peer-reviewed

Akemi Yamagishi, Kazuki Sato, Mitsunori Miyashita, Yasuo Shima, Yoshiyuki Kizawa, Megumi Umeda, Hiroya Kinoshita, Yutaka Shirahige, Miki Akiyama, Takuhiro Yamaguchi, Tatsuya Morita

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　48　(4)　602-610　2014/10

DOI： 10.1016/j.jpainsymman.2013.11.016 　

ISSN： 0885-3924

eISSN： 1873-6513
Progressive Development and Enhancement of Palliative Care Services in Japan: Nationwide Surveys of Designated Cancer Care Hospitals for Three Consecutive Years Peer-reviewed

Isseki Maeda, Satoru Tsuneto, Mitsunori Miyashita, Tatsuya Morita, Megumi Umeda, Miwa Motoyama, Fumie Kosako, Yoshihisa Hama, Yoshiyuki Kizawa, Tomoyo Sasahara, Kenji Eguchi

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　48　(3)　364-373　2014/09

DOI： 10.1016/j.jpainsymman.2013.09.017 　

ISSN： 0885-3924

eISSN： 1873-6513
Does a regional comprehensive palliative care program improve pain in outpatient cancer patients? Peer-reviewed

Tatsuya Morita, Kazuki Sato, Mitsunori Miyashita, Akemi Yamagishi, Yoshiyuki Kizawa, Yasuo Shima, Hiroya Kinoshita, Satoshi Suzuki, Yutaka Shirahige, Takuhiro Yamaguchi, Kenji Eguchi

SUPPORTIVE CARE IN CANCER　22　(9)　2445-2455　2014/09

DOI： 10.1007/s00520-014-2232-1 　

ISSN： 0941-4355

eISSN： 1433-7339
Association between Quality of End-of-Life Care and Possible Complicated Grief among Bereaved Family Members Peer-reviewed

Kaya Miyajima, Daisuke Fujisawa, Kimio Yoshimura, Masaya Ito, Satomi Nakajima, Joichiro Shirahase, Masaru Mimura, Mitsunori Miyashita

JOURNAL OF PALLIATIVE MEDICINE　17　(9)　1025-1031　2014/09

DOI： 10.1089/jpm.2013.0552 　

ISSN： 1096-6218

eISSN： 1557-7740
A Japanese Region-wide Survey of the Knowledge, Difficulties and Self-reported Palliative Care Practices Among Nurses Peer-reviewed

Kazuki Sato, Yoko Inoue, Megumi Umeda, Ichie Ishigamori, Ayumi Igarashi, Sei Togashi, Kumiko Harada, Masako Miyashita, Yumi Sakuma, Junko Oki, Ritsuko Yoshihara, Kenji Eguchi

JAPANESE JOURNAL OF CLINICAL ONCOLOGY　44　(8)　718-728　2014/08

DOI： 10.1093/jjco/hyu075 　

ISSN： 0368-2811

eISSN： 1465-3621
What Bereavement Follow-Up Does Family Members Request in Japanese Palliative Care Units? A Qualitative Study Peer-reviewed

Rieko Muta, Makiko Sanjo, Mitsunori Miyashita, Rieko Wakabayashi, Etsuko Ando, Tatsuya Morita, Satoru Tsuneto, Yasuo Shima

AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE　31　(5)　485-494　2014/08

DOI： 10.1177/1049909113488239 　

ISSN： 1049-9091

eISSN： 1938-2715
Symptom Burden and Achievement of Good Death of Elderly Cancer Patients Peer-reviewed

Tatsuya Morita, Meiko Kuriya, Mitsunori Miyashita, Kazuki Sato, Kenji Eguchi, Tatsuo Akechi

JOURNAL OF PALLIATIVE MEDICINE　17　(8)　887-893　2014/08

DOI： 10.1089/jpm.2013.0625 　

ISSN： 1096-6218

eISSN： 1557-7740
Care strategy for death rattle in terminally ill cancer patients and their family members: recommendations from a cross-sectional nationwide survey of bereaved family members' perceptions. International-journal Peer-reviewed

Yoichi Shimizu, Mitsunori Miyashita, Tatsuya Morita, Kazuki Sato, Satoru Tsuneto, Yasuo Shima

Journal of pain and symptom management　48　(1)　2-12　2014/07

DOI： 10.1016/j.jpainsymman.2013.07.010 　

ISSN： 0885-3924
遺族調査が遺族に与える負担と受益

竹内真帆, 吉田早希, 山田祐司, 柳原一広, 安部睦美, 白土明美, 首藤真理子, 岡本禎晃, 浜野淳, 森田達也, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　19回　515-515　2014/06
Publisher: (NPO)日本緩和医療学会
遺族によるがん患者の死亡前の症状の評価

竹内真帆, 宮本蒼, 岡本禎晃, 山田祐司, 柳原一広, 安部睦美, 白土明美, 首藤真理子, 浜野淳, 森田達也, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　19回　515-515　2014/06
Publisher: (NPO)日本緩和医療学会
がん患者の遺族による緩和ケアの構造・プロセスの評価尺度Care Evaluation Scale ver2.0の信頼性・妥当性の検討

竹内真帆, 中畑美里, 平井啓, 山田祐司, 柳原一広, 安部睦美, 白土明美, 首藤真理子, 岡本禎晃, 浜野淳, 宮下光令, CESver2開発グループ

日本緩和医療学会学術大会プログラム・抄録集　19回　516-516　2014/06
Publisher: (NPO)日本緩和医療学会
A Pilot Study of Adaptation of the Transtheoretical Model to Narratives of Bereaved Family Members in the Bereavement Life Review Peer-reviewed

Michiyo Ando, Akira Tsuda, Tatsuya Morita, Mitsunori Miyashita, Makiko Sanjo, Yasuo Shima

AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE　31　(4)　422-427　2014/06

DOI： 10.1177/1049909113490068 　

ISSN： 1049-9091

eISSN： 1938-2715
Psychometric Properties of the Japanese Version of the Concerns About Recurrence Scale (CARS-J) Peer-reviewed

Kanae Momino, Tatuo Akechi, Toshinari Yamashita, Takashi Fujita, Hironori Hayahi, Nobuyuki Tsunoda, Mitsunori Miyashita, Hiroji Iwata

JAPANESE JOURNAL OF CLINICAL ONCOLOGY　44　(5)　456-462　2014/05

DOI： 10.1093/jjco/hyu032 　

ISSN： 0368-2811

eISSN： 1465-3621
A Population-Based Survey on Perceptions of Opioid Treatment and Palliative Care Units: OPTIM Study Peer-reviewed

Ayumi Igarashi, Mitsunori Miyashita, Tatsuya Morita, Nobuya Akizuki, Miki Akiyama, Yutaka Shirahige, Kenji Eguchi

AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE　31　(2)　155-160　2014/03

DOI： 10.1177/1049909113481260 　

ISSN： 1049-9091

eISSN： 1938-2715
Regional Medical Professionals' Confidence in Providing Palliative Care, Associated Difficulties and Availability of Specialized Palliative Care Services in Japan Peer-reviewed

Kayo Hirooka, Mitsunori Miyashita, Tatsuya Morita, Takeyuki Ichikawa, Saran Yoshida, Nobuya Akizuki, Miki Akiyama, Yutaka Shirahige, Kenji Eguchi

JAPANESE JOURNAL OF CLINICAL ONCOLOGY　44　(3)　249-256　2014/03

DOI： 10.1093/jjco/hyt204 　

ISSN： 0368-2811

eISSN： 1465-3621
Perceived Stigma and Social Discrimination Among Cancer Survivors in Japan - A Web-Based Survey Peer-reviewed

Daisuke Fujisawa, Maiko Fujimori, Ado Basaki-Tange, Shino Umezawa, Junko Ueda-Nouno, Akiko Adachi, Kazuho Hisamura, Yuriko Suzuki, Mitsunori Miyashita

PSYCHO-ONCOLOGY　23　126-127　2014/02

ISSN： 1057-9249

eISSN： 1099-1611
One-year Follow-up of an Educational Intervention for Palliative Care Consultation Teams Peer-reviewed

Yoko Nakazawa, Yoshiyuki Kizawa, Takahiro Hashizume, Tatsuya Morita, Tomoyo Sasahara, Mitsunori Miyashita

JAPANESE JOURNAL OF CLINICAL ONCOLOGY　44　(2)　172-179　2014/02

DOI： 10.1093/jjco/hyt183 　

ISSN： 0368-2811

eISSN： 1465-3621
Complicated grief of bereaved families in the emergency department and ICU: comparison with the general ward Peer-reviewed

Kinoshita Satomi, Fujisawa Daisuke, Nakajima Satomi, Ito Masaya, Miyashita Mitsunori

Journal of the Japanese Society of Intensive Care Medicine　21　(2)　199-203　2014
Publisher: The Japanese Society of Intensive Care Medicine
DOI： 10.3918/jsicm.21.199 　

ISSN： 1340-7988

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Using a self-administered questionnaire, we compared the prevalence of complicated grief in family members of patients who had died in the emergency department (n=49) or ICU (n=156) and those of patients who had died in the general ward (n=432). Participants were community-dwelling individuals (aged 40-79 years) who had experienced bereavement within the past 10 years. Complicated grief was assessed using the brief grief questionnaire. There were 3 (6%) emergency-department-bereaved, 5 (3%) ICU-bereaved, and 10 (2%) general ward-bereaved individuals with complicated grief, while 11 (22%), 37 (24%), and 99 (23%) in these groups had subthreshold complicated grief, respectively. Thus, prevalence of complicated grief did not significantly differ between groups. The emergency- and ICU-bereaved showed significant differences from the general ward-bereaved in cause of death and whether the death was expected. These results imply that these two variables did not affect prevalence.
Views on death with regard to end-of-life care preferences among cancer patients at a Japanese university hospital. Peer-reviewed

Kuroda Y, Iwamitsu Y, Miyashita M, Hirai K, Kanai Y, Kawakami S, Nakano K, Nakagawa K

Palliat Support Care　11　1-11　2014
Difficulty with cancer care and related factors among nurses at Tohoku University Hospital

宮下光令, 小野寺麻衣, 熊田真紀子, 大桐規子, 浅野玲子, 小笠原喜美代, 後藤あき子, 柴田弘子, 庄子由美, 仙石美枝子, 山内かず子, 門間典子

Palliat Care Res (Web)　9　(3)　158-166 (J-STAGE)　2014

DOI： 10.2512/jspm.9.158 　

ISSN： 1880-5302
Personal growth and related factors among family primary caregivers after bereavement of a terminally ill cancer patient at home

佐野知美, 草島悦子, 白井由紀, 瀬戸山真理子, 玉井照枝, 廣岡佳代, 佐藤隆裕, 宮下光令, 河正子, 岡部健

Palliat Care Res (Web)　9　(3)　140-150 (J-STAGE)　2014

DOI： 10.2512/jspm.9.140 　

ISSN： 1880-5302
Factors affecting death at home

五十嵐美幸, 佐藤一樹, 清水恵, 菅野雄介, 菅野喜久子, 川原礼子, 宮下光令

Palliat Care Res (Web)　9　(2)　114-121 (J-STAGE)-121　2014
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.9.114 　

ISSN： 1880-5302

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This ecological study revealed the relationship between the percentage of death at home and medical and socioeconomic characteristics. This study was a secondary analysis of national data from the Population Survey Report in 2010 and government statistics in Japan. This data was analyzed by exploratory factor analysis and multiple linear regression analysis. As a result of exploratory factor analysis, medical and social characteristics are classified in three domains, "depopulation and aging", "hospital and medical facility resources" and "access for home medical care". By multiple linear regression analysis using results of exploratory factor analysis, cancer death was associated with "access for home medical care" and death from all causes was associated with "hospital and medical facility resources" and "access for home medical care". In conclusion, death at home in cancer patients was strongly affected by "access for home medical care". Death at home from all causes was due to poor hospital and medical facility resources and good access to home medical.
Complicated grief of bereaved families in the emergency department and ICU: comparison with the general ward

木下里美, 藤澤大介, 中島聡美, 伊藤正哉, 宮下光令

日本集中治療医学会雑誌(Web)　21　(2)　199-203 (J-STAGE)　2014

DOI： 10.3918/jsicm.21.199 　

ISSN： 1882-966X
Development and Feasibility of the Japanese language version Liverpool Care Pathway for the Dying Patient-Home

菅野雄介, 平原優美, 荒木和美, 松村優子, 八杉まゆみ, 川村幸子, 古賀友之, 茅根義和, 宮下光令

Palliat Care Res (Web)　9　(4)　112-120 (J-STAGE)-120　2014
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.9.112 　

ISSN： 1880-5302

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Background: The aim of this study was to develop the Japanese language version of the Liverpool Care Pathway － Home (LCP－H), and to examine the feasibility of the LCP－H in a pilot study. Methods: LCP－H was administered to cancer patients who were predicted to be in their last few days. We evaluated the achieved care goals of LCP－H. A cross－sectional anonymous questionnaire was administered to home nurses who used LCP－H to evaluate usefulness in using LCP－H. Results: LCP－H was used to 35 patients. The care goals of LCP－H were achieved in almost 80%. The nurses evaluated the usefulness of LCP－H: Providing to continuous end－of－life care each staff, Communication well between home nurses and co－medical home staff, and Education for home nurses with limited experience with end－of－life care. Conclusion: The feasibility of LCP－H was confirmed. Therefore, LCP－H should help home nurses to care for dying patients and their families as guide for end－of－life care in home, and improve the quality of end－of－life care in home. However, because the LCP is now being phased out in the UK, it may be necessary to develop an original education tool to assist in care for dying patients and their families in Japan.
Policies, Priorities, and Criteria for Admission into Palliative Care Units in Japan: A Nationwide Survey Peer-reviewed

Kizawa Yoshiyuki, Miyashita Mitsunori, Morita Tatsuya, Sakashita Akihiro, Yamaguchi Takashi, Kishino Megumi, Shima Yasuo

JOURNAL OF PALLIATIVE CARE　30　(3)　230-231　2014

DOI： 10.1177/1049909115579407 　

ISSN： 0825-8597
Evaluations and needs of bereavement services among the bereaved whose family member died at palliative care units

坂口幸弘, 宮下光令, 森田達也, 恒藤暁, 志真泰夫

Palliat Care Res (Web)　8　(2)　217-222　2013/12
Publisher:
DOI： 10.2512/jspm.8.217 　

ISSN： 1880-5302

eISSN： 1880-5302
Complicated grief, depressive symptoms, and suicidial ideation among the bereaved whose family member died at palliative care units

坂口幸弘, 宮下光令, 森田達也, 恒藤暁, 志真泰夫

Palliat Care Res (Web)　8　(2)　203-210　2013/12
Publisher:
DOI： 10.2512/jspm.8.203 　

ISSN： 1880-5302

eISSN： 1880-5302
Exploring the perceived changes and the reasons why expected outcomes were not obtained in individual levels in a successful regional palliative care intervention trial: an analysis for interpretations Peer-reviewed

Tatsuya Morita, Kazuki Sato, Mitsunori Miyashita, Miki Akiyama, Masashi Kato, Shohei Kawagoe, Hiroya Kinoshita, Yutaka Shirahige, Sen Yamakawa, Masako Yamada, Kenji Eguchi

SUPPORTIVE CARE IN CANCER　21　(12)　3393-3402　2013/12

DOI： 10.1007/s00520-013-1910-8 　

ISSN： 0941-4355

eISSN： 1433-7339
Living with pleasure in daily life at the end of life: Recommended care strategy for cancer patients from the perspective of physicians and nurses Peer-reviewed

Kimiko Nakano, Kazuki Sato, Harumi Katayama, Mitsunori Miyashita

PALLIATIVE & SUPPORTIVE CARE　11　(5)　405-413　2013/10

DOI： 10.1017/S1478951512000442 　

ISSN： 1478-9515

eISSN： 1478-9523
Depressive symptoms after treatment in hepatocellular carcinoma survivors: prevalence, determinants, and impact on health-related quality of life Peer-reviewed

Naoko Mikoshiba, Mitsunori Miyashita, Tomoko Sakai, Ryosuke Tateishi, Kazuhiko Koike

PSYCHO-ONCOLOGY　22　(10)　2347-2353　2013/10

DOI： 10.1002/pon.3300 　

ISSN： 1057-9249
Specialized Palliative Care Services in Japan: A Nationwide Survey of Resources and Utilization by Patients With Cancer Peer-reviewed

Yoshiyuki Kizawa, Tatsuya Morita, Jun Hamano, Hiroka Nagaoka, Mitsunori Miyashita, Satoru Tsuneto

AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE　30　(6)　552-555　2013/09

DOI： 10.1177/1049909112457874 　

ISSN： 1049-9091
The influence of alexithymia on psychological distress with regard to the seriousness of complicated grief and the time since bereavement in the Japanese general population Peer-reviewed

Minako Deno, Mitsunori Miyashita, Daisuke Fujisawa, Satomi Nakajima, Masaya Ito

JOURNAL OF AFFECTIVE DISORDERS　149　(1-3)　202-208　2013/07

DOI： 10.1016/j.jad.2013.01.025 　

ISSN： 0165-0327
Evaluation of End-of-Life Cancer Care in the ICU: Perceptions of the Bereaved Family in Japan Peer-reviewed

Satomi Kinoshita, Mitsunori Miyashita

AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE　30　(3)　225-230　2013/05

DOI： 10.1177/1049909112446805 　

ISSN： 1049-9091
Both Maintaining Hope and Preparing for Death: Effects of Physicians' and Nurses' Behaviors From Bereaved Family Members' Perspectives Peer-reviewed

Akemi Shirado, Tatsuya Morita, Terukazu Akazawa, Mitsunori Miyashita, Kazuki Sato, Satoru Tsuneto, Yasuo Shima

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　45　(5)　848-858　2013/05

DOI： 10.1016/j.jpainsymman.2012.05.014 　

ISSN： 0885-3924

eISSN： 1873-6513
Reliability and validity of Japanese version Caregiver Quality of Life Index-Cancer (CQOLC)

安藤早紀, 原田真里子, WEITZNER Michael A, 久慈瑞希, 清水恵, 佐藤一樹, 宮下光令

Palliat Care Res (Web)　8　(2)　286-292 (J-STAGE)-292　2013
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.8.286 　

ISSN： 1880-5302

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Purpose: This study was to examine both the reliability and validity of the Japanese version of the Caregiver Quality of Life Index-Cancer (CQOLC), which was developed to measure the quality of life of family caregivers of cancer patients. Methods & Results: Study subjects comprised 400 family caregivers who were registered at an Internet research company. The explanatory factor analysis yielded the following 4 domains: psychological burden (8 items); positive emotions (5 items); and financial burden (3 items); disruption of daily living (5 items). The Cronbach's alpha coefficients of the total score and each domain were 0.85 and 0.75 to 0.88, respectively. The total score and each domain were moderately correlated with mental health, vitality, social functioning, general health, role emotinal scores from the SF-36. The intraclass correlation coefficients of the total score and each domain were 0.78 and 0.67 to 0.74, respectively. Conclusion: These results suggest that the Japanese version of the CQOLC has sufficient reliability and validity.
Decadal trends in the structure and usage status of palliative care units in Japan and the association with length of stay

佐藤一樹, 志真泰夫, 羽川瞳, 安部奈津子, 竹内真帆, 宮下光令

Palliat Care Res (Web)　8　(2)　264-272 (J-STAGE)-272　2013
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.8.264 　

ISSN： 1880-5302

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Background: The aim of this study was to clarify the decadal trends in the structure and usage status of palliative care units in Japan and the association with length of stay. Methods: We conducted a secondary analysis of data from nationwide surveys of palliative care units conducted by Hospice Palliative Care Japan from 2002 to 2012. Length of stay was divided into three categories (within 30 days, 31 to 60 days, and 61 days or more). Results: Significant decadal trends in usage status were observed: the mean annual number of admitted patients (119±55 persons in 2001, 163.0±77.7 in 2011, p＜0.001), and deaths (99±44, 136±58, p＜0.001) increased and the mean length of stay in a palliative care unit (8±15 days, 39±15, p＜0.001) decreased. Palliative care units with a shorter mean length of stay had significantly more admitted patients, and more discharged patients, and a significantly lower mean ratio of death to discharge, and a lower bed availability rate. In contrast, length of stay was not significantly associated with the structure of palliative care units, including the type of units, number of inpatient beds, percentage of private rooms, and number of staff. Conclusion: The features of decadal trends in the structure and usage status of palliative care units in Japan were a shortening of length of stay, and an increase in the number of patients. Palliative care units with a shorter mean length of stay cared for a larger number of terminally ill patients.
Development of scale to measure nurses' difficulty with cancer care (NDCC)

小野寺麻衣, 熊田真紀子, 大桐規子, 浅野玲子, 小笠原喜美代, 後藤あき子, 柴田弘子, 庄子由美, 仙石美枝子, 山内かず子, 門間典子, 宮下光令

Palliat Care Res (Web)　8　(2)　240-247 (J-STAGE)-247　2013
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.8.240 　

ISSN： 1880-5302

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Purpose: This study was to develop a scale to measure difficulties encountered by cancer care by nurses and to evaluate the reliability and the validity of the scale. Methods: Self-reported questionnaires were administered to nurses who are engaged in cancer care in Tohoku University Hospital. Results: Of 512 questionnaires distributed to nurses, 356 were completed and returned 70%. We selected 49 items in 6 domains, including "communication" "knowledge and skill" "collaboration with doctor" "disclosure and explanation of disease" "hospital system and regional alliances" and "death and dying" using explanatory factor analysis. Cronbach's α coefficient was 0.68 across domains and ranged from 0.69 to 0.74 for each domain. Construct validity was demonstrated and the scaling success rates were 100% for all domains on multitrait scaling analysis. In terms of the known groups validity, the score for the nurses in the palliative care unit was significantly lower than for nurses on the general wards. Conclusion: This study showed that the scale has sufficient reliability and validity. This scale may contribute to cancer nursing by assessing hospital nurses' perception of cancer care and as a method of determining outcomes of educational or organizational interventions.
訪問看護師からみた終末期がん患者の在宅療養に関する問題とその解決策

大園康文, 石井容子, 宮下光令

日本がん看護学会誌　26　(3)　52-60　2012/12/25
Publisher:
DOI： 10.11477/mf.7007200443 　

ISSN： 0914-6423
GOOD DEATH AMONG ELDERLY CANCER PATIENTS IN JAPAN BASED ON PERSPECTIVES OF THE GENERAL POPULATION Peer-reviewed

Tatsuo Akechi, Mitsunori Miyashita, Tatsuya Morita, Toru Okuyama, Masaki Sakamoto, Ryuichi Sagawa, Yosuke Uchitomi

ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY　8　220-220　2012/11

ISSN： 1743-7555
Preferred place of care and place of death of the general public and cancer patients in Japan Peer-reviewed

Akemi Yamagishi, Tatsuya Morita, Mitsunori Miyashita, Saran Yoshida, Nobuya Akizuki, Yutaka Shirahige, Miki Akiyama, Kenji Eguchi

SUPPORTIVE CARE IN CANCER　20　(10)　2575-2582　2012/10

DOI： 10.1007/s00520-011-1373-8 　

ISSN： 0941-4355
A Family's Difficulties in Caring for a Cancer Patient at the End of Life at Home in Japan Peer-reviewed

Yoko Ishii, Mitsunori Miyashita, Kazuki Sato, Taketoshi Ozawa

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　44　(4)　552-562　2012/10

DOI： 10.1016/j.jpainsymman.2011.10.011 　

ISSN： 0885-3924
Measuring the Structure and Process of End-of-Life Care in Korea: Validation of the Korean Version of the Care Evaluation Scale (CES) Peer-reviewed

Dong Wook Shin, Ji Eun Choi, Mitsunori Miyashita, Jin Young Choi, Jina Kang, Young Ji Baik, Ha Na Mo, Young Sung Kim, Dae Seog Heo, Hyeon Ju Shin

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　44　(4)　615-+　2012/10

DOI： 10.1016/j.jpainsymman.2011.09.021 　

ISSN： 0885-3924
PEACE研修会において緩和ケアの知識を測定するための尺度(PEACE-Q33)の作成と信頼性・妥当性の検討

山本亮, 木澤義之, 佐藤哲観, 中澤葉宇子, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　17回　327-327　2012/06
Publisher: (NPO)日本緩和医療学会
Making the Decision for Home Hospice: Perspectives of Bereaved Japanese Families who had Loved Ones in Home Hospice Peer-reviewed

Ji Eun Choi, Mitsunori Miyashita, Kei Hirai, Kazuki Sato, Tatsuya Morita, Satoru Tsuneto, Yasuo Shima, Boon Han Kim

JAPANESE JOURNAL OF CLINICAL ONCOLOGY　42　(6)　498-505　2012/06

DOI： 10.1093/jjco/hys036 　

ISSN： 0368-2811

eISSN： 1465-3621
What patients in the advanced stages of cancer know and believe about palliative and home care: a nationwide survey in Japan. Peer-reviewed

u, AKIYAMA Miki, Takebayashi T, Morita T, Miyashita M, Hirai K, Matoba M, Akizuki, N, Shirahige Y, Yamagishi A, Eguchi K

Supportive Care in Cancer　20　(5)　923-31　2012/05
Knowledge, beliefs, and concerns about opioids, palliative care, and homecare of advanced cancer patients: a nationwide survey in Japan Peer-reviewed

Miki Akiyama, Toru Takebayashi, Tatsuya Morita, Mitsunori Miyashita, Kei Hirai, Motohiro Matoba, Nobuya Akizuki, Yutaka Shirahige, Akemi Yamagishi, Kenji Eguchi

SUPPORTIVE CARE IN CANCER　20　(5)　923-931　2012/05

DOI： 10.1007/s00520-011-1161-5 　

ISSN： 0941-4355
Family member perspectives of deceased relatives' end-of-life options on admission to a palliative care unit in Japan Peer-reviewed

Kazuki Sato, Mitsunori Miyashita, Tatsuya Morita, Satoru Tsuneto, Yasuo Shima

SUPPORTIVE CARE IN CANCER　20　(5)　893-900　2012/05

DOI： 10.1007/s00520-012-1405-z 　

ISSN： 0941-4355

eISSN： 1433-7339
The Current Status and Issues Regarding Hospital-based Specialized Palliative Care Service in Japanese Regional Cancer Centers: A Nationwide Questionnaire Survey Peer-reviewed

Yoko Nakazawa, Mitsunori Miyashita, Tatsuya Morita, Tomoyo Misawa, Satoru Tsuneto, Yasuo Shima

JAPANESE JOURNAL OF CLINICAL ONCOLOGY　42　(5)　432-441　2012/05

DOI： 10.1093/jjco/hys022 　

ISSN： 0368-2811
Pain Intensity, Quality of Life, Quality of Palliative Care, and Satisfaction in Outpatients With Metastatic or Recurrent Cancer: A Japanese, Nationwide, Region-Based, Multicenter Survey Peer-reviewed

Akemi Yamagishi, Tatsuya Morita, Mitsunori Miyashita, Ayumi Igarashi, Miki Akiyama, Nobuya Akizuki, Yutaka Shirahige, Kenji Eguchi

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　43　(3)　503-514　2012/03

DOI： 10.1016/j.jpainsymman.2011.04.025 　

ISSN： 0885-3924
Acculturation and Preferences About End-of-life (EOL) Cancer Care Among Individuals of Japanese Ancestry Living in America Peer-reviewed

Masanori Mori, Henrique Parsons, Takamaru Ashikaga, Steven Grunberg, Mitsunori Miyashita

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　43　(2)　372-373　2012/02

DOI： 10.1016/j.jpainsymman.2011.12.100 　

ISSN： 0885-3924
A Scale for Measuring Feelings of Support and Security Regarding Cancer Care in a Region of Japan: A Potential New Endpoint of Cancer Care Peer-reviewed

Ayumi Igarashi, Mitsunori Miyashita, Tatsuya Morita, Nobuya Akizuki, Miki Akiyama, Yutaka Shirahige, Kenji Eguchi

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　43　(2)　218-225　2012/02

DOI： 10.1016/j.jpainsymman.2011.04.005 　

ISSN： 0885-3924
The mediating effects of social support and self-efficacy on the relationship between social distress and emotional distress in head and neck cancer outpatients with facial disfigurement Peer-reviewed

Minako Deno, Mie Tashiro, Mitsunori Miyashita, Takahiro Asakage, Koji Takahashi, Kenich Saito, Yasunobu Busujima, Yoshiyuki Mori, Hiroto Saito, Yuji Ichikawa

PSYCHO-ONCOLOGY　21　(2)　144-152　2012/02

DOI： 10.1002/pon.1877 　

ISSN： 1057-9249

eISSN： 1099-1611
Family's Difficulty Scale in End-of-Life Home Care: A New Measure of the Family's Difficulties in Caring for Patients with Cancer at the End of Life at Home from Bereaved Family's Perspective Peer-reviewed

Yoko Ishii, Mitsunori Miyashita, Kazuki Sato, Taketoshi Ozawa

JOURNAL OF PALLIATIVE MEDICINE　15　(2)　210-215　2012/02

DOI： 10.1089/jpm.2011.0248 　

ISSN： 1096-6218
Good Death in Elderly Adults with Cancer in Japan Based on Perspectives of the General Population Peer-reviewed

Tatsuo Akechi, Mitsunori Miyashita, Tatsuya Morita, Toru Okuyama, Masaki Sakamoto, Ryuichi Sagawa, Yosuke Uchitomi

JOURNAL OF THE AMERICAN GERIATRICS SOCIETY　60　(2)　271-276　2012/02

DOI： 10.1111/j.1532-5415.2012.03895.x 　

ISSN： 0002-8614
Brief Measure for Screening Complicated Grief: Reliability and Discriminant Validity Peer-reviewed

Masaya Ito, Satomi Nakajima, Daisuke Fujisawa, Mitsunori Miyashita, Yoshiharu Kim, M. Katherine Shear, Angela Ghesquiere, Melanie M. Wall

PLOS ONE　7　(2)　e31209　2012/02

DOI： 10.1371/journal.pone.0031209 　

ISSN： 1932-6203
The effects of an administration policy of the palliative care unit of a cancer care hospital on the rate of region-based home death rate

Kinoshita Hiroya, Matsumoto Yoshihisa, Abe Keiko, Miyashita Mitsunori, Morita Tatsuya

Palliat Care Res　7　(2)　348-353　2012
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.7.348 　

ISSN： 1880-5302

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The aim of this study was to explore the changes in the rates of discharge to home from the palliative care unit in the region where the regional palliative care intervention program, their home death rate, and their ratio to whole home death cancer patients in the region. During the study period, the palliative care unit changed an administrative policy actively end-of-life care to support patients at home. The rate of discharge to home from the palliative care unit increased 11% to 22% during the study period, and their home death rate increased 10% to 41%. The overall home death rate of cancer patients however remained 6.8% to 8.1%, and their ratio to whole home death cancer patients in the region was less than 10%. To establish health care system to support cancer patients at home, changing administrative policy of palliative care units is insufficient and increasing quality community palliative care resources seems to be essential.
Counting the use of specialized palliative care services

Morita Tatsuya, Akizuki Nobuya, Suzuki Satoshi, Kinoshita Hiroya, Shirahige Yutaka, Miyashita Mitsunori

Palliat Care Res　7　(2)　374-381　2012
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.7.374 　

ISSN： 1880-5302

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The primary aim of this study was to compare the ratios of specialized palliative care use to all cancer death using 2 methods: 1) total number of patients who received either of specialized palliative care services (unadjusted), and 2) number of patients after adjustment of potentially duplicated counts (adjusted). The research team obtained patient list from all specialized palliative care services, and counted the number of the patients who received any specialized palliative care services. The ratio of adjusted value to unadjusted value was 0.59, and had large region differences. Unadjusted values had, although overestimated, essentially similar trends in changes by year and differences in the regions. In conclusion, total number of patients who received either of specialized palliative care services could be simple and feasible indicator to roughly determine the activity of specialized palliative care services, but exact number of the patients who received specialized palliative care services should be determined on the basis of the patient lists without duplicated counts.
An estimation of the number of cancer patients who wanted home death based on the bereaved family survey

森田達也, 宮下光令, 井上芙蓉子, 佐藤一樹, 五十嵐歩, 五十嵐美幸, 山口拓洋, 橋本修二

Palliat Care Res (Web)　7　(2)　403-407 (J-STAGE)-407　2012
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.7.403 　

ISSN： 1880-5302

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The primary aim of this study was to estimate the number of cancer patients who wanted home death based on the bereaved family survey. A postal survey performed on 1,137 bereaved family members in 4 regions to clarify the degree what they believed that the patient actually died where s/he had wanted on the Good Death Inventory, and to explore the preferred place of death. We calculated estimated number of patients who had wanted home death as a total of (1) the actual number of home death × the percentages of the family members who agreed that the patient actually died where s/he had wanted, and × the actual number of hospital death × the percentages of the family members who disagreed that the patient actually died where s/he had wanted and home was the preferred place of death. Estimated number of cancer patients who wanted home death was 32.8%［95%C.I., 31.7, 33.9］ in the surveyed regions, and 31.2%［95%C.I., 31.1, 31.4］ for national data.
Leaflet for health professionals based on patient and family surveys: "Voices of cancer patients and families"

山田博英, 小田切拓也, 津村明美, 井村千鶴, 宮下光令, 森田達也

Palliat Care Res (Web)　7　(1)　342-347 (J-STAGE)-347　2012
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.7.342 　

ISSN： 1880-5302

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This study was conducted to identify the needs of patients and their families based on surveys involving patients and bereaved families, and describe the process of producing a survey-based leaflet for health care professionals. Questionnaire surveys were conducted on 550 advanced cancer patients and 632 bereaved families in Hamamatsu, and 337 and 432 responses were collected. Opinions and requests regarding cancer treatment and palliative care were analyzed, and 378 meaning units were collapsed into six categories of requests to health professionals: "Share patient and family feelings and support decisions"; "Allow the patient to stay where he/she wants"; "Relieve physical discomfort as much as possible"; "Support to complete what family members want for the patient not to regret"; "Help patient and family have hope", and; "Reduce concerns about opioids". A leaflet for health care professionals about what they should take into the considerations was created based on patient and family surveys.
The significance and possibility of introduction of a Japanese language version of the Liverpool Care Pathway for the Dying Patient: The pilot study in the two palliative care units

市原香織, 宮下光令, 福田かおり, 茅根義和, 清原恵美, 森田達也, 田村恵子, 葉山有香, 大石ふみ子

Palliat Care Res (Web)　7　(1)　149-162 (J-STAGE)-162　2012
Publisher:
DOI： 10.2512/jspm.7.149 　

ISSN： 1880-5302

eISSN： 1880-5302
Are specialized home care clinics and the Doctor net exclusive to each other?

森田達也, 野末よし子, 宮下光令, 小野宏志, 藤島百合子, 白髭豊, 川越正平

Palliat Care Res (Web)　7　(1)　317-322 (J-STAGE)-322　2012
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.7.317 　

ISSN： 1880-5302

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The purpose of the present study was to obtain the insights about the roles of specialized home care clinics and the "Doctor net" in community palliative care by investigating changes in the home death rates of cancer patients in a city where both specialized home care clinics and the Doctor net are available. A region palliative care intervention study was conducted, and data on the rate of cancer patients who died at home between 2007 and 2010 in the region were collected. The rate of cancer patients who died at home increased from 7.0% in 2007 to 13.0% in 2010. In 2007, 49% of the total number of people who died at home were patients of specialized home care clinics, and the rate increased to 13.0% in 2010. However, the number of cancer patients of other clinics who died at home did not decrease, from 63 in 2007 to 98 in 2009 and 77 in 2010. The functions of specialized home care clinics and the Doctor net adopted in general clinics were not exclusive to each other, and specialized home care clinics may improve palliative care implemented for cancer patients at home by participating in the Doctor net to provide general clinics with support.
Changes experienced by physicians and nurses after a region-based palliative care intervention trial: the OPTIM-study

森田達也, 野末よし子, 花田芙蓉子, 宮下光令, 鈴木聡, 木下寛也, 白髭豊, 江口研二

Palliat Care Res (Web)　7　(1)　121-135 (J-STAGE)-135　2012
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.7.121 　

ISSN： 1880-5302

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The primary aim of this study was to collect the views of physicians and nurses in the regions where community-based palliative care intervention trial, the OPTIM-study, was performed. A content analysis of free comments of the questionnaire survey was conducted. Questionnaires were mailed to 1,763 physicians and 3,156 nurses after the intervention, and 706 and 2,236 responses were obtained, respectively. A content analysis identified 327 free comments from physicians and 737 from nurses. As favorable effects, the categories [Multidisciplinary teams and community networks were established] [Home-based care is widespread] [Medical knowledge and skills are acquired just as those involved in palliative care] emerged. The main effects of the community palliative care program included the establishment of multidisciplinary teams and community networks, development of home-based care, and increasing knowledge, skills, and awareness about palliative care.
Providing Palliative Care for Cancer Patients: The Views and Exposure of Community General Practitioners and District Nurses in Japan Peer-reviewed

Akemi Yamagishi, Tatsuya Morita, Mitsunori Miyashita, Takayuki Ichikawa, Nobuya Akizuki, Yutaka Shirahige, Miki Akiyama, Kenji Eguchi

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　43　(1)　59-67　2012/01

DOI： 10.1016/j.jpainsymman.2011.03.012 　

ISSN： 0885-3924

eISSN： 1873-6513
A region-based palliative care intervention trial using the mixed-method approach: Japan OPTIM study Peer-reviewed

Tatsuya Morita, Mitsunori Miyashita, Akemi Yamagishi, Nobuya Akizuki, Yoshiyuki Kizawa, Yutaka Shirahige, Miki Akiyama, Kei Hirai, Motohiro Matoba, Masako Yamada, Taketoshi Matsumoto, Takuhiro Yamaguchi, Kenji Eguchi

BMC PALLIATIVE CARE　11　2　2012/01

DOI： 10.1186/1472-684X-11-2 　

ISSN： 1472-684X
The relationships between complicated grief, depression, and alexithymia according to the seriousness of complicated grief in the Japanese general population Peer-reviewed

Minako Deno, Mitsunori Miyashita, Daisuke Fujisawa, Satomi Nakajima, Masaya Ito

JOURNAL OF AFFECTIVE DISORDERS　135　(1-3)　122-127　2011/12

DOI： 10.1016/j.jad.2011.06.037 　

ISSN： 0165-0327
Evaluation of the End-of-Life Nursing Education Consortium-Japan Faculty Development Program Validity and Reliability of the "End-of-Life Nursing Education Questionnaire" Peer-reviewed

Sayaka Takenouchi, Mitsunori Miyashita, Keiko Tamura, Yoshiyuki Kizawa, Shinji Kosugi

JOURNAL OF HOSPICE & PALLIATIVE NURSING　13　(6)　368-375　2011/11

DOI： 10.1097/NJH.0b013e31822da9d7 　

ISSN： 1522-2179
Measuring Comprehensive Outcomes in Palliative Care: Validation of the Korean Version of the Good Death Inventory Peer-reviewed

Dong Wook Shin, JiEun Choi, Mitsunori Miyashita, Jin Young Choi, Jina Kang, Young Ji Baik, Ha Na Mo, Jong Soon Choi, Young Sun Son, Hae Sook Lee

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　42　(4)　632-642　2011/10

DOI： 10.1016/j.jpainsymman.2010.12.012 　

ISSN： 0885-3924
Development of a scale for "difficulties felt by ICU nurses providing end-of-life care" (DFINE): A survey study Peer-reviewed

Satomi Kinoshita, Mitsunori Miyashita

Intensive and Critical Care Nursing　27　(4)　202-210　2011/08

DOI： 10.1016/j.iccn.2011.04.006 　

ISSN： 0964-3397
Public Awareness, Knowledge of Availability, and Readiness for Cancer Palliative Care Services: A Population-Based Survey across Four Regions in Japan Peer-reviewed

Kei Hirai, Tadashi Kudo, Miki Akiyama, Motohiro Matoba, Mariko Shiozaki, Teruko Yamaki, Akemi Yamagishi, Mitsunori Miyashita, Tatsuya Morita, Kenji Eguchi

JOURNAL OF PALLIATIVE MEDICINE　14　(8)　918-922　2011/08

DOI： 10.1089/jpm.2010.0529 　

ISSN： 1096-6218
がん診療連携拠点病院の緩和ケア機能の充足度平成19-21年度医療水準調査の結果

宮下光令, 木澤義之, 笹原朋代, 佐治重豊, 江口研二

日本緩和医療学会学術大会プログラム・抄録集　16回　284-284　2011/06
Publisher: (NPO)日本緩和医療学会
Developing the social distress scale for head and neck cancer outpatients in Japan Peer-reviewed

Minako Deno, Mie Tashiro, Mitsunori Miyashita, Takahiro Asakage, Koji Takahashi, Kenich Saito, Yasunobu Busujima, Yoshiyuki Mori, Hiroto Saito, Yuji Ichikawa

PALLIATIVE & SUPPORTIVE CARE　9　(2)　165-172　2011/06

DOI： 10.1017/S1478951511000034 　

ISSN： 1478-9515
遺族,在宅医療・福祉関係者からみた,終末期がん患者の在宅療養において家族介護者が体験する困難に関する研究

石井容子, 宮下光令, 佐藤一樹, 小澤竹俊

日本がん看護学会誌　25　(1)　24-36　2011/05/25
Publisher:
DOI： 10.11477/mf.7007200327 　

ISSN： 0914-6423
A Nationwide Survey of the Palliative Care Provided by Pharmacists in Designated Regional Cancer Centers in Japan

杉浦宗敏, 宮下光令, 佐藤一樹, 森田達也, 佐野元彦, 的場元弘, 恒藤暁, 志真泰夫

日本緩和医療薬学雑誌　4　(1)　23-30　2011/03
Publisher:
ISSN： 1882-9783
Experience with Prognostic Disclosure of Families of Japanese Patients with Cancer Peer-reviewed

Saran Yoshida, Kei Hirai, Tatsuya Morita, Mariko Shiozaki, Mitsunori Miyashita, Kazuki Sato, Satoru Tsuneto, Yasuo Shima

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　41　(3)　594-603　2011/03

DOI： 10.1016/j.jpainsymman.2010.06.013 　

ISSN： 0885-3924

eISSN： 1873-6513
Factors that influence the efficacy of bereavement life review therapy for spiritual well-being: a qualitative analysis Peer-reviewed

Michiyo Ando, Tatsuya Morita, Mitsunori Miyashita, Makiko Sanjo, Haruko Kira, Yasuo Shima

SUPPORTIVE CARE IN CANCER　19　(2)　309-314　2011/02

DOI： 10.1007/s00520-010-1006-7 　

ISSN： 0941-4355
Cross-Cultural Application of the Korean Version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative Care Peer-reviewed

Dong Wook Shin, Ji Eun Choi, Mitsunori Miyashita, Jin Young Choi, Jina Kang, Young Ji Baik, Ha Na Mo, Jeanno Park, Hea-Ja Kim, Eun Cheol Park

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　41　(2)　478-484　2011/02

DOI： 10.1016/j.jpainsymman.2010.05.009 　

ISSN： 0885-3924
Requests for cancer treatment and palliative care: suggestions from 821 advanced cancer patients and bereaved families

古村和恵, 宮下光令, 木澤義之, 川越正平, 秋月伸哉, 山岸暁美, 的場元弘, 鈴木聡, 木下寛也, 白髭豊, 森田達也, 江口研二

Palliat Care Res (Web)　6　(2)　237-245 (J-STAGE)-245　2011
Publisher:
DOI： 10.2512/jspm.6.237 　

ISSN： 1880-5302

eISSN： 1880-5302
Health-related quality of life among community-dwelling patients with intractable neurological diseases and their caregivers in Japan Peer-reviewed

Mitsunori Miyashita, Yugo Narita, Aki Sakamoto, Norikazu Kawada, Miki Akiyama, Mami Kayama, Yoshimi Suzukamo, Shunichi Fukuhara

PSYCHIATRY AND CLINICAL NEUROSCIENCES　65　(1)　30-38　2011

DOI： 10.1111/j.1440-1819.2010.02155.x 　

ISSN： 1323-1316

eISSN： 1440-1819
再考看取りのケア;リバプール・ケア・パスウェイを用いた看取りのケアの質向上 LCP日本語版の概要と使用方法

宮下光令, 清水恵

臨床看護　36　(14)　1829-1837　2010/12/15
Publisher:
ISSN： 0386-7722
Who pronounced the patient's death? A study of the experience of bereaved Japanese families in palliative care units

新城拓也, 森田達也, 平井啓, 宮下光令, 佐藤一樹, 恒藤暁, 志真泰夫

Palliat Care Res (Web)　5　(2)　162-170　2010/12
Publisher:
DOI： 10.2512/jspm.5.162 　

ISSN： 1880-5302

eISSN： 1880-5302
Prevalence and determinants of complicated grief in general population Peer-reviewed

Daisuke Fujisawa, Mitsunori Miyashita, Satomi Nakajima, Masaya Ito, Motoichiro Kato, Yoshiharu Kim

JOURNAL OF AFFECTIVE DISORDERS　127　(1-3)　352-358　2010/12

DOI： 10.1016/j.jad.2010.06.008 　

ISSN： 0165-0327
Preference of place for end-of-life cancer care and death among bereaved Japanese families who experienced home hospice care and death of a loved one Peer-reviewed

JiEun Choi, Mitsunori Miyashita, Kei Hirai, Kazuki Sato, Tatsuya Morita, Satoru Tsuneto, Yasuo Shima

SUPPORTIVE CARE IN CANCER　18　(11)　1445-1453　2010/11

DOI： 10.1007/s00520-009-0767-3 　

ISSN： 0941-4355

eISSN： 1433-7339
The Care Strategy for Families of Terminally Ill Cancer Patients Who Become Unable to Take Nourishment Orally Recommendations from a Nationwide Survey of Bereaved Family Members' Experiences Peer-reviewed

Akemi Yamagishi, Tatsuya Morita, Mitsunori Miyashita, Kazuki Sato, Satoru Tsuneto, Yasuo Shima

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　40　(5)　671-683　2010/11

DOI： 10.1016/j.jpainsymman.2010.02.025 　

ISSN： 0885-3924
Changes in medical and nursing care after admission to palliative care units: a potential method for improving regional palliative care Peer-reviewed

Ayumi Igarashi, Tatsuya Morita, Mitsunori Miyashita, Emi Kiyohara, Satoshi Inoue

SUPPORTIVE CARE IN CANCER　18　(9)　CP5-1113　2010/09

DOI： 10.1007/s00520-010-0936-4 　

ISSN： 0941-4355
Effects of Bereavement Life Review on Spiritual Well-Being and Depression Peer-reviewed

Michiyo Ando, Tatsuya Morita, Mitsunori Miyashita, Makiko Sanjo, Haruko Kira, Yasuo Shima

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　40　(3)　453-459　2010/09

DOI： 10.1016/j.jpainsymman.2009.12.028 　

ISSN： 0885-3924
Self-Perceived Burden in Terminally Ill Cancer Patients: A Categorization of Care Strategies Based on Bereaved Family Members' Perspectives Peer-reviewed

Terukazu Akazawa, Tatsuo Akechi, Tatsuya Morita, Mitsunori Miyashita, Kazuki Sato, Satoru Tsuneto, Yasuo Shima, Toshiaki A. Furukawa

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　40　(2)　224-234　2010/08

DOI： 10.1016/j.jpainsymman.2009.12.015 　

ISSN： 0885-3924

eISSN： 1873-6513
Value of religious care for relief of psycho-existential suffering in Japanese terminally ill cancer patients: the perspective of bereaved family members Peer-reviewed

Michiyo Ando, Ryo Kawamura, Tatsuya Morita, Kei Hirai, Mitsunori Miyashita, Takuya Okamoto, Yasuo Shima

PSYCHO-ONCOLOGY　19　(7)　750-755　2010/07

DOI： 10.1002/pon.1625 　

ISSN： 1057-9249
Analysis of Factors Related to the Use of Opioid Analgesics in Regional Cancer Centers in Japan Peer-reviewed

Munetoshi Sugiura, Mitsunori Miyashita, Kazuki Sato, Satoru Tsuneto, Motohiro Matoba, Motohiko Sano, Yasuo Shima

JOURNAL OF PALLIATIVE MEDICINE　13　(7)　841-846　2010/07

DOI： 10.1089/jpm.2010.0065 　

ISSN： 1096-6218
終末期の療養場所を検討するがん患者の家族へのケアに関する基礎的研究緩和ケアに従事する医療者への面接調査の結果から

三條真紀子, 笹原朋代, 木村理恵子, 牟田理恵子, 木澤義之, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　15回　214-214　2010/06
Publisher: (NPO)日本緩和医療学会
地域の医療機関に勤務する医師の緩和ケアに関する知識・実践・困難感は? がん対策のための戦略研究『緩和ケア普及のための地域プロジェクト』介入前調査から OPTIM-study

木澤義之, 宮下光令, 佐藤一樹, 森田達也, 江口研二

日本緩和医療学会学術大会プログラム・抄録集　15回　219-219　2010/06
Publisher: (NPO)日本緩和医療学会
がん診療連携拠点病院緩和ケアチームのコンサルテーション活動に関する実態調査

中澤葉宇子, 木澤義之, 森田達也, 笹原朋代, 宮下光令, 橋爪隆弘, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　15回　254-254　2010/06
Publisher: (NPO)日本緩和医療学会
The Palliative Care Self-Reported Practices Scale and the Palliative Care Difficulties Scale: Reliability and Validity of Two Scales Evaluating Self-Reported Practices and Difficulties Experienced in Palliative Care by Health Professionals Peer-reviewed

Yoko Nakazawa, Mitsunori Miyashita, Tatsuya Morita, Megumi Umeda, Yasuko Oyagi, Toshie Ogasawara

JOURNAL OF PALLIATIVE MEDICINE　13　(4)　427-437　2010/04

DOI： 10.1089/jpm.2009.0289 　

ISSN： 1096-6218

eISSN： 1557-7740
Multiple evaluation of a hospital-based palliative care consultation team in a university hospital: Activities, patient outcome, and referring staff's view Peer-reviewed

Tomoyo Sasahara, Mitsunori Miyashita, Megumi Umeda, Hitomi Higuchi, Junko Shinoda, Masako Kawa, Keiko Kazuma

PALLIATIVE & SUPPORTIVE CARE　8　(1)　49-57　2010/03

DOI： 10.1017/S1478951509990708 　

ISSN： 1478-9515
Religious Care Required for Japanese Terminally Ill Patients With Cancer From the Perspective of Bereaved Family Members Peer-reviewed

Takuya Okamoto, Michiyo Ando, Tatsuya Morita, Kei Hirai, Ryo Kawamura, Miyashita Mitsunori, Kazuki Sato, Yasuo Shima

AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE　27　(1)　50-54　2010/02

DOI： 10.1177/1049909109346562 　

ISSN： 1049-9091
Inter-rater reliability of proxy simple symptom assessment scale between physician and nurse: a hospital-based palliative care team setting

M. Miyashita, M. Yasuda, R. Baba, S. Iwase, R. Teramoto, K. Nakagawa, Y. Kizawa, Y. Shima

EUROPEAN JOURNAL OF CANCER CARE　19　(1)　124-130　2010/01

DOI： 10.1111/j.1365-2354.2008.00967.x 　

ISSN： 0961-5423
Care for the Bodies of Deceased Cancer Inpatients in Japanese Palliative Care Units Peer-reviewed

Takuya Shinjo, Tatsuya Morita, Mitsunori Miyashita, Kazuki Sato, Satoru Tsuneto, Yasuo Shima

JOURNAL OF PALLIATIVE MEDICINE　13　(1)　27-31　2010/01

DOI： 10.1089/jpm.2009.0152 　

ISSN： 1096-6218

eISSN： 1557-7740
Administrators' perspectives on end-of-life care for cancer patients in Japanese long-term care facilities Peer-reviewed

Hiroki Fukahori, Mitsunori Miyashita, Tatsuya Morita, Takayuki Ichikawa, Nobuya Akizuki, Miki Akiyama, Yutaka Shirahige, Kenji Eguchi

SUPPORTIVE CARE IN CANCER　17　(10)　1247-1254　2009/10

DOI： 10.1007/s00520-009-0665-8 　

ISSN： 0941-4355

eISSN： 1433-7339
Validity and Reliability of the Japanese Version of the Caregiver Reaction Assessment Scale (CRA-J) for Community-Dwelling Cancer Patients Peer-reviewed

Tomoyo Misawa, Mitsunori Miyashita, Masako Kawa, Koji Abe, Mayumi Abe, Yasuko Nakayama, Charles W. Given

AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE　26　(5)　334-340　2009/10

DOI： 10.1177/1049909109338480 　

ISSN： 1049-9091

eISSN： 1938-2715
The long-term effect of a population-based educational intervention focusing on end-of-life home care, life-prolongation treatment, and knowledge about palliative care Peer-reviewed

Sato Kazuki, Miyashita Mitsunori, Morita Tatsuya, Suzuki Masao

Journal of Palliative Care　25　(3)　206-212　2009/09

ISSN： 0825-8597
Late Referrals to Palliative Care Units in Japan: Nationwide Follow-Up Survey and Effects of Palliative Care Team Involvement After the Cancer Control Act Peer-reviewed

Tatsuya Morita, Mitsunori Miyashita, Satoru Tsuneto, Kazuki Sato, Yasuo Shima

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　38　(2)　191-196　2009/08

DOI： 10.1016/j.jpainsymman.2008.09.011 　

ISSN： 0885-3924

eISSN： 1873-6513
Caregiving Consequences Inventory: a measure for evaluating caregiving consequences from the bereaved family member's perspective Peer-reviewed

Makiko Sanjo, Tatsuya Morita, Mitsunori Miyashita, Mariko Shiozaki, Kazuki Sato, Kei Hirai, Yasuo Shima, Yosuke Uchitomi

PSYCHO-ONCOLOGY　18　(6)　657-666　2009/06

DOI： 10.1002/pon.1447 　

ISSN： 1057-9249

eISSN： 1099-1611
Prospective Evaluation of Transition to Specialized Home Palliative Care in Japan Peer-reviewed

Etsuko Kusajima, Masako Kawa, Mitsunori Miyashita, Keiko Kazuma, Takeshi Okabe

AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE　26　(3)　172-179　2009/06

DOI： 10.1177/1049909108330029 　

ISSN： 1049-9091
Symptom Prevalence and Longitudinal Follow-Up in Cancer Outpatients Receiving Chemotherapy Peer-reviewed

Akemi Yamagishi, Tatsuya Morita, Mitsunori Miyashita, Fukuko Kimura

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　37　(5)　823-830　2009/05

DOI： 10.1016/j.jpainsymman.2008.04.015 　

ISSN： 0885-3924

eISSN： 1873-6513
Meaninglessness in Terminally Ill Cancer Patients: A Randomized Controlled Study Peer-reviewed

Tatsuya Morita, Hisayuki Murata, Emi Kishi, Mitsunori Miyashita, Takuhiro Yamaguchi, Yosuke Uchitomi

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　37　(4)　649-658　2009/04

DOI： 10.1016/j.jpainsymman.2008.04.017 　

ISSN： 0885-3924
The Japan HOspice and Palliative Care Evaluation Study (J-HOPE Study): Views About Legalization of Death With Dignity and Euthanasia Among the Bereaved Whose Family Member Died at Palliative Care Units Peer-reviewed

Nao Okishiro, Mitsunori Miyashita, Satoru Tsuneto, Kazuki Sato, Yasuo Shima

AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE　26　(2)　98-104　2009/04

DOI： 10.1177/1049909108327027 　

ISSN： 1049-9091
The Process of Change in the Appreciation of Illness by Adults with Congenital Heart Disease A Qualitative Study

落合亮太, 日下部智子, 宮下光令, 佐藤秀郎, 村上新, 萱間真美, 数間恵子

看護研究　42　(1)　57-68　2009/02/15

DOI： 10.11477/mf.1681100356 　

ISSN： 0022-8370
Discharge from a Palliative Care Unit: Prevalence and Related Factors from a Retrospective Study in Japan

Mitsunori Miyashita, Kazuko Arai, Yosuke Yamada, Machiko Owada, Tomoyo Sasahara, Masako Kawa, Taketo Mukaiyama

JOURNAL OF PALLIATIVE MEDICINE　12　(2)　142-149　2009/02

DOI： 10.1089/jpm.2008.0216 　

ISSN： 1096-6218
J-HOPE study: Evaluation of End-of-Life Cancer Care in Japan from the Perspective of Bereaved Family Members Peer-reviewed

Miyashita M, Morita T, Hirai K

J Clin Oncol　27　(15)　2009

DOI： 10.1200/JCO.2007.15.8287 　

ISSN： 0732-183X
Care burden and depression in caregivers caring for patients with intractable neurological diseases at home in Japan

Mitsunori Miyashita, Yugo Narita, Aki Sakamoto, Norikazu Kawada, Miki Akiyama, Mami Kayama, Yoshimi Suzukamo, Shunichi Fukuhara

JOURNAL OF THE NEUROLOGICAL SCIENCES　276　(1-2)　148-152　2009/01

DOI： 10.1016/j.jns.2008.09.022 　

ISSN： 0022-510X

eISSN： 1878-5883
成人先天性心疾患患者の親が成育医療に対して抱く要望

落合亮太, 佐藤秀郎, 村上新, 日下部智子, 宮下光令, 萱間真美, 数間恵子

心臓　40　(12)　1094-1102　2008/12/15

DOI： 10.11281/shinzo1969.40.12_1094 　

ISSN： 0586-4488
Palliative Care in Japan: Shifting from the Stage of Disease to the Intensity of Suffering Peer-reviewed

Tatsuya Morita, Mitsunori Miyashita, Satoru Tsuneto, Yasuo Shima

Journal of Pain and Symptom Management　36　(6)　e6-e7　2008/12

DOI： 10.1016/j.jpainsymman.2008.06.004 　

ISSN： 0885-3924
Quality of Life, Day Hospice Needs, and Satisfaction of Community-Dwelling Patients with Advanced Cancer and their Caregivers in Japan

Mitsunori Miyashita, Tomoyo Misawa, Mayumi Abe, Yasuko Nakayama, Koji Abe, Masako Kawa

JOURNAL OF PALLIATIVE MEDICINE　11　(9)　1203-1207　2008/11

DOI： 10.1089/jpm.2008.0067 　

ISSN： 1096-6218
Palliative Care in Japan: Current Status and a Nationwide Challenge to Improve Palliative Care by the Cancer Control Act and the Outreach Palliative Care Trial of Integrated Regional Model (OPTIM) Study Peer-reviewed

Akemi Yamagishi, Tatsuya Morita, Mitsunori Miyashita, Nobuya Akizuki, Yoshiyuki Kizawa, Yutaka Shirahige, Miki Akiyama, Kei Hirai, Tadashi Kudo, Takuhiro Yamaguchi, Asuka Fukushima, Kenji Eguchi

AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE　25　(5)　412-418　2008/10

DOI： 10.1177/1049909108318568 　

ISSN： 1049-9091
Measuring the regret of bereaved family members regarding the decision to admit cancer patients to palliative care units

M. Shiozaki, K. Hirai, R. Dohke, T. Morita, M. Miyashita, K. Sato, S. Tsuneto, Y. Shima, Y. Uchitomi

PSYCHO-ONCOLOGY　17　(9)　926-931　2008/09

DOI： 10.1002/pon.1312 　

ISSN： 1057-9249
成人先天性心疾患患者が成育医療に対して抱く要望

落合亮太, 日下部智子, 宮下光令, 佐藤秀郎, 村上新, 萱間真美, 数間恵子

心臓　40　(8)　700-706　2008/08/15
Publisher: Japan Heart Foundation
DOI： 10.11281/shinzo1969.40.8_700 　

ISSN： 0586-4488
終末期がん患者の療養場所移行に関する家族の経験と医療者への家族支援ニーズ ~終末期に一般病棟で療養したがん患者の遺族への質的調査を通じて~

三條真紀子, 広瀬寛子, 柳澤博, 宮下光令, 数間恵子

がん看護　13　(5)　580-588　2008/07/20
Publisher:
ISSN： 1342-0569
What kind of support does a hospital-based palliative care team provide in a university hospital?: a result from participant-observation approach Peer-reviewed

笹原朋代, 三條真紀子, 梅田, 恵, 樋口比登実, 篠田淳子, 柴山大賀, 宮下光令, 河, 正子, 数間恵子

日本がん看護学会　22　(1)　12-22-22　2008/07
Publisher: Japanese Society of Cancer Nursing
DOI： 10.18906/jjscn.2008-22-1-12 　

ISSN： 0914-6423

More details Close

AbstractBackground : As the number of regional cancer centers increases, the number of hospital-based palliative care teams is also increasing rapidly. However, it is not clear what kind of support palliative care teams provide.Purpose : To illustrate what kind of support a pioneering palliative care team provides, using a participant-observation approach.Methods : From February to October 2004, we collected data using a participant-observation approach with three members of a palliative care team in a university hospital, which has operated since before palliative care team services were covered by National Health Insurance. Words and actions involved in the interaction between palliative care team members and ward staff/patients/families/other professional care-givers were recorded as field notes. Data were analyzed using a content analysis method.Results : Contents of support provided by a palliative care team was divided into seven categories, with 82 sub-categories. The categories are symptom management, emotional support for patients, clarifying care goals, support for selection of and transfer to place of care, terminal care, family support, education and emotional support for professional care-givers. Strategies for better palliative care team function, comprising 6 sub-categories were also formulated.Conclusion : We elucidated the contents of support provided by a pioneering palliative care team in Japan. Our findings should be a helpful reference as a practical guideline for newer palliative care teams.
Effect of a population-based educational intervention focusing on end-of-life home care, life-prolonging treatment and knowledge about palliative care

M. Miyashita, K. Sato, T. Morita, M. Suzuki

PALLIATIVE MEDICINE　22　(4)　376-382　2008/06

DOI： 10.1177/0269216308090073 　

ISSN： 0269-2163
The Japan HOspice and Palliative care Evaluation study (J-HOPE study): Study design and characteristics of participating institutions

Mitsunori Miyashita, Tatsuya Morita, Satoru Tsuneto, Kazuki Sato, Yasuo Shima

AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE　25　(3)　223-232　2008/06

DOI： 10.1177/1049909108315517 　

ISSN： 1049-9091

eISSN： 1938-2715
Factors contributing to evaluation of a good death from the bereaved family member's perspective

Mitsunori Miyashita, Tatsuya Morita, Kazuki Sato, Kei Hirai, Yasuo Shima, Yosuke Uchitomi

PSYCHO-ONCOLOGY　17　(6)　612-620　2008/06

DOI： 10.1002/pon.1283 　

ISSN： 1057-9249
Reliability assessment and findings of a newly developed quality measurement instrument: Quality indicators of end-of-life cancer care from medical chart review at a Japanese regional cancer center Peer-reviewed

Kazuki Sato, Mitsunori Miyashita, Tatsuya Morita, Makiko Sanjo, Yasuo Shima, Yosuke Uchitomi

JOURNAL OF PALLIATIVE MEDICINE　11　(5)　729-737　2008/06

DOI： 10.1089/jpm.2007.0227 　

ISSN： 1096-6218
A study of disease management activities of hip osteoarthritis patients under conservative treatment

Yurie Koyama, Mitsunori Miyashita, Shinji Irie, Motoi Yamamoto, Tatsuro Karita, Toru Moro, Yoshio Takatori, Keiko Kazuma

Journal of Orthopaedic Nursing　12　(2)　75-83　2008/05

DOI： 10.1016/j.joon.2008.07.005 　

ISSN： 1361-3111
変形性股関節症のADLとQOL 寛骨臼回転骨切り術(RAO)を受けた患者の生活

小山友里江, 宮下光令, 数間恵子, 高取吉雄

J Clin Rehabil　17　(4)　344-349　2008/04/15

ISSN： 0918-5259
Attitude of outpatients with neuromuscular diseases in Japan to pain and use of analgesics Peer-reviewed

Yoshiki Abe, Mitsunori Miyashita, Naomi To, Yuki Shirai, Yoshio Momose, Yaeko Ichikawa, Sholl Tsuli, Kelko Kazuma

JOURNAL OF THE NEUROLOGICAL SCIENCES　267　(1-2)　22-27　2008/04

DOI： 10.1016/j.jns.2007.09.027 　

ISSN： 0022-510X
Perceptions of specialized inpatient palliative care: A population-based survey in Japan Peer-reviewed

Makiko Sanjo, Mitsunori Miyashita, Tatsuya Morita, Kei Hirai, Masako Kawa, Tornoko Ashiya, Tatsuhiko Ishihara, Izuru Miyoshi, Tatsuhiro Matsubara, Toshimichi Nakaho, Nobuaki Nakashima, Hideki Onishi, Taketoshi Ozawa, Kazuyuki Suenaga, Tsukasa Tajima, Takayuki Hisanaga, Yosuke Uchitomi

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　35　(3)　275-282　2008/03

DOI： 10.1016/j.jpainsymman.2007.04.021 　

ISSN： 0885-3924
Identification of quality indicators of end-of-life cancer care from medical chart review using a modified Delphi method in Japan

Mitsunori Miyashita, Asumi Nakamura, Tatsuya Morita, Seiji Bito

AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE　25　(1)　33-38　2008/02

DOI： 10.1177/1049909107307376 　

ISSN： 1049-9091
Quality of end-of-life treatment for cancer patients in general wards and the palliative care unit at a regional cancer center in Japan: a retrospective chart review Peer-reviewed

Kazuki Sato, Mitsunori Miyashita, Tatsuya Morita, Makiko Sanjo, Yasuo Shima, Yosuke Uchitomi

SUPPORTIVE CARE IN CANCER　16　(2)　113-122　2008/02

DOI： 10.1007/s00520-007-0332-x 　

ISSN： 0941-4355
神経内科的疾患患者の在宅介護者に対する「個別化された重みつきQOL尺度」SEIQoL‐DWの測定

宮下光令, 秋山美紀, 落合亮太, 萩原章子, 中島孝, 福原俊一, 大生定義

厚生の指標　55　(1)　9-14　2008/01/15
Publisher:
ISSN： 0452-6104
Current Status and a Nationwide Challenge to Improve Palliative Care by the Cancer Control Act and the Outreach Palliative Care Trial of Integrated Regional Model (OPTIM) Study

Yamagishi A, Morita T, Miyashita M, Akizuki N, Kizawa Y, Shirahige Y, Akiyama M, Hirai K, Kudo T, Yamaguchi T, Fukushima A, Eguchi K. Palliative, Care in Japan

American Journal of Hospice and Palliative Medicine　44　(12)　1657-1662　2008
Nurse views of the adequacy of decision making and nurse distress regarding artificial hydration for terminally ill cancer patients: A nationwide survey

Mitsunori Miyashita, Tatsuya Morita, Yasuo Shima, Rieko Kimura, Mikako Takahashi, Isamu Adachi

American Journal of Hospice and Palliative Medicine　24　(6)　463-469　2008
Publisher: SAGE Publications Inc.
DOI： 10.1177/1049909107302301 　

ISSN： 1049-9091
Family caregiver's experiences in caring for a patient with terminal cancer at home in Japan Peer-reviewed

Tomomi Sano, Etsuko Maeyama, Masako Kawa, Yuki Shirai, Mitsunori Miyashita, Keiko Kazuma, Takeshi Okabe

Palliative and Supportive Care　5　(4)　389-395　2007/12

DOI： 10.1017/S1478951507000582 　

ISSN： 1478-9515 1478-9523
2004年の都道府県別在宅死亡割合と医療・社会的指標の関連

宮下光令, 白井由紀, 三條真紀子, 羽佐田知美, 三澤知代

死の臨床　30　(2)　204-9　2007/10/15

ISSN： 0912-4292
Physician and nurse attitudes toward artificial hydration for terminally ill cancer patients in Japan: Results of 2 nationwide surveys

Mitsunori Miyashita, Tatsuya Morita, Yasuo Shima, Rieko Kimura, Mikako Takahashi, Isamu Adachi

American Journal of Hospice and Palliative Medicine　24　(5)　383-389　2007/10

DOI： 10.1177/1049909107300552 　

ISSN： 1049-9091
The current status of palliative care teams in Japanese University Hospitals: a nationwide questionnaire survey

Mitsunori Miyashita, Shigehito Nishida, Yurie Koyama, Rieko Kimura, Tomoyo Sasahara, Yuki Shirai, Masako Kawa

SUPPORTIVE CARE IN CANCER　15　(7)　801-806　2007/07

DOI： 10.1007/s00520-006-0189-4 　

ISSN： 0941-4355
Nursing autonomy plays an important role in nurses' attitudes toward caring for dying patients

Mitsunori Miyashita, Yuko Nakai, Tomoyo Sasahara, Yurie Koyama, Yoichi Shimizu, Naoko Tsukamoto, Masako Kawa

American Journal of Hospice and Palliative Medicine　24　(3)　202-210　2007/06

DOI： 10.1177/1049909106298396 　

ISSN： 1049-9091
A study of the reality of daily life among patients with osteoarthritis of the hip undergoing conservative treatment

Yurie Koyama, Mitsunori Miyashita, Shinji Irie, Yoshio Takatori, Motoi Yamamoto, Tatsuro Karita, Keiko Kazuma

Journal of Orthopaedic Nursing　11　(2)　81-90　2007/05

DOI： 10.1016/j.joon.2007.01.008 　

ISSN： 1361-3111
Barriers to providing palliative care and priorities for future actions to advance palliative care in Japan: A nationwide expert opinion survey

Mitsunori Miyashita, Makiko Sanjo, Tatsuya Morita, Kei Hirai, Yoshiyuki Kizawa, Yasuo Shima, Naohito Shimoyama, Satoru Tsuneto, Kazuaki Hiraga, Kazuki Sato, Yosuke Uchitomi

JOURNAL OF PALLIATIVE MEDICINE　10　(2)　390-399　2007/04

DOI： 10.1089/jpm.2006.0154 　

ISSN： 1096-6218

eISSN： 1557-7740
Factors relating to terminally ill cancer patients' willingness to continue living at home during the early phase of home care after discharge from clinical cancer centers in Japan. Peer-reviewed

Hirabayashi Y, Miyashita M, Kawa M, Kazuma K, Yamashita K, Okamoto N

Palliative & supportive care　5　(1)　19-30　2007/03

DOI： 10.1017/S1478951507070046 　

ISSN： 1478-9515
The Japanese perception of feasibility of end-of-life home care until death and related factors.

佐藤一樹, 宮下光令, 森田達也, 鈴木雅夫

Palliat Care Res (Web)　2　(1)　101-111 (J-STAGE)-111　2007
Publisher: Japanese Society for Palliative Medicine
DOI： 10.2512/jspm.2.101 　

ISSN： 1880-5302

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Purpose: To clarify factors associated with the Japanese perception of whether they can live at home until death with the inclusion of knowledge and beliefs about end-of-life. Methods: A questionnaire survey was conducted on the Japanese general population who participated in a lecture meeting about palliative home care (N=61, effective response rate, 100%). Results: Ten (16%) responded they could live at home until death. Barriers to end-of-life home care were "Home care would burden my family (80%)," " Family and I are anxious about emergency care when I get worse (59%)" and "Family and I are anxious about whether I can enter a hospital emergently when I get worse (52%)" in that order. From the multivariate logistic regression model, respondents who expressed "Opioids cause addiction (OR, 95% confidential interval (CI):0.29, 0.09-0.99)" and "Artificial hydration and nutrition should be continued as the minimum standard until death (OR, 95%CI:0.39, 0.16-0.95)" were more likely to perceive that they could live at home until death. Conclusion: The empowerment activity for the general population regarding correct knowledge about palliative care, benefit and disadvantage of life-sustaining treatment, and correct knowledge about home care is important for the end-of-life patients who want to live at home until death to achieve their wish.
Attitudes toward disease and prognosis disclosure and decision making for terminally ill patients in Japan, based on a nationwide random sampling survey of the general population and medical practitioners. Peer-reviewed

Miyashita M, Hashimoto S, Kawa M, Shima Y, Kawagoe H, Hase T, Shinjo Y, Suemasu K

Palliative & supportive care　4　(4)　389-398　2006/12

ISSN： 1478-9515
Frommeltのターミナルケア態度尺度日本語版(FATCOD‐B‐J)の因子構造と信頼性の検討 ―尺度翻訳から一般病院での看護師調査,短縮版の作成まで―

中井裕子, 宮下光令, 笹原朋代, 小山友里江, 清水陽一, 河正子

がん看護　11　(6)　723-729　2006/09/20
Publisher:
ISSN： 1342-0569
Validation of the Burden Index of Caregivers (BIC), a multidimensional short care burden scale from Japan

Mitsunori Miyashita, Aki Yamaguchi, Mami Kayama, Yugo Narita, Norikazu Kawada, Miki Akiyama, Akiko Hagiwara, Yoshimi Suzukamo, Shunichi Fukuhara

HEALTH AND QUALITY OF LIFE OUTCOMES　4　52　2006/08

DOI： 10.1186/1477-7525-4-52 　

ISSN： 1477-7525
Preparing a version of the Nottingham Adjustment Scale (for psychological adjustment) tailored to osteoarthritis of the hip Peer-reviewed

Yurie Koyama, Mitsunori Miyashita, Keiko Kazuma, Yoshimi Suzukamo, Motoi Yamamoto, Tatsuro Karita, Yoshio Takatori

JOURNAL OF ORTHOPAEDIC SCIENCE　11　(4)　359-364　2006/07

DOI： 10.1007/s00776-006-1036-7 　

ISSN： 0949-2658
Knowledge and beliefs about end-of-life care and the effects of specialized palliative care: A population-based survey in Japan Peer-reviewed

T Morita, M Miyashita, M Shibagaki, K Hirai, T Ashiya, T Ishihara, T Matsubara, Miyoshi, I, T Nakaho, N Nakashima, H Onishi, T Ozawa, K Suenaga, T Tajima, T Akechi, Y Uchitomi

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　31　(4)　306-316　2006/04

DOI： 10.1016/j.jpainsymman.2005.09.004 　

ISSN： 0885-3924
Artificial hydration therapy, laboratory findings, and fluid balance in terminally ill patients with abdominal malignancies Peer-reviewed

T Morita, Hyodo, I, T Yoshimi, M Ikenaga, Y Tamura, A Yoshizawa, A Shimada, T Akechi, M Miyashita, Adachi, I

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT　31　(2)　130-139　2006/02

DOI： 10.1016/j.jpainsymman.2005.06.015 　

ISSN： 0885-3924
Attitudes towards disease and prognosis disclosure and decision-making for terminally ill patients in Japan, based on a nationwide random sampling survey of the general population and medical practitioners.

Miyashita M, Hashimoto S, Kawa M, Shima Y, Kawagoe H, Hase T, Shinjo Y, Suemasu K

Palliat Support Care.　4　389-98　2006
Pain management and related factors in advanced cancer patients who initiated opioid therapy in an outpatient setting. Peer-reviewed

Kimura R, Hashiguchi S, Kawa M, Miyashita M, Sasahara T, Shirai Y, Kazuma K

Palliative & supportive care　3　(4)　301-309　2005/12

ISSN： 1478-9515
―原著論文― 看護職員の「白血病ターミナル期」に関する認識とその関連要因

白井由紀, 宮下光令, 前山悦子, 河正子, 数間佳子

がん看護　10　(6)　541-545　2005/11/20
Publisher:
ISSN： 1342-0569
Nurses' perception of adequacy of care for leukemia patients with distress during the incurable phase and related factors Peer-reviewed

Y Shirai, M Kawa, M Miyashita, K Kazuma

LEUKEMIA RESEARCH　29　(3)　293-300　2005/03

DOI： 10.1016/j.leukres.2004.07.009 　

ISSN： 0145-2126
Factors associated with difficulties encountered by nurses in the care of terminally ill cancer patients in hospitals in Japan. Peer-reviewed

Sasahara T, Miyashita M, Kawa M, Kazuma K

Palliative & supportive care　3　(1)　15-22　2005/03

ISSN： 1478-9515
Factors That Influence Diet-Related Quality of Life in Middle-Aged Patients with Type 2 Diabetes

佐藤栄子, 宮下光令, 数間恵子

日本看護科学会誌　24　(4)　65-73　2004/12/30
Publisher: Japan Academy of Nursing Science
DOI： 10.5630/jans1981.24.4_65 　

ISSN： 0287-5330

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With the aim of exploration of the factors affecting the diet-related quality of life (QOL) of diabetic patients, a self-administered questionnaire survey was conducted among diabetic patients in middle age followed up at the outpatient clinic. Among 238 outpatients who consented to participate in the survey, effective responses were obtained from 231 (effective response rate; 97.1%). The Diabetes Diet-Related QOL (DDRQOL) scale was used for determination of the diet-related QOL, and multiple regression analysis was conducted using the subscale scores as the criterion variables. The major factors associated with a better QOL were as follows: a good understanding of the purpose and method of the diet therapy was related to the subscale score for"satisfaction with diet,"low HbA_1c values were related to the subscale score for"burden of diet therapy,"implementation of self-management behaviors and support from family and friends were related to the subscale score for"perceived merits of diet therapy,"and implementation of self-management behaviors, support from family and friends, and low HbA_1c values were related to the subscale score for"general perception of diet."In addition, the score for"restriction of social functions"was associated with lack of the need to be in charge of the cooking and lack of support from family and friends. Scores for"vitality"and"mental health"were affected by the stronger tendency of internal locus of control in the Health Locus of Control. These results suggest that improvement of the understanding of all aspects of diet therapy, as well as care for the promotion of self-management behaviors are important, and that support from family and friends is necessary from the point of view of improvement of the diet-related QOL.
Physician- and nurse-reported effects of intravenous hydration therapy on symptoms of terminally ill patients with cancer Peer-reviewed

Tatsuya Morita, Yasuo Shima, Mitsunori Miyashita, Rieko Kimura, Isamu Adachi

Journal of Palliative Medicine　7　(5)　683-693　2004/10

DOI： 10.1089/jpm.2004.7.683 　

ISSN： 1096-6218
Development of a diabetes diet-related quality-of-life scale Peer-reviewed

E Sato, Y Suzukamo, M Miyashita, K Kazuma

DIABETES CARE　27　(6)　1271-1275　2004/06

DOI： 10.2337/diacare.27.6.1271 　

ISSN： 0149-5992
Measurement of occipitocervical angle Peer-reviewed

N Shoda, K Takeshita, A Seichi, T Akune, S Nakajima, Y Anamizu, M Miyashita, K Nakamura

SPINE　29　(10)　E204-E208　2004/05

ISSN： 0362-2436
Reliability and Validity of Japanese version STAS (STAS-J).

Miyashita M, Matoba K, Sasahara T, Kizawa Y, Maruguchi M, Abe M, Kawa M, Shima Y

Palliat Support Care.　2　(4)　379-84　2004
Emotional burden of nurses in palliative sedation therapy Peer-reviewed

T Morita, M Miyashita, R Kimura, Adachi, I, Y Shima

PALLIATIVE MEDICINE　18　(6)　550-557　2004

DOI： 10.1191/0269216304pm911oa 　

ISSN： 0269-2163
Multiprofessional team approach in palliative care units in Japan Peer-reviewed

E Maeyama, M Kawa, M Miyashita, T Ozawa, N Futami, Y Nakagami, C Sugishita, K Kazuma

SUPPORTIVE CARE IN CANCER　11　(8)　509-515　2003/08

DOI： 10.1007/s00520-003-0465-5 　

ISSN： 0941-4355

eISSN： 1433-7339
Effects of an Off-Site Walking Program on Energy Expenditure, Serum Lipids, and Glucose Metabolism in Middle-Aged Women Peer-reviewed

Fumiko Furukawa, Keiko Kazuma, Masako Kawa, Mitsunori Miyashita, Kyohko Niiro, Reizo Kusukawa, Michiyo Kojima

Biological Research For Nursing　4　(3)　181-192　2003

DOI： 10.1177/1099800402239623 　

ISSN： 1552-4175 1099-8004
Difficulties encountered by nurses in the care of terminally ill cancer patients in general hospitals in Japan Peer-reviewed

T Sasahara, M Miyashita, M Kawa, K Kazuma

PALLIATIVE MEDICINE　17　(6)　520-526　2003

DOI： 10.1191/0269216303pm802oa 　

ISSN： 0269-2163
転倒・転落アセスメントシートの段階的評価‐患者参加型の転倒転落防止まで‐

石井敦子, 戸嶋りつ子, 川井幸江, 宮下光令

日本看護学会論文集看護管理　33rd　48-50　2002
Publisher:
ISSN： 1347-8184
Evidence‐Based Nursing誌とわが国の看護研究わが国の看護研究論文に用いられている統計手法について

宮下光令, 笹原朋代, 数間恵子

Qual Nurs　7　(10)　849-854　2001/10/01

ISSN： 1340-9875
Evidence‐Based Nursing誌とわが国の看護研究 Evidence‐Based Nursing誌について研究デザインと統計用語の集計から

宮下光令, 笹原朋代

Qual Nurs　7　(10)　841-848　2001/10/01

ISSN： 1340-9875
ホスピス・緩和ケアについての相談支援と情報提供に関する研究末期がん患者と家族の意識

今村由香, 小沢竹俊, 宮下光令, 河正子, 小島通代

日本がん看護学会誌　13　(2)　60-68　1999/12/22

DOI： 10.11477/mf.7007900090 　

ISSN： 0914-6423
Attitudes towards terminal care among the general population and medical practitioners in Japan

M. Miyashita, S. Hashimoto, M. Kawa, M. Kojima

[Nippon kōshū eisei zasshi] Japanese journal of public health　46　391-401　1999/01/01

ISSN： 0546-1766

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Misc. 318

死亡票情報を用いた遺族調査の二次解析によるがん診療連携拠点病院と非拠点病院で死亡したがん患者の特性と緩和ケアの質の比較

伊藤里美, 中澤葉宇子, 高橋理智, 小川朝生, 余谷暢之, 浜野淳, 宮下光令

日本サイコオンコロジー学会総会(Web)　37th　2024
専門的緩和ケアサービスが提供する標準的がん疼痛治療による疼痛改善理由の探索:多施設共同観察研究から得られた質的データの内容分析

菅原佑菜, 菅原佑菜, 田上恵太, 升川研人, 倉橋美岬, 菊池里美, 小杉和博, 石木寛人, 平塚裕介, 平塚裕介, 清水正樹, 森雅紀, 邱士い, 下田真優, 平山英幸, 山口拓洋, 井上彰, 里見絵理子, 宮下光令

Palliative Care Research (Web)　18　(Supplement)　2023

ISSN： 1880-5302
注目!がん看護における最新エビデンス第63回緩和ケア病棟入院時における緩和ケアの病期(Phase of Illness)の分布と症状との関連

大日方裕紀, 大日方裕紀, 宮下光令

エンド・オブ・ライフケア　7　(3)　2023
Phase of Illness (Palliative Care Phase) in Palliative Care: A Literature review

大日方裕紀, 大日方裕紀, 青山真帆, 宮下光令

日本がん看護学会誌(Web)　37　2023

ISSN： 2189-7565
がん患者の遺族による終末期呼吸困難のケアに対する満足度併存する苦痛症状との関連

山本瀬奈, 荒尾晴惠, 青木美和, 森雅紀, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 升川研人, 宮下光令

Palliative Care Research　17　(Suppl.)　S.205-S.205　2022/07
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
宗教ががん患者遺族の複雑性悲嘆・うつ・ケアの質評価に与える影響

青山真帆, 多田恵里香, 坂口幸弘, 高橋原, 金田諦晃, 升川研人, 平山英幸, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research　17　(Suppl.)　S.217-S.217　2022/07
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
緩和ケア病棟のケアの質および遺族の悲嘆・抑うつの施設間差とベンチマーキングの検討

関澤麻菜香, 青山真帆, 升川研人, 平山英幸, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research　17　(Suppl.)　S.389-S.389　2022/07
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
ホスピス・緩和ケア病棟患者における専門職によるリハビリテーションの満足度と関連要因 J-HOPE4付帯研究

長谷川貴昭, 明智龍男, 大佐賀智, 辻哲也, 奥山徹, 桜井春香, 升川研人, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research　17　(Suppl.)　S.198-S.198　2022/07
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
患者報告型アウトカムを用いた専門的緩和ケア質評価のための患者登録システムの開発:日本緩和医療学会緩和ケアの質評価WPGによる多施設パイロット調査

平山英幸, 里見絵理子, 木澤義之, 宮崎万友子, 田上恵太, 関根龍一, 鈴木梢, 余谷暢之, 菅野康二, 安保博文, 坂下明大, 佐藤一樹, 中川左理, 中澤葉宇子, 浜野淳, 宮下光令, 安保博文, 坂下明大, 佐藤一樹, 中川左理, 中澤葉宇子, 浜野淳, 宮下光令

Palliative Care Research (Web)　17　(Supplement)　2022

ISSN： 1880-5302
The positive effects of lung cancer bereavement on bereaved families

嶋田和貴, 恒藤暁, 坂口幸弘, 森田達也, 木澤義之, 志真泰夫, 升川研人, 宮下光令

日本呼吸器学会誌(Web)　11　2022

ISSN： 2186-5884
死亡診断時の医師の立ち居振る舞いに関するコンピテンシーおよびEntrustable professional activityの確立 Peer-reviewed

結束貴臣, 釆野優, 大屋清文, 宮地由佳, 日下部明彦, 中島淳, 市川靖史, 宮下光令, 森雅紀, 森田達也

Palliative Care Research　16　(Suppl.)　S409-S409　2021/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
「お看取り」の教育を考える死亡診断時の医師の立ち居振る舞いに関するコンピテンシーとEntrustable professional activityリストの確立 Peer-reviewed

結束貴臣, 釆野優, 大屋清文, 宮地由佳, 日下部明彦, 小林規俊, 中島淳, 市川靖史, 宮下光令, 森雅紀, 森田達也

Palliative Care Research　16　(Suppl.)　S164-S164　2021/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
在宅医療専門医のがん疼痛治療の知識と経験:全国質問紙調査

松本禎久, 松本禎久, 上原優子, 上原優子, 加藤雅志, 小杉寿文, 曽根美雪, 中村直樹, 森田達也, 水嶋章郎, 宮下光令, 山口拓洋, 里見絵理子

Palliative Care Research (Web)　16　(Supplement)　2021

ISSN： 1880-5302
緩和ケアにおける苦痛を表現する方言:緩和医療専門医・認定医に対する質問紙調査

三輪聖, 森田達也, 上原優子, 上原優子, 加藤雅志, 小杉寿文, 曽根美雪, 水嶋章郎, 宮下光令, 山口拓洋, 松本禎久, 松本禎久, 里見絵理子

Palliative Care Research (Web)　16　(Supplement)　2021

ISSN： 1880-5302
がん治療医のがん疼痛治療の知識と経験:全国質問紙調査

里見絵理子, 松本禎久, 松本禎久, 上原優子, 上原優子, 加藤雅志, 小杉寿文, 曽根美雪, 森田達也, 水嶋章郎, 宮下光令, 山口拓洋, 中村直樹

Palliative Care Research (Web)　16　(Supplement)　2021

ISSN： 1880-5302
Japanese Dialects for Expressing Symptoms in Palliative Care: A Nationwide Questionnaire Survey of Palliative Care Specialists

三輪聖, 森田達也, 松本禎久, 松本禎久, 上原優子, 上原優子, 加藤雅志, 小杉寿文, 曽根美雪, 中村直樹, 水嶋章郎, 宮下光令, 山口拓洋, 里見絵理子

Palliative Care Research (Web)　16　(4)　2021

ISSN： 1880-5302
緩和ケア病棟における終末期呼吸困難のケアの評価と終末期ケアの評価の関連:多施設遺族調査からの報告

山本瀬奈, 荒尾晴恵, 青木美和, 森雅紀, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 升川研人, 宮下光令

日本がんサポーティブケア学会学術集会プログラム・抄録集　6th (CD-ROM)　2021
クリティカルケア領域における医師の基本的緩和ケアの認識と専門的緩和ケアコンサルテーションの実態:ICUおよび救命救急センターに対する自記式質問紙調査

田中雄太, 加藤茜, 伊藤香, 五十嵐佑子, 五十嵐佑子, 木下里美, 木澤義之, 宮下光令

Palliative Care Research (Web)　16　(Supplement)　2021

ISSN： 1880-5302
看取り前の病院での終末期がん患者の入浴の実態と遺族による評価:遺族調査より

林ゑり子, 林ゑり子, 林ゑり子, 青山真帆, 升川研人, 宮下光令, 森田達也, 志真泰夫, 木澤義之, 恒藤暁

Palliative Care Research (Web)　16　(Supplement)　2021

ISSN： 1880-5302
がん患者遺族のうつ・複雑性悲嘆の予測モデルの開発

青山真帆, 宮下光令, 升川研人, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 明智龍男

Palliative Care Research (Web)　16　(Supplement)　2021

ISSN： 1880-5302
日本と英国のホスピス・緩和ケア病棟における死亡前2日間と死亡後のケアの質比較

石田美空, 五十嵐尚子, 升川研人, 青山真帆, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research (Web)　16　(Supplement)　2021

ISSN： 1880-5302
がん患者遺族の希死念慮と関連要因

青山真帆, 宮下光令, 升川研人, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 明智龍男

Palliative Care Research (Web)　16　(Supplement)　2021

ISSN： 1880-5302
医療者と遺族の終末期せん妄の有無に関する認識の一致度とその関連要因

内田恵, 内田恵, 明智龍男, 明智龍男, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 升川研人, 森雅紀, 宮下光令

Palliative Care Research (Web)　16　(Supplement)　2021

ISSN： 1880-5302
独居がん患者と同居家族がいるがん患者の望ましい死の達成度の死亡場所別の比較:多施設遺族調査の二次解析

五十嵐尚子, 青山真帆, 升川研人, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research (Web)　16　(Supplement)　2021

ISSN： 1880-5302
認知機能低下のあるがん患者への家族の介護体験と介護負担感の関連-緩和ケア病棟で患者を看取った家族への遺族調査結果より-

青木美和, 荒尾晴惠, 高尾鮎美, 山本瀬奈, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 升川研人, 宮下光令

Palliative Care Research (Web)　16　(Supplement)　2021

ISSN： 1880-5302
原発不明がん患者の検査・診断に伴う苦悩-3大がんとの比較-

石田京子, 石田京子, 石田京子, 安藤詳子, 小松弘和, 森田達也, 佐藤一樹, 内田恵, 明智龍男, 佐橋朋代, 足立珠美, 古川陽介, 古川陽介, 村田有希, 升川研人, 五十嵐尚子, 志真康夫, 木澤義之, 恒籐暁, 宮下光令

Palliative Care Research (Web)　16　(Supplement)　2021

ISSN： 1880-5302
原発不明がん患者の家族の苦悩と患者の望ましい死の達成および遺族の抑うつとの関連:J-HOPE付帯調査

石田京子, 石田京子, 石田京子, 安藤詳子, 小松弘和, 森田達也, 佐藤一樹, 内田恵, 明智龍男, 佐橋朋代, 足立珠美, 村田有希, 古川陽介, 古川陽介, 升川研人, 五十嵐尚子, 志真泰夫, 木澤義之, 恒藤暁, 宮下光令

日本サイコオンコロジー学会総会プログラム・抄録集　34th (Web)　2021
ホスピス・緩和ケア病棟の遺族が療養を振り返って希望する緩和的リハビリテーションの内容:J-HOPE4付帯研究

長谷川貴昭, 明智龍男, 明智龍男, 大佐賀智, 辻哲也, 奥山徹, 奥山徹, 桜井春香, 升川研人, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

日本サイコオンコロジー学会総会プログラム・抄録集　34th (Web)　2021
循環器疾患における遺族調査

水野篤, 宮下光令, 河野隆志, 東谷迪昭, 川松直人, 北井豪, 柴田龍宏, 武井眞, 後岡広太郎, 中澤学, 塩見紘樹, 立野滋

日本心不全学会学術集会プログラム・抄録集　24th (CD-ROM)　2020
看取りケアエビデンスとプラクティス

宮下光令, 林ゑり子, 林ゑり子

死の臨床　43　(1)　2020

ISSN： 0912-4292
がん患者の療養生活の最終段階における体系的な苦痛緩和法の構築に関する研究難治性がん疼痛治療実態調査・予備調査

松本禎久, 上原優子, 加藤雅志, 小杉寿文, 曽根美雪, 中村直樹, 水嶋章郎, 宮下光令, 森田達也, 山口拓洋

がん患者の療養生活の最終段階における体系的な苦痛緩和法の構築に関する研究令和元年度総括・分担研究報告書(Web)　2020
放射線治療への期待:難治性がん疼痛に対する専門医対象質問紙調査

松本禎久, 松本禎久, 松本禎久, 上原優子, 上原優子, 上原優子, 中村直樹, 中村直樹, 小杉寿文, 曽根美雪, 水嶋章郎, 水嶋章郎, 加藤雅志, 宮下光令, 山口拓洋, 里見絵理子, 里見絵理子

日本サイコオンコロジー学会総会プログラム・抄録集　33rd (Web)　2020
がん患者の療養生活の最終段階における体系的な苦痛緩和法の構築に関する研究がん疼痛の治療アルゴリズム構築に関する研究

田上恵太, 宮下光令, 森田達也, 山口拓洋

がん患者の療養生活の最終段階における体系的な苦痛緩和法の構築に関する研究令和元年度総括・分担研究報告書(Web)　2020
全国の専門的緩和ケアにおけるPatient Reported Outcomeの日常的な使用状況

伊藤奈央, 伊藤奈央, 青山真帆, 安保博文, 坂下明大, 松村優子, 宮下光令

日本サイコオンコロジー学会総会プログラム・抄録集　33rd (Web)　2020
終末期造血器腫瘍患者の死亡前在宅療養期間の関連因子

李美玲, 李美玲, 高橋瑞穂, 今野朱美, 市川聡, 青山真帆, 宮下光令

日本サイコオンコロジー学会総会プログラム・抄録集　33rd (Web)　2020
全国の専門的緩和ケアにおける苦痛スクリーニングの頻度と使用しているスケール

伊藤奈央, 伊藤奈央, 青山真帆, 安保博文, 坂下明大, 松村優子, 宮下光令

日本サイコオンコロジー学会総会プログラム・抄録集　33rd (Web)　2020
日本語版FAMCARE(家族の満足度尺度)の遺族に対する妥当性・信頼性の検討

伊藤千佳, 青山真帆, 升川研人, 田中雄太, 五十嵐尚子, 下妻晃二郎, 宮下光令

日本サイコオンコロジー学会総会プログラム・抄録集　33rd (Web)　2020
東京都のがん患者・一般市民・医師・看護師の終末期を過ごす場所の希望に関するアンケート調査

佐々木睦望, 青山真帆, 中川恵一, 川上祥子, 升川研人, 五十嵐尚子, 田中雄太, 佐藤祐里, 宮下光令

日本サイコオンコロジー学会総会プログラム・抄録集　33rd (Web)　2020
東京都のがん患者・一般市民・医師・看護師の予後告知の希望に関するアンケート調査

小山早紀, 青山真帆, 中川恵一, 川上祥子, 宮下光令

日本サイコオンコロジー学会総会プログラム・抄録集　33rd (Web)　2020
がん患者に対する死亡前1年間の漢方薬処方 DPCデータを用いた全国実態調査 Peer-reviewed

松居千夏, 田辺公一, 佐藤一樹, 宮下光令, 石川ベンジャミン光一, 森田達也, 伏見清秀, 内冨庸介, 酒井隆全, 大津史子

日本薬剤師会学術大会講演要旨集　52回　P-365　2019/10
Publisher: (公社)日本薬剤師会
大学病院緩和ケア病棟における臨床宗教師の役割入院患者の語りの主題分析結果を通して

金田諦晃, 青山真帆, 平塚裕介, 田上恵太, 宮下光令, 井上彰

Palliative Care Research　14　(Suppl.)　S229-S229　2019/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
臨床宗教師介入による心理的影響に対するインタビュー調査

平塚裕介, 青山真帆, 金田諦晃, 升川研人, 田上恵太, 宮下光令, 井上彰

Palliative Care Research　14　(Suppl.)　S342-S342　2019/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
緩和ケア病棟に入院中の終末期がん患者の家族介護者のレジリエンスと精神的健康の関連の検討

清水陽一, 前田一石, 林章敏, 松本禎久, 井上彰, 高野真優子, 石垣和美, 升川研人, 宮下光令

Palliative Care Research　14　(Suppl.)　S332-S332　2019/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
認知症患者におけるGood Deathの在り方に関する認知症患者、家族、医師、看護師、介護職に対するインタビュー調査の内容分析 Peer-reviewed

渡会紘子, 高橋在也, 山川みやえ, 青山真帆, 五十嵐尚子, 坂井志麻, 深堀浩樹, 中西三春, 佐藤一樹, 長江弘子, 宮下光令

Palliative Care Research　14　(Suppl.)　S433-S433　2019/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
複雑性悲嘆のスクリーニング尺度であるBrief Grief Questionnaire(BGQ)の短縮化についての研究

佐藤桃香, 青山真帆, 伊藤正哉, 竹林由武, 森田達也, 志真泰夫, 升川研人, 五十嵐尚子, 宮下光令

Palliative Care Research　14　(Suppl.)　S331-S331　2019/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
臨死期の治療やケアの見直しのための簡便な予後指標-Liverpool Care Pathwayの使用基準の予後7日の予測能(J-Proval研究)-

菊池里美, 青山真帆, 浜野淳, 滝川千鶴子, 長岡広香, 鄭陽, 木内大祐, 永松美佳子, 竹田幸彦, 森田達也, 宮下光令

Palliative Care Research (Web)　14　(Supplement)　2019

ISSN： 1880-5302
未成年の子どもを有するがんサバイバーにおけるQuality of Lifeと心理的苦痛

畑琴音, 畑琴音, 藤森麻衣子, 藤澤大介, 鈴木伸一, 宮下光令

日本サイコオンコロジー学会総会プログラム・抄録集　32nd　2019
Quality of life and psychological distress in cancer survivors with a minor child

Kotone Hata, Maiko Fujimori, Daisuke Fujisawa, Shin-ichi Suzuki, Mitsunori Miyashita

PSYCHO-ONCOLOGY　27　190-190　2018/10

ISSN： 1057-9249

eISSN： 1099-1611
2014年のがん患者の市町村別自宅死亡率と医療社会的指標との関連地域相関研究

佐藤一樹, 藤田裕子, 田辺公一, 橋本孝太郎, 河原正典, 鈴木雅夫, 宮下光令

Palliative Care Research　13　(Suppl.)　S436-S436　2018/06
Publisher: (NPO)日本緩和医療学会
オピオイド消費量の都道府県格差に関する検討

高橋理智, 村上義孝, 宮下光令

Palliative Care Research　13　(Suppl.)　S343-S343　2018/06
Publisher: (NPO)日本緩和医療学会
心血管疾患における遺族調査

水野篤, 宮下光令

Palliative Care Research　13　(Suppl.)　S444-S444　2018/06
Publisher: (NPO)日本緩和医療学会
J-HOPE研究の10年 2007年〜2016年のわが国の緩和ケアの質の推移

宮下光令, 五十嵐尚子, 青山真帆, 清水恵, 佐藤一樹, 森田達也, 木澤義之, 恒藤暁, 志真泰夫

Palliative Care Research　13　(Suppl.)　S314-S314　2018/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
心血管疾患における遺族調査

水野篤, 宮下光令

Palliative Care Research　13　(Suppl.)　S444-S444　2018/06
Publisher: (NPO)日本緩和医療学会
がん薬物療法の効果の認識による看取り場所の希望と実際

佐藤悠子, 大石隆之, 高橋昌宏, 宮下光令, 石岡千加史

Palliative Care Research　13　(Suppl.)　S421-S421　2018/06
Publisher: (NPO)日本緩和医療学会
高齢者ケア施設におけるエンド・オブ・ライフ・ケアのIntegrated Care Pathwaysに関する介入・実装研究スコーピングレビュー

山縣千尋, 深堀浩樹, 廣岡佳代, 菅野雄介, 田口敦子, 松本佐知子, 宮下光令

Palliative Care Research　13　(Suppl.)　S440-S440　2018/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
心不全患者におけるリスクで調整した緩和ケアの質(Risk-adjusted Palliative Care Quality of Care in Heart Failure Patients)

水野篤, 河野隆志, 長友祐司, 香坂俊, 筋野容守, 武井眞, 合田あゆみ, 吉川勉, 宮下光令

日本循環器学会学術集会抄録集　82回　LBCS2-6　2018/03
Publisher: (一社)日本循環器学会
がんサバイバーが感じるスティグマの頻度と関連因子 Peer-reviewed

藤澤大介, 藤森麻衣子, 宮下光令

日本サイコオンコロジー学会総会・日本臨床死生学会総会合同大会プログラム・抄録集　30回・23回　219-219　2017/10
Publisher: (一社)日本サイコオンコロジー学会・日本臨床死生学会
注目!がん看護における最新エビデンス第18回ステップ2の弱オピオイドは必要か?

宮下光令

エンド・オブ・ライフケア　1　(3)　94‐95　2017/07/20
遺族調査と施設概要調査から学ぶ~緩和ケアの質~

宮下光令

Best Nurse　28　(7)　17‐20-20　2017/07/01
Publisher: 北海道医療新聞社
造血器腫瘍患者の終末期に関連した意思決定に関する意識調査

李美玲, 今野朱美, 福原規子, 宮下光令, 張替秀郎

Palliative Care Research　12　(Suppl.)　S543-S543　2017/06
Publisher: (NPO)日本緩和医療学会
進行がん患者に対するSpiPasを用いたスピリチュアルケアの有効性前後比較2相試験

市原香織, 大内紗也子, 岡山幸子, 木下富貴子, 宮下光令, 森田達也, 田村恵子

Palliative Care Research　12　(Suppl.)　S349-S349　2017/06
Publisher: (NPO)日本緩和医療学会
注目!がん看護における最新エビデンス第16回終末期せん妄にセレネース,リスパダールは効かない?むしろ悪化させる?

宮下光令

エンド・オブ・ライフケア　1　(1)　110‐111　2017/03/20
原発性悪性脳腫瘍患者における終末期ケアの質の評価-ホスピス・緩和ケア病棟での多施設遺族調査-

杉山育子, 青山真帆, 佐藤一樹, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

日本がん看護学会誌(Web)　31　2017

ISSN： 2189-7565
がん患者の遺族における複雑性悲嘆のスクリーニング尺度であるBrief Grief Questionnaire(BGQ)とInventory of Complicated Grief(ICG)の比較(J‐HOPE2016研究)

五十嵐尚子, 青山真帆, 伊藤正哉, 中島聡美, 坂口幸弘, 森田達也, 志真泰夫, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　22nd　S333　2017
働くがん患者の職場復帰支援に関する研究―病院における離職予防プログラム開発評価と企業文化づくりの両面から「がん診断後から離職までの時間に対する要因分析(横断的観察研究)」

高橋都, 青儀健二郎, 宮下光令, 荒井保明, 堀尾芳嗣, 船崎初美, 堀尾芳嗣, 船崎初美, 宮内一恵, 土屋雅子

働くがん患者の職場復帰支援に関する研究-病院における離職予防プログラム開発評価と企業文化づくりの両面から平成28年度総括・分担研究報告書(Web)　7‐12 (WEB ONLY)　2017
がん患者遺族に対する「不用意な言葉かけ」は何か?―全国調査から―

石田真弓, 大西秀樹, 清水恵, 森田達也, 宮下光令, 内富庸介

心身医学　56　(12)　1261　2016/12/01

ISSN： 0385-0307
終末期がん患者の家族が、患者の死を前提として行いたいことを達成するための望ましいケア

高尾鮎美, 荒尾晴惠, 山下亮子, 升谷英子, 森田也, 木澤義之, 恒藤暁, 志真泰夫, 青山真帆, 宮下光令

第1回関西緩和医療研究会プログラム抄録集　2016/11
注目!がん看護における最新エビデンス第13回在宅緩和ケアは入院に比べて生命予後を短くしないだけでなく,延長するかもしれない

宮下光令

オンコロジーナース　10　(1)　88‐90　2016/09/20
注目!がん看護における最新エビデンス第12回終末期の化学療法は患者の死亡直前のQOLを改善せず,全身状態(PS)がよい患者ではむしろQOLを悪化させる。

宮下光令

オンコロジーナース　9　(6)　46‐47　2016/07/20
死の臨床における研究―倫理的視点から―

宮下光令

死の臨床　39　(1)　25‐26　2016/06/30

ISSN： 0912-4292
がん患者の療養生活における意思決定に関する家族の困難感

清水恵, 柳原一広, 青山真帆, 森田達也, 恒藤暁, 志真泰夫, 宮下光令

Palliative Care Research　11　(Suppl.)　S314-S314　2016/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
終末期がん患者へのリハビリテーションに関する家族の体験に関する研究

関根龍一, 関根龍一, 森田達也, 前田一石, 木澤義之, 恒藤暁, 志真泰夫, 青山真帆, 宮越浩一, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　11　(Suppl.)　S291-S291　2016/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
傾向スコア法によって調整した最期の療養場所とクオリティ・オブ・ケア,クオリティ・オブ・デスとの関連:J‐HOPE study3

羽多野裕, 羽多野裕, 青山真帆, 山口拓洋, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　11　(Suppl.)　S319-S319　2016/06
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
DPCデータを用いたDPC算定病床におけるがん患者の緩和医療の質

佐藤悠子, 石岡千加史, 藤森研司, 石川光一, 佐藤一樹, 宮下光令

Palliative Care Research　11　(Suppl.)　S316-S316　2016/06
Publisher: (NPO)日本緩和医療学会
重要テーマ別!緩和ケアの最新エビデンスケア提供体制~早期からの緩和ケアなど

宮下光令

オンコロジーナース　9　(5)　79‐84　2016/05/20
遺族の声を臨床に生かす~J‐HOPE2研究(多施設遺族調査)からの学び~第6回(最終回)望ましい看護師のあり方

宮下光令

がん看護　21　(3)　363‐368-368　2016/03/20
Publisher: 南江堂
DOI： 10.15106/J03022.2016236106 　

ISSN： 1342-0569
注目!がん看護における最新エビデンス第10回終末期がん患者の呼吸困難に対する扇風機による送風の効果

宮下光令

オンコロジーナース　9　(4)　46‐47　2016/03/20
遺族の声を臨床に生かす~J‐HOPE2研究(多施設遺族調査)からの学び~第5回遺族のつらさを和らげるために

宮下光令

がん看護　21　(1)　55‐59-59　2016/01/20
Publisher: 南江堂
DOI： 10.15106/J03022.2016150310 　

ISSN： 1342-0569
在宅がん患者の精神症状と介護者の精神的つらさの関連について

小早川誠, 小川朝生, 金野倫子, 倉田明子, 青山真帆, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

日本サイコオンコロジー学会総会プログラム・抄録集　29th　2016
希望する療養場所と実際の療養場所の一致が患者のquality of life,遺族の悲嘆・抑うつへ与える影響

首藤真理子, 首藤真理子, 森田達也, 森田達也, 青山真帆, 青山真帆, 木澤義之, 木澤義之, 恒藤暁, 恒藤暁, 志真泰夫, 志真泰夫, 宮下光令, 宮下光令

日本プライマリ・ケア連合学会学術大会抄録集　7th　2016
終末期がん患者を介護する家族の不安と抑うつの実態とその関連要因の検証に関する研究

佐竹宣明, 佐藤一樹, 中保利通, 井上彰, 宮下光令

Palliative Care Research　11　(Suppl.)　315　2016
がん診療拠点病院におけるがん疼痛緩和に対する取り組みの評価と改善に関する研究がん診療連携拠点病院におけるがん疼痛に関する多施設調査―痛みの状況と施設間差の検討―

宮下光令, 重野朋子

がん診療拠点病院におけるがん疼痛緩和に対する取り組みの評価と改善に関する研究平成27年度総括・分担研究報告書　51‐68　2016
働くがん患者の職場復帰支援に関する研究―病院における離職予防プログラム開発評価と企業文化づくりの両面からがん患者の就労実態と病院における就労支援プログラムに関するニーズ調査(横断的観察研究)

高橋都, 山本精一郎, 溝田友里, 青儀健二郎, 宮下光令, 荒井保明, 堀尾芳嗣, 堀尾芳嗣, 船崎初美, 船崎初美, 宮内一恵, 土屋雅子, 田崎牧子, 富田眞紀子

働くがん患者の職場復帰支援に関する研究‐病院における離職予防プログラム開発評価と企業文化づくりの両面から平成27年度総括・分担研究報告書　13‐39　2016
遺族によるホスピス・緩和ケアの質の評価に関する研究(J‐HOPE3研究)―研究方法および応諾状況・対象者背景の報告

青山真帆, 宮下光令

日本がん看護学会誌　30　264　2016/01

ISSN： 0914-6423
がん疼痛管理指標の開発

佐藤悠子, 宮下光令, 岸野恵, 木澤義之, 森田達也, 細川豊史

日本緩和医療学会学術大会プログラム・抄録集　21st　(Suppl.)　S322-S322　2016
Publisher: (NPO)日本緩和医療学会
eISSN： 1880-5302
超高齢がん患者の緩和ケアの特徴に関する研究

坂下明大, 森田達也, 青山真帆, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

日本臨床腫瘍学会学術集会(CD-ROM)　14th　ROMBUNNO.O1‐2‐4　2016
DPC算定病床における高齢がん患者の終末期医療:DPCデータを用いた後方視的観察研究

佐藤悠子, 高橋昌宏, 藤森研司, 佐藤一樹, 宮下光令, 石岡千加史

日本癌治療学会学術集会(Web)　54th　ROMBUNNO.WS97‐6 (WEB ONLY)　2016
遺族の声を臨床に生かす~J‐HOPE 2研究(多施設遺族調査)からの学び~第4回看取り前後のケア

宮下光令

がん看護　20　(7)　730-735　2015/11/20
Publisher: 南江堂
ISSN： 1342-0569
遺族の声を臨床に生かす~J‐HOPE 2研究(多施設遺族調査)からの学び~第3回家族に対するケア

宮下光令

がん看護　20　(6)　649-654　2015/09/20
Publisher: 南江堂
ISSN： 1342-0569
死の臨床における研究―倫理的視点から

宮下光令

死の臨床　38　(2)　254　2015/09/09

ISSN： 0912-4292
遺族の声を臨床に生かす~J‐HOPE 2研究(多施設遺族調査)からの学び~第2回医療用麻薬をめぐって

宮下光令

がん看護　20　(5)　548-552　2015/07/20
Publisher: 南江堂
ISSN： 1342-0569
非がん患者の緩和ケア Part1 緩和ケアの考え方と非がん疾患の緩和ケアの現状

宮下光令

看護技術　61　(7)　671-678　2015/06/20
Publisher: メヂカルフレンド社
ISSN： 0449-752X
苦痛緩和のための鎮静に関する家族への説明・ケアについての検討 Peer-reviewed

池永昌之, 恒藤暁, 平井啓, 宮下光令, 森田達也

日本緩和医療学会学術大会プログラム・抄録集　20回　358-358　2015/06
Publisher: (NPO)日本緩和医療学会
東北大学病院における5大癌患者の終末期医療 DPCデータを用いた集計方法の検討

佐藤悠子, 宮下光令, 藤森研司, 中谷純, 藤本容子, 栗原誠, 佐藤一樹, 石岡千加史

日本緩和医療学会学術大会プログラム・抄録集　20回　315-315　2015/06
Publisher: (NPO)日本緩和医療学会
終末期がん患者に在宅療養移行を勧める時の望ましいコミュニケーション多施設遺族研究

山岸暁美, 森田達也, 川越正平, 清水恵, 小澤竹俊, 安恵美, 小早川誠, 恒藤暁, 志真泰夫, 宮下光令

癌と化学療法　42　(3)　327-333　2015/03
Publisher: (株)癌と化学療法社
ISSN： 0385-0684
DPCデータを用いた東北大学病院の5大がん入院患者の終末期がん医療に関する調査

佐藤悠子, 宮下光令, 藤森研司, 中谷純, 藤本容子, 石岡千加史

日本内科学会雑誌　104　(Suppl.)　241-241　2015/02
Publisher: (一社)日本内科学会
ISSN： 0021-5384
大学病院入院中のがん患者の突出痛の頻度に関する予備調査

岸野恵, 木澤義之, 佐藤悠子, 宮下光令, 森田達也, 細川豊史

日本緩和医療学会学術大会プログラム・抄録集　20th　2015
受療行動調査による患者の満足度と意識・行動等の現状と推移,相互の関連性およびその規定要因に関する研究受療行動調査における心身の状態と満足度の疾患別分布および相互の関連についての研究

宮下光令

受療行動調査による患者の満足度と意識・行動等の現状と推移、相互の関連性およびその規定要因に関する研究平成26年度総括・分担研究報告書　74-107　2015
がん対策における緩和ケアの評価に関する研究がん対策推進基本計画策定前後の医療者からみた緩和ケアの変化に関する量的研究

宮下光令, 中澤葉宇子

がん対策における緩和ケアの評価に関する研究平成26年度総括・分担研究報告書　11‐12　2015
被災地に展開可能ながん在宅緩和医療システムの構築に関する研究「がん在宅緩和ケア提供の障害の分析」に関する研究東日本大震災におけるがん緩和ケア・がん在宅医療の経験

宮下光令, 菅野喜久子, 森田達也

被災地に展開可能ながん在宅緩和医療システムの構築に関する研究平成26年度総括・分担研究報告書　209‐228　2015
被災地に展開可能ながん在宅緩和医療システムの構築に関する研究がん緩和・在宅医療における東日本大震災の経験を生かした東南海地震への備えに関する研究

森田達也, 秋山聖子, 河原正典, 菅野喜久子, 金野良則, 白土明美, 高橋美保, 伊達久, 橋本孝太郎, 星野彰, 宮下光令, 村上雅彦, 渡辺芳江

被災地に展開可能ながん在宅緩和医療システムの構築に関する研究平成26年度総括・分担研究報告書　39‐63　2015
働くがん患者の職場復帰支援に関する研究―病院における離職予防プログラム開発評価と企業文化づくりの両面から「働くがん患者のための症状別対応ヒント集(案)」作成に向けた体験談収集調査

高橋都, 山本精一郎, 溝田友里, 宮下光令, 平岡晃, 古屋佑子, 酒井瞳, 赤羽和久, 富田眞紀子, 田崎牧子

働くがん患者の職場復帰支援に関する研究‐病院における離職予防プログラム開発評価と企業文化づくりの両面から平成26年度総括・分担研究報告書　41‐53　2015
がん診療拠点病院におけるがん疼痛緩和に対する取り組みの評価と改善に関する研究がん診療連携拠点病院の痛みの評価方法の開発について

木澤義之, 宮下光令, 森田達也, 浜野淳, 服部政治, 櫻井宏樹, 廣瀬宗孝, 上野博司, 細川豊史

がん診療拠点病院におけるがん疼痛緩和に対する取り組みの評価と改善に関する研究平成26年度総括・分担研究報告書　7‐38　2015
インターネット・モニター調査による,がんサバイバーの就業状況の変化の経験に関する検討

宮下光令, 菅野喜久子, 菅野喜久子, 佐藤一樹, 高橋都

日本がん看護学会誌　29　248　2015/01

ISSN： 0914-6423
遺族からみたがん患者のGood Deathの達成および終末期のケアに対する全般的満足度の関連要因

竹内真帆, 清水恵, 佐藤一樹, 菅野雄介, 杉山育子, 重野朋子, 杉沢真衣, 志真泰夫, 宮下光令

日本がん看護学会誌　29　171　2015/01

ISSN： 0914-6423
緩和医療の現場で直面する疑問や問題を解決! ○×で学ぶ緩和ケアのエビデンス(第5回)

宮下光令, 藤本亘史

Nursing today　29　(6)　72-75　2014/12
Publisher: 日本看護協会出版会
ISSN： 0912-2974
緩和医療の現場で直面する疑問や問題を解決! ○×で学ぶ緩和ケアのエビデンス(第4回)

宮下光令, 齋藤明美

Nursing today　29　(5)　68-70　2014/10
Publisher: 日本看護協会出版会
ISSN： 0912-2974
緩和医療の現場で直面する疑問や問題を解決! ○×で学ぶ緩和ケアのエビデンス(第3回)

宮下光令, 中條庸子

Nursing today　29　(4)　74-76　2014/08
Publisher: 日本看護協会出版会
ISSN： 0912-2974
Caregiver Quality of Life Index-Cancer(CQOLC)日本語版の信頼性・妥当性の検証

清水恵, 安藤早紀, 原田真里子, 久慈瑞希, 佐藤一樹, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　19回　356-356　2014/06
Publisher: (NPO)日本緩和医療学会
遺族の視点から臨終前後の患者と家族の看取りのケアの質を評価する尺度の開発と信頼性・妥当性の検証

菅野雄介, 佐藤一樹, 清水恵, 安藤秀明, 舩水裕子, 岸野恵, 前原絵美理, 高橋徹, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　19回　403-403　2014/06
Publisher: (NPO)日本緩和医療学会
医療者から受けた看取りのケアの実践と遺族の望ましい看取りの達成との関連要因の探索

菅野雄介, 佐藤一樹, 清水恵, 安藤秀明, 舩水裕子, 岸野恵, 前原絵美理, 高橋徹, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　19回　403-403　2014/06
Publisher: (NPO)日本緩和医療学会
看護師に対するELNEC-Jコアカリキュラム看護師教育プログラムの有効性の検証 Wait list controlによる無作為化比較試験

新幡智子, 宮下光令, 梅田恵, 桑田美代子, 田村恵子, 木澤義之

日本緩和医療学会学術大会プログラム・抄録集　19回　504-504　2014/06
Publisher: (NPO)日本緩和医療学会
注目!がん看護における最新エビデンス早期からの緩和ケアは生存期間を延長する可能性がある

宮下光令

オンコロジーナース　7　(5)　76-77　2014/05/20
緩和医療の現場で直面する疑問や問題を解決!○×で学ぶ緩和ケアのエビデンス

宮下光令, 大沼美智子

Nurs Today　29　(3)　84-86　2014/05/15

ISSN： 0912-2974
誌上コンサルテーションシリーズ 8)病棟から在宅につなぐ緩和ケア退院支援と在宅ケアの現状

佐藤一樹, 宮下光令

Nurs Today　29　(3)　8-14　2014/05/15

ISSN： 0912-2974
緩和医療の現場で直面する疑問や問題を解決!○×で学ぶ緩和ケアのエビデンス第1回

宮下光令, 武田真恵

Nurs Today　29　(2)　78-80　2014/03/15

ISSN： 0912-2974
宮城県医師会員を対象としたがん地域医療連携に関する意識調査

秋山聖子, 熊坂夏菜子, 宮下光令, 森隆弘, 石岡千加史

日本内科学会雑誌　103　252　2014/02/20

ISSN： 0021-5384
終末期ケアの質と遺族の複雑性悲嘆の関連

宮島加耶, 藤澤大介, 吉村公雄, 伊藤正哉, 中島聡美, 白波瀬丈一郎, 三村將, 宮下光令

日本精神神経学会総会プログラム・抄録集　110th　(2014特別)　S.566-S566　2014
Publisher: (公社)日本精神神経学会
ISSN： 0033-2658
緩和ケアの構造・プロセス、アウトカム評価における家族による代理評価の信頼性の検証に関する研究

佐竹宣明, 大学院医学系研究科医科学専攻緩和医療学分野, 中保利通, 佐藤一樹, 佐藤千穂子, 島田哲, 田島つかさ, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集19回　516　2014
秋田県の看護師におけるELNEC‐Jコアカリキュラム看護師教育プログラム受講前後の評価

舩水裕子, 苅安真佐美, 高橋加代子, 冨野江里子, 石川千夏, 阿部緑, 煙山晶子, 伊藤登茂子, 安藤秀明, 新幡智子, 菅野雄介, 宮下光令

日本癌治療学会学術集会(CD-ROM)　52nd　(3)　ROMBUNNO.P129-15-2785　2014
Publisher: (一社)日本癌治療学会
ISSN： 0021-4671
QOL向上のための,主に精神,心理,社会,スピリチュアルな側面からの患者・家族支援プログラムに関する研究がん患者に対する包括的支援システムの開発―医師・患者コミュニケーションに関する研究―

内富庸介, 藤森麻衣子, 浅井真理子, 小川朝生, 藤澤大介, 木下寛也, 白井由紀, 山田祐, 横尾実乃里, 柴山修, 近藤享子, 宮下光令, 稲垣正俊, 井上真一郎, 土山璃沙, 福島倫子, 樋口裕二

QOL向上のための、主に精神、心理、社会、スピリチュアルな側面からの患者・家族支援プログラムに関する研究平成25年度総括・分担研究報告書　31-36　2014
QOLの向上をめざしたがん治療法の開発研究がん患者のQOLの評価指標の開発

宮下光令, 御子柴直子, 酒井智子, 山花令子

「QOLの向上をめざしたがん治療法の開発研究」に関する研究平成25年度総括・分担研究報告書　31-33　2014
被災地に展開可能ながん在宅緩和医療システムの構築に関する研究がん緩和・在宅医療における東日本大震災の経験を生かした東南海地震への備えに関する研究

森田達也, 秋山聖子, 河原正典, 菅野喜久子, 金野良則, 白土明美, 高橋美保, 伊達久, 橋本孝太郎, 星野彰, 宮下光令, 村上雅彦, 渡辺芳江

被災地に展開可能ながん在宅緩和医療システムの構築に関する研究平成25年度総括・分担研究報告書　95-118　2014
被災地に展開可能ながん在宅緩和医療システムの構築に関する研究「がん在宅緩和ケア提供の障害の分析」に関する研究東日本大震災におけるがん緩和ケア・がん在宅医療の経験

宮下光令, 菅野喜久子, 森田達也

被災地に展開可能ながん在宅緩和医療システムの構築に関する研究平成25年度総括・分担研究報告書　119-124　2014
受療行動調査による患者の満足度と意識・行動等の現状と推移,相互の関連性およびその規定要因に関する研究受療行動調査における心身の状態と満足度の疾患別分布および相互の関連についての研究

宮下光令

受療行動調査による患者の満足度と意識・行動等の現状と推移、相互の関連性およびその規定要因に関する研究平成25年度総括・分担研究報告書　34-57　2014
がん患者・職場関係者・医療者に向けた就業支援カリキュラムの開発と普及啓発手法に関する研究がんサバイバーの就業状況の変化の経験に関する分析

宮下光令

がん患者・職場関係者・医療者に向けた就業支援カリキュラムの開発と普及啓発手法に関する研究平成25年度総括・分担研究報告書　144-147　2014
緩和医療に携わる医療従事者の育成に関する研究看護師の育成の評価に関する研究

宮下光令

緩和医療に携わる医療従事者の育成に関する研究平成25年度総括・分担研究報告書　40-42　2014
Caregiver Quality of Life Index-Cancer(CQOLC)日本語版の信頼性・妥当性の検証

安藤早紀, 原田真里子, Weitzner Michael A, 久慈瑞希, 清水恵, 佐藤一樹, 宮下光令

Palliative Care Research　8　(2)　286-292　2013/12
Publisher: (NPO)日本緩和医療学会
DOI： 10.2512/jspm.8.286 　

ISSN： 1880-5302
キャリアプロモート支援に関する3年間の看護職員の認識の変化

佐々木百合花, 宮下光令, 早川ひと美, 岡村由紀子, 亀岡淳一, 塩飽仁, 門間典子

日本看護科学学会学術集会講演集　33rd　307　2013/12
根拠に基づいた看取りのケア遺族によるわが国のがん患者の終末期ケア・看取りのケアの質の評価~日本の看取りのケアの質は高い.しかし,改善が必要な点もある~

宮下光令, 菅野雄介

がん看護　18　(7)　675-678　2013/11/20
Publisher: 南江堂
ISSN： 1342-0569
英国での看取りのケアのクリニカルパス Liverpool Care Pathwayの動向について

菅野雄介, 茅根義和, 池永昌之, 宮下光令

緩和ケア　23　(6)　464-467　2013/11/15
Publisher: 青海社
ISSN： 1349-7138
患者・遺族の緩和ケアの質評価・quality of life,医師:看護師の困難感と施設要因との関連

森田達也, 佐藤一樹, 五十嵐美幸, 宮下光令

緩和ケア　23　(6)　497-501　2013/11/15
Publisher: 青海社
ISSN： 1349-7138
QUALITY OF LIFE OF JAPANESE CANCER PATIENTS: A NATIONALLY REPRESENTATIVE SAMPLE SURVEY USING PATIENT'S BEHAVIOR SURVEY

M. Miyashita, M. Kato, M. Shimizu, T. Morita, K. Sato, D. Fujisawa

ANNALS OF ONCOLOGY　24　49-49　2013/11

ISSN： 0923-7534

eISSN： 1569-8041
アウトカム評価としての診療録ピアレビューシステムの信頼性の検討(第2報)

亀岡淳一, 宮下光令, 大久保智哉, 小熊絵美, 高橋文恵, 石井誠一, 金塚完

医学教育　44　(Suppl.)　89-89　2013/07
Publisher: (一社)日本医学教育学会
ISSN： 0386-9644
がん診療連携拠点病院緩和ケアチーム研修会の評価研修後追跡調査結果

中澤葉宇子, Kizawa Yoshiyuki, 橋爪隆弘, 森田達也, 笹原朋代, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集18回　453　2013/06
看取りの質を評価する看取りのケアの質を遺族・看護師の視点から評価する尺度の開発

宮下光令, 菅野雄介, 佐藤一樹, 清水恵, 五十嵐美幸, 菅野喜久子

日本緩和医療学会学術大会プログラム・抄録集　18回　220-220　2013/06
Publisher: (NPO)日本緩和医療学会
ご遺体へのケアを看護師が家族と一緒に行うことについての家族の体験・評価

山脇道晴, 森田達也, 清原恵美, 宮下光令, 清水恵, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　18回　347-347　2013/06
Publisher: (NPO)日本緩和医療学会
看護師による臨終前後の患者と家族の看取りのケアに関する実践と看取りのケアに対する困難感の関連要因の探索

菅野雄介, 安藤秀明, 舩水裕子, 岸野恵, 前原絵美理, 高橋徹, 清水恵, 佐藤一樹, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　18回　360-360　2013/06
Publisher: (NPO)日本緩和医療学会
看護師による臨終前後の患者と家族の看取りのケアの質を評価する尺度の信頼性と妥当性の検証

菅野雄介, 安藤秀明, 舩水裕子, 岸野恵, 前原絵美理, 高橋徹, 清水恵, 佐藤一樹, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　18回　360-360　2013/06
Publisher: (NPO)日本緩和医療学会
2010年の全死亡およびがん死亡の都道府県別自宅死亡割合と医療社会的指標の地域相関分析

宮下光令, 五十嵐美幸, 佐藤一樹, 清水恵, 菅野雄介, 菅野喜久子, 川原礼子

日本緩和医療学会学術大会プログラム・抄録集　18回　361-361　2013/06
Publisher: (NPO)日本緩和医療学会
がん患者の死亡場所に関連する要因死亡票の分析

五十嵐美幸, 宮下光令, 佐藤一樹, 清水恵, 川原礼子, 森田達也, 江口研二

日本緩和医療学会学術大会プログラム・抄録集　18回　362-362　2013/06
Publisher: (NPO)日本緩和医療学会
遺族によるケアの質の評価に関する研究J-HOPE2-study 日本ホスピス緩和ケア協会会員施設で亡くなった患者の遺族を対象とした全国的大規模質問紙調査

清水恵, 宮下光令, 恒藤暁, 志真泰夫, J-HOP, 運営委員会

日本緩和医療学会学術大会プログラム・抄録集　18回　363-363　2013/06
Publisher: (NPO)日本緩和医療学会
医療用麻薬の使用に対する遺族の体験に基づいた認識と意向

新城拓也, 森田達也, 平井啓, 宮下光令, 清水恵, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　18回　548-548　2013/06
Publisher: (NPO)日本緩和医療学会
悲嘆を経験する遺族の睡眠障害の実態調査

谷向仁, 足立浩祥, 平井啓, 松井智子, 宮下光令, 清水恵, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　18回　550-550　2013/06
Publisher: (NPO)日本緩和医療学会
進行がん患者の廃用症候群に対するリハビリテーションはQOLの維持に貢献している可能性がある:J‐REACT

緒方政美, 内山郁代, 閏間愛, 彦田由子, 宇田和晃, 宮越浩一, 関根龍一, 宮下光令, 森田達也

日本緩和医療学会学術大会プログラム・抄録集　18th　328-328　2013/06
Publisher: (NPO)日本緩和医療学会
客観的身体機能と主観的QOLはリハビリ介入前後でどのように相関するか:J‐REACT

閏間愛, 彦田由子, 宇田和晃, 宮越浩一, 関根龍一, 緒方政美, 内山郁代, 宮下光令, 森田達也

日本緩和医療学会学術大会プログラム・抄録集　18th　328-328　2013/06
Publisher: (NPO)日本緩和医療学会
緩和ケア病棟入院中に患者と家族が交わす思いと言葉に関する量的研究(J-HOPE2) 果たして思いは言葉にしないと伝わらないのか?

中里和弘, 塩崎麻里子, 平井啓, 森田達也, 多田羅竜平, 市原香織, 清水恵, 宮下光令, 恒藤暁, 志真泰夫, J-HOP, 研究運営委員会

日本緩和医療学会学術大会プログラム・抄録集　18回　333-333　2013/06
Publisher: (NPO)日本緩和医療学会
医学教育アウトカム評価としての診療録ピアレビューシステムの信頼性の検討

亀岡淳一, 宮下光令, 大久保智哉, 小熊絵美, 高橋文恵, 石井誠一, 金塚完

日本医療マネジメント学会雑誌　14　(Supplement)　303　2013/06/01

ISSN： 1881-2503
終末期がん患者が「明るさを失わずに過ごす」ための医療者の支援のあり方―緩和ケア病棟の医師・看護師を対象としたエキスパート・インタビュー調査

中野貴美子, 佐藤一樹, 片山はるみ, 宮下光令

緩和ケア　23　(3)　250-256　2013/05/15
Publisher: 青海社
ISSN： 1349-7138
地域における緩和ケア(在宅緩和ケア)緩和ケア普及のための地域プロジェクト(1)緩和ケア普及のための地域プロジェクトで使用した評価尺度

佐藤一樹, 宮下光令, 森田達也

保健の科学　55　(4)　230-235　2013/04/01
Publisher: 杏林書院
ISSN： 0018-3342
無作為化クロスオーバー試験による進行期がん患者の倦怠感に対するリフレクソロジーの有効性の検討

宮内貴子, 宮下光令, 山口拓洋

がん看護　18　(3)　395-400　2013/03/20
Publisher: 南江堂
ISSN： 1342-0569
緩和ケア専門従事者の臨床現場の「質」評価に関する考察~「緩和ケア病棟臨床指標開発に関するパイロット調査」に付帯して実施したヒアリングから~

伊藤惠子, 伊藤惠子, 宮下光令, 佐藤一樹, 林章敏, 東尚弘, 渡辺敏, 鈴木正寛, 關本翌子, 中村めぐみ

日本緩和医療学会学術大会プログラム・抄録集　18th　2013
がん性疼痛治療の施設成績を評価する指標の妥当性を検証する研究緩和ケアの質と除痛率の評価方法の開発

宮下光令

がん性疼痛治療の施設成績を評価する指標の妥当性を検証する研究平成24年度総括・分担研究報告書　101-103　2013
がん性疼痛治療の施設成績を評価する指標の妥当性を検証する研究緩和ケアの質と除痛率の評価方法の開発

宮下光令

がん性疼痛治療の施設成績を評価する指標の妥当性を検証する研究平成22-24年度総合研究報告書　191-195　2013
全国のがん患者のQuality of Life:平成23年度受療行動調査と一般市民の比較

宮下光令, 加藤雅志, 清水恵, 佐藤一樹, 藤澤大介, 森田達也

日本癌治療学会学術集会(CD-ROM)　51st　ROMBUNNO.O33-6　2013
被災地に展開可能ながん在宅緩和医療システムの構築に関する研究被災地域の緩和ケア連携体制の再構築と大規模災害下での緩和ケア関連情報の提供体制に関する研究

的場元弘, 伊藤達朗, 村上雅彦, 金野良則, 武田彩, 渡邊清高, 浦久保安輝子, 加賀谷肇, 吉本鉄介, 赤木徹, 宮下光令

被災地に展開可能ながん在宅緩和医療システムの構築に関する研究平成24年度総括・分担研究報告書　23-136　2013
「QOLの向上をめざしたがん治療法の開発研究」に関する研究がん患者のQOLの評価指標の開発

宮下光令, 御子柴直子, 酒井智子, 山花令子

「QOLの向上をめざしたがん治療法の開発研究」に関する研究平成24年度総括・分担研究報告書　33-35　2013
緩和医療に携わる医療従事者の育成に関する研究看護師の育成の評価に関する研究

宮下光令

緩和医療に携わる医療従事者の育成に関する研究平成24年度総括・分担研究年度終了報告書　33-34　2013
緩和ケアプログラムによる地域介入に関する研究評価測定に関する研究

宮下光令, 佐藤一樹, 五十嵐美幸

緩和ケアプログラムによる地域介入研究平成24年度総括研究報告書　36-38　2013
がん対策に資するがん患者の療養生活の質の評価方法の確立に関する研究

宮下光令

がん対策に資するがん患者の療養生活の質の評価方法の確立に関する研究平成24年度総括・分担研究報告書　3-17　2013
診断時から早期に緩和ケアを提供する体制整備に関する研究

宮下光令

診断時から早期に緩和ケアを提供する体制整備に関する研究平成25年度総括・分担研究報告書　15-18　2013
がん患者の利用できるシンボルマークの必要性と外出に対する意識調査

佐藤悠子, 秋山聖子, 伊藤祝栄, 古澤義人, 宮下光令, 中野弘枝, 小笠原喜美代, 小幡泉, 森隆弘, 石岡千加史

日本臨床腫瘍学会学術集会(CD-ROM)　11th　ROMBUNNO.P3-160　2013
がん対策に資するがん患者の療養生活の質の評価方法の確立に関する研究平成22~24年度

宮下光令

がん対策に資するがん患者の療養生活の質の評価方法の確立に関する研究平成22-24年度総合研究報告書　131P　2013
The effect of an intervention of a regional palliative care intervention program on home hospice utilization and hospital staff's perceptions about home care: an observation from the OPTIM-study

Shirahige Yutaka, Noda Takatoshi, Hojo Minoru, Goto Shinichi, Tomiyasu Shiro, Deguchi Masahiro, Okudaira Sadayuki, Yasunaka Masakazu, Hirayama Mika, Yoshihara Ritsuko, Funamoto Taeko, Igarashi Ayumi, Miyashita Mitsunori, Morita Tatsuya

Palliative Care Research　7　(2)　389-394　2012/12
Publisher: 日本緩和医療学会
DOI： 10.2512/jspm.7.389 　

ISSN： 1880-5302
いまさら聞けない臨床試験の読み方,活かし方 QOL評価―QOLはどう評価されているの?

宮下光令

月刊薬事　54　(13)　2159-2165　2012/12/01
Publisher: じほう
ISSN： 0016-5980
STAFF PERCEPTIONS OF END-OF-LIFE COMMUNICATION WITH FAMILY MEMBERS IN JAPANESE NURSING HOMES

H. Fukahori, N. Yamamoto-Mitani, T. Sugiyama, Y. Chiba, M. Miyashita, M. Ersek

GERONTOLOGIST　52　572-572　2012/11

ISSN： 0016-9013
がん患者のQOL評価尺度としてEORTC QLQ-C30とFACT-Gのいずれの使用が推奨されるか

佐藤一樹, 清水恵, 宮下光令

日本癌治療学会誌　47　(3)　1332-1332　2012/10
Publisher: (一社)日本癌治療学会
ISSN： 0021-4671
患者によるがん医療の質の構造・プロセス評価尺度Cancer Care Evaluation Scaleの開発

佐藤一樹, 森田達也, 清水恵, 宮下光令

日本癌治療学会誌　47　(3)　2672-2672　2012/10
Publisher: (一社)日本癌治療学会
ISSN： 0021-4671
急性期病棟におけるLCP導入後の看取りのケアの変化と課題

後藤佳子, 舩水裕子, 宮下光令, 菅野雄介

死の臨床　35　(2)　317　2012/09/28

ISSN： 0912-4292
看護師が経験した「困難なターミナルケア内容」と克服のプロセス―コミュニケーションに焦点を当てて

櫁柑富貴子, 宮下光令

死の臨床　35　(2)　249　2012/09/28

ISSN： 0912-4292
看取りのケアのクリニカルパスLiverpool Care Pathway日本語版在宅バージョン試作版のパイロット使用経験

松村優子, 八杉まゆみ, 菅野雄介, 宮下光令

死の臨床　35　(2)　318　2012/09/28

ISSN： 0912-4292
アウトカム評価としての診療録ピアレビューシステムの信頼性の検討

亀岡淳一, 宮下光令, 小熊絵美, 高橋文恵, 田中克典, 石井誠一, 金塚完

医学教育　43　(Suppl.)　76　2012/07/04

ISSN： 0386-9644
看取りのケアにおけるクリティカルパス LCP(看取りのパス;リバプール・ケア・パスウェイ)日本語版の使用方法と使用の実際

宮下光令

死の臨床　35　(1)　51　2012/06/20

ISSN： 0912-4292
緩和ケア病棟で提供される終末期がん医療の施設間差と施設背景の関連多施設診療記録調査 Peer-reviewed

佐藤一樹, 宮下光令, 森田達也, 嶋崎朱美, 鈴木里奈, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　17回　287-287　2012/06
Publisher: (NPO)日本緩和医療学会
緩和ケア病棟で提供される終末期がん医療の施設間差による緩和ケアの質評価への影響 Peer-reviewed

佐藤一樹, 宮下光令, 森田達也, 鈴木里奈, 嶋崎朱美, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　17回　287-287　2012/06
Publisher: (NPO)日本緩和医療学会
一般市民から抽出したがん患者の遺族による終末期医療の評価死亡場所別の検討

五十嵐美幸, 片倉梓, 佐藤一樹, 清水恵, 井上芙蓉子, 菅野雄介, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　17回　278-278　2012/06
Publisher: (NPO)日本緩和医療学会
終末期がん患者の家族介護者の医療者との説明・話し合いにおける選好一般市民を対象とした全国的質問紙調査

清水恵, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　17回　306-306　2012/06
Publisher: (NPO)日本緩和医療学会
一般市民から抽出したがん・脳卒中・心疾患の遺族による終末期医療の評価

宮下光令, 竹鼻靖子, 佐藤一樹, 清水恵, 井上芙蓉子, 菅野雄介, 五十嵐美幸

日本緩和医療学会学術大会プログラム・抄録集　17回　311-311　2012/06
Publisher: (NPO)日本緩和医療学会
地域緩和ケア介入研究<OPTIM study>が明らかにしたこと明日への示唆 OPTIM-studyがわが国の緩和ケアの研究方法論にもたらすもの

宮下光令, 五十嵐歩, 佐藤一樹, 花田芙蓉子, 五十嵐美幸, 山口拓洋

日本緩和医療学会学術大会プログラム・抄録集　17回　173-173　2012/06
Publisher: (NPO)日本緩和医療学会
PEACE研修会受講により医師の緩和ケアに対する知識は向上するか?

山本亮, 木澤義之, 佐藤哲観, 大出幸子, 中澤葉宇子, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　17回　328-328　2012/06
Publisher: (NPO)日本緩和医療学会
がん性疼痛治療の施設成績を評価する指標の妥当性を検証する研究緩和ケアの質と除痛率の評価方法の開発

宮下光令

がん性疼痛治療の施設成績を評価する指標の妥当性を検証する研究平成23年度総括・分担研究報告書　61-63　2012
受療行動調査を用いて全国のがん患者の療養生活の質(QOL)を測定するシステムの開発

宮下光令, 加藤雅志, 清水恵, 佐藤一樹, 藤澤大介, 森田達也

日本癌治療学会学術集会(CD-ROM)　50th　ROMBUNNO.OS40-1　2012
東北大学病院に勤務する看護師のがん看護に対する困難感および緩和ケアに関する実践と知識の実態と関連要因

熊田真紀子, 宮下光令, 大桐規子, 浅野玲子, 小笠原喜美代, 後藤あき子, 今野礼子, 柴田弘子, 庄子由美, 仙石美枝子, 山内かず子, 門間典子

日本がん看護学会誌　26　240　2012/01

ISSN： 0914-6423
がん看護に対する看護師の困難感尺度の作成

熊田真紀子, 宮下光令, 大桐規子, 浅野玲子, 小笠原喜美代, 後藤あき子, 今野礼子, 柴田弘子, 庄子由美, 仙石美枝子, 山内かず子, 門間典子

日本がん看護学会誌　26　240　2012/01

ISSN： 0914-6423
A Nationwide Survey of the Palliative Care and Difficulty with Pharmacist's Duties Provided by Pharmacists Designated in Regional Cancer Centers in Japan

杉浦宗敏, 宮下光令, 佐藤一樹, 森田達也, 佐野元彦, 的場元弘, 恒藤暁, 志真泰夫

日本緩和医療薬学雑誌　4　(4)　103-109　2011/12
Publisher: (一社)日本緩和医療薬学会
ISSN： 1882-9783
日本版複雑性悲嘆スクリーニング尺度の信頼性と妥当性:一般成人を対象とした検討

伊藤正哉, 中島聡美, 藤澤大介, 宮下光令, 金吉晴

国立精神・神経医療研究センター精神保健研究所年報　(24)　233-233　2011/08/31
Publisher: (国研)国立精神・神経医療研究センター精神保健研究所
看取りのケアにおけるクリティカルパス LCP(看取りのパス;リバプール・ケア・パスウエイ)日本語版の使用方法と使用の実際

宮下光令

死の臨床　34　(2)　206　2011/08/30

ISSN： 0912-4292
東北大学保健学科の授業改善への取り組み―学生による授業評価とFaculty Developmentの実施を中心として―

亀岡淳一, 塩飽仁, 町田好男, 三浦昌人, 高橋香子, 仲田栄子, 石井恵子, 宮下光令, 石井誠一, 金塚完, 吉沢豊子

東北大学医学部保健学科紀要　20　(2)　69-80　2011/07/31
Publisher: 東北大学医学部保健学科
ISSN： 1348-8899
がん医療における家族ケア終末期がん患者の家族のメンタルヘルス

清水恵, 宮下光令

月刊腫瘍内科　8　(1)　24-32　2011/07/28
Publisher: 科学評論社
ISSN： 1881-6568
緩和ケア病棟の遺族の「医療用麻薬」「緩和ケア」「緩和ケア病棟」に対する認識の関連要因 J-HOPE study Peer-reviewed

宮下光令, 森田達也, 佐藤一樹, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　16回　258-258　2011/06
Publisher: (NPO)日本緩和医療学会
J-HOPE studyにおける遺族による緩和ケアの質評価とそれに関連する施設要因 Peer-reviewed

宮下光令, 佐藤一樹, 森田達也, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　16回　274-274　2011/06
Publisher: (NPO)日本緩和医療学会
緩和ケア病棟で提供された終末期鎮静の関連要因と遺族による緩和ケアの質評価への影響 Peer-reviewed

佐藤一樹, 宮下光令, 森田達也, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　16回　284-284　2011/06
Publisher: (NPO)日本緩和医療学会
緩和ケア病棟の遺族による質の評価は、死亡後の経過期間の影響を受けるか? J-HOPE study Peer-reviewed

宮下光令, 佐藤一樹, 森田達也, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　16回　435-435　2011/06
Publisher: (NPO)日本緩和医療学会
緩和ケア病棟における医療者-家族間の説明/話し合いのあり方

清水恵, 宮下光令, 白井由紀, 吉田沙蘭, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　16回　258-258　2011/06
Publisher: (NPO)日本緩和医療学会
一般外来通院中、外来化学療法室通院中、入院中の患者に対する緩和ケアの質の評価

宮下光令, 清水恵, 安藤秀明

日本緩和医療学会学術大会プログラム・抄録集　16回　444-444　2011/06
Publisher: (NPO)日本緩和医療学会
「緩和ケアプログラムによる地域介入研究」評価測定に関する研究

宮下光令, 佐藤一樹, 花田芙蓉子

緩和ケアプログラムによる地域介入研究平成22年度総括研究報告書　32-35　2011
成人がん患者と小児がん患者の家族に対する望ましい心理社会的支援のあり方に関する研究がん患者の家族のQOLの概念化に関する研究

宮下光令, 三條真紀子

成人がん患者と小児がん患者の家族に対する望ましい心理社会的支援のあり方に関する研究平成22年度総括・分担研究報告書　30-32　2011
成人がん患者と小児がん患者の家族に対する望ましい心理社会的支援のあり方に関する研究がん患者の家族のQOLの概念化に関する研究

宮下光令, 三條真紀子

成人がん患者と小児がん患者の家族に対する望ましい心理社会的支援のあり方に関する研究平成20-22年度総合研究報告書　39-44　2011
がん性疼痛治療の施設成績を評価する指標の妥当性を検証する研究緩和ケアの質と除痛率の評価方法の開発

宮下光令

がん性疼痛治療の施設成績を評価する指標の妥当性を検証する研究平成22年度総括・分担研究報告書　15-16　2011
緩和医療に携わる医療従事者の育成に関する研究看護師の育成の評価に関する研究

宮下光令

緩和医療に携わる医療従事者の育成に関する研究平成22年度総括・分担研究報告書　68-69　2011
がん患者の療養生活の質の評価方法の確立に関する研究

宮下光令

がん対策に資するがん患者の療養生活の質の評価方法の確立に関する研究平成22年度総括・分担研究報告書　1-8　2011
QOLの向上をめざしたがん治療法の開発研究がん患者のQOLの評価指標の開発

宮下光令, 御子柴直子, 酒井智子, 山花令子

QOLの向上をめざしたがん治療法の開発研究に関する研究平成22年度総括・分担研究報告書　31-32　2011
Liverpool Care Pathway日本語版による看取りのケアの目標達成状況:緩和ケア病棟2施設におけるパイロットスタディからの検討

市原香織, 宮下光令, 田村恵子, 葉山有香, 大石ふみ子

日本がん看護学会誌　25　292　2011/01

ISSN： 0914-6423
大学病院でがん診療を行う医師,看護師の余命告知の方法に関する認識

宮下光令, 三條真紀子

日本がん看護学会誌　25　280　2011/01

ISSN： 0914-6423
在宅緩和ケアで終末期がん患者に提供された医療:診療記録調査

佐藤一樹, 宮下光令, 志真泰夫

日本がん看護学会誌　25　295　2011/01

ISSN： 0914-6423
緩和ケアの質の評価

宮下光令

東北医学雑誌　122　(2)　167-169　2010/12/25

ISSN： 0040-8700
特集にあたって (特集再考看取りのケア--リバプール・ケア・パスウェイを用いた看取りのケアの質向上)

宮下光令

臨床看護　36　(14)　1812-1814　2010/12
Publisher: へるす出版
ISSN： 0386-7722
緩和ケア病棟で死亡したがん患者の遺族の「緩和ケア」に対するイメージ:J‐HOPE Study

宮下光令, 恒藤暁, 志真泰夫

死の臨床　33　(2)　261-261　2010/10
Publisher: 日本死の臨床研究会
ISSN： 0912-4292
看取りのクリニカルパス:Liverpool Care Pathway(LCP)日本語版の開発経過とパイロット試用の結果

茅根義和, 宮下光令, 市原香織, 中島信久

死の臨床　33　(2)　272　2010/10/01

ISSN： 0912-4292
放射線科外来がん患者の「望ましい死」に関する認識の変化:1年半のコホート追跡研究

宮下光令, 川上祥子, 中野貴美子, 加藤大基, 中川恵一

日本癌治療学会誌　45　(2)　858　2010/09/21

ISSN： 0021-4671
緩和ケアの質の評価

宮下光令, 佐藤一樹, 清水恵

東北大学医学部保健学科紀要　19　(2)　63-71　2010/07/31
Publisher: 東北大学医学部保健学科
ISSN： 1348-8899
「希望をもちながらも、同時にこころ残りのないように準備しておく」ために医師や看護師は何ができるのか J-HOPE study Peer-reviewed

白土明美, 森田達也, 宮下光令, 赤澤輝和, 佐藤一樹, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　15回　164-164　2010/06
Publisher: (NPO)日本緩和医療学会
遺族から見た死前喘鳴に対する望ましいケア J-HOPE STUDY Peer-reviewed

清水陽一, 宮下光令, 森田達也, 佐藤一樹, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　15回　164-164　2010/06
Publisher: (NPO)日本緩和医療学会
緩和ケア病棟で提供された終末期がん医療の実態に関する多施設診療記録調査 J-HOPE study Peer-reviewed

佐藤一樹, 宮下光令, 森田達也, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　15回　164-164　2010/06
Publisher: (NPO)日本緩和医療学会
家族の視点からみた望ましい緩和ケアシステム J-HOPE Study Peer-reviewed

三條真紀子, 森田達也, 宮下光令, 佐藤一樹, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　15回　164-164　2010/06
Publisher: (NPO)日本緩和医療学会
終末期のがん患者を介護した遺族の介護経験の評価および健康関連QOL 7994名の全国調査 J-HOPE Study Peer-reviewed

三條真紀子, 宮下光令, 森田達也, 佐藤一樹, 上別府圭子, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　15回　164-164　2010/06
Publisher: (NPO)日本緩和医療学会
がん患者に対する緩和ケアの構造・プロセスを評価する尺度(患者版Care Evaluation Scale)の信頼性と妥当性の検討 Peer-reviewed

宮下光令, 和田信, 森田達也, 的場元弘, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　15回　165-165　2010/06
Publisher: (NPO)日本緩和医療学会
がん患者に対する包括的QOLを測定する尺度の信頼性と妥当性の検討 Peer-reviewed

宮下光令, 和田信, 森田達也, 的場元弘, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　15回　165-165　2010/06
Publisher: (NPO)日本緩和医療学会
在宅ホスピスケアを受けたがん患者の遺族の在宅療養開始時の意思決定過程 J-HOPE Study Peer-reviewed

宮下光令, 平井啓, Choi Ji Eun, 森田達也, 佐藤一樹, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　15回　188-188　2010/06
Publisher: (NPO)日本緩和医療学会
「終末期がん患者の家族が大事にしたいと思うこと」の構成要素家族と遺族を対象とした面接調査の結果から Peer-reviewed

三條真紀子, 宮下光令, 森田達也, 栗原幸江, 出野美那子, 恒藤暁, 志真泰夫, 平井啓

日本緩和医療学会学術大会プログラム・抄録集　15回　215-215　2010/06
Publisher: (NPO)日本緩和医療学会
緩和ケア病棟の遺族は追悼会や死別後の手紙をどうとらえているか? 44名のインタビュー調査 Peer-reviewed

牟田理恵子, 三條真紀子, 宮下光令, 若林理恵子, 安藤悦子, 森田達也, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　15回　215-215　2010/06
Publisher: (NPO)日本緩和医療学会
ホスピス・緩和ケア病棟への入院検討時の家族のつらさと望ましい支援に関する質的研究遺族への面接調査の結果から

三條真紀子, 塩崎麻里子, 吉田沙蘭, 森田達也, 宮下光令, 上別府圭子, 恒藤暁, 志真泰夫, 平井啓

日本緩和医療学会学術大会プログラム・抄録集　15回　215-215　2010/06
Publisher: (NPO)日本緩和医療学会
看護師に対するEnd-of-Lifeケアの教育に関する指導者講習会の評価尺度の開発とELNEC-J指導者養成プログラムの評価

竹之内沙弥香, 宮下光令, 木澤義之, 田村恵子

日本緩和医療学会学術大会プログラム・抄録集　15回　225-225　2010/06
Publisher: (NPO)日本緩和医療学会
地域の病院(一般病棟、緩和ケア病棟)、診療所のがん患者の遺族による緩和ケアの質の評価 OPTIM-study

宮下光令, 森田達也, 佐藤一樹, 五十嵐歩, 秋山美紀, 秋月伸哉, 白髭豊, 江口研二

日本緩和医療学会学術大会プログラム・抄録集　15回　157-157　2010/06
Publisher: (NPO)日本緩和医療学会
終末期がん患者における死亡場所と死亡前の療養場所の特徴 OPTIM-study

五十嵐歩, 森田達也, 宮下光令, 佐藤一樹, 秋山美紀, 秋月伸哉, 白髭豊, 江口研二, OPTIM study group

日本緩和医療学会学術大会プログラム・抄録集　15回　175-175　2010/06
Publisher: (NPO)日本緩和医療学会
地域の医療機関に勤務し、がん患者をケアする看護師の緩和ケアに関する知識、実践、困難感の実態とその関連要因 OPTIM-study

佐藤一樹, 宮下光令, 五十嵐歩, 梅田恵, 石ヶ森一枝, 木澤義之, 秋山美紀, 秋月伸哉, 森田達也, 白髭豊, 江口研二

日本緩和医療学会学術大会プログラム・抄録集　15回　226-226　2010/06
Publisher: (NPO)日本緩和医療学会
「緩和ケアの質の臨床指標(Quality Indicator)」は遺族から見て妥当なのか? 緩和ケア病棟の遺族に対する質問紙調査から

宮下光令, 森田達也, 井上聡, 市川尭之, 佐藤一樹, 志真泰夫, 内富庸介

日本緩和医療学会学術大会プログラム・抄録集　15回　166-166　2010/06
Publisher: (NPO)日本緩和医療学会
「看護キャリアプロモート支援システム開発」におけるニーズ調査報告第1報-看護職のキャリアに関する認識について-

早川ひと美, 門間典子, 佐々木百合花, 平野かよ子, 宮下光令, 朝倉京子, 岡村由紀子, 吉沢豊予子, 菅原美知子

日本看護管理学会年次大会講演抄録集　14th　2010
がん患者のQOLを向上させることを目的とした支持療法のあり方に関する研究

宮下光令

がん患者のQOLを向上させることを目的とした支持療法のあり方に関する研究平成21年度総括・分担研究報告書　1-12　2010
成人がん患者と小児がん患者の家族に対する望ましい心理社会的支援のあり方に関する研究がん患者の家族のQOLの概念化に関する研究

宮下光令, 三條真紀子

成人がん患者と小児がん患者の家族に対する望ましい心理社会的支援のあり方に関する研究平成21年度総括・分担研究報告書　40-45　2010
がん患者のQOLを向上させることを目的とした支持療法のあり方に関する研究

宮下光令

がん患者のQOLを向上させることを目的とした支持療法のあり方に関する研究平成19-21年度総合研究報告書　1-26　2010
緩和ケアプログラムによる地域介入研究評価測定に関する研究

宮下光令, 佐藤一樹

緩和ケアプログラムによる地域介入研究平成21年度総括研究報告書　81-84　2010
遺族・在宅医療従事者からみた,終末期に在宅療養するがん患者の家族介護者が抱える困難に関する質的研究

石井容子, 宮下光令, 小澤竹俊, 佐藤一樹

日本がん看護学会誌　24　139　2010/01

ISSN： 0914-6423
緩和ケア認定看護師の職務満足度とバーンアウト度に関連する職場環境要因

舩水裕子, 大島佐和子, 伊藤美智子, 宮下光令, 安藤秀明

日本がん看護学会誌　24　(Suppl.)　126-126　2010/01
Publisher: (一社)日本がん看護学会
ISSN： 0914-6423

eISSN： 2189-7565
緩和ケア病棟で死亡したがん患者の遺族の,緩和ケア病棟に対するイメージの入棟前後の変化:J‐HOPE Study

宮下光令, 佐藤一樹, 志真泰夫

日本がん看護学会誌　24　218　2010/01

ISSN： 0914-6423
がん対策基本法を受けて変わりつつあること―今後の緩和ケアを見つめて―がん診療連携拠点病院における緩和ケアの提供体制の調査と緩和ケアの質の評価に関する研究について

宮下光令

緩和医療学　11　(4)　356-366　2009/10/01
Publisher: 先端医学社
ISSN： 1345-5575
全国のがん診療連携拠点病院の緩和ケア機能の充足度

宮下光令, 梅田恵, 許山美和

死の臨床　32　(2)　248　2009/09/30

ISSN： 0912-4292
がん患者,一般市民,医師,看護師の「望ましい死」のあり方に関する認識

宮下光令, 加藤大基, 川上祥子, 中野貴美子, 中川恵一

日本癌治療学会誌　44　(2)　415-415　2009/09/14

ISSN： 0021-4671
がん患者,一般市民,がん医療に携わる医師・看護師の「死生観」に関する認識

加藤大基, 宮下光令, 川上祥子, 中野貴美子, 中川恵一

日本癌治療学会誌　44　(2)　847　2009/09/14

ISSN： 0021-4671
緩和ケア病棟のがん患者の遺族の医療用麻薬に対する認識:J‐HOPE study

中野貴美子, 宮下光令, 恒藤暁, 志真泰夫

死の臨床　32　(2)　237-237　2009/09
Publisher: 日本死の臨床研究会
ISSN： 0912-4292
緩和ケア病棟で家族を亡くした遺族の死別後の支え―遺族への面接調査から―

牟田理恵子, 宮下光令, 若林理恵子, 安藤悦子, 恒藤暁

死の臨床　32　(2)　272-272　2009/09
Publisher: 日本死の臨床研究会
ISSN： 0912-4292
外科医が知っておくべき症状緩和のエッセンス症状緩和治療における病診連携と在宅医療

宮下光令

外科治療　101　(2)　159-169　2009/08/01
Publisher: 永井書店
ISSN： 0433-2644
外来通院中の神経筋疾患患者における疼痛の有無と健康関連QOLに関する検討

阿部吉樹, 伊藤直美, 宮下光令, 数間恵子

日本慢性看護学会誌　3　(1)　A61　2009/05/25

ISSN： 1882-2061
一般市民が希望する終末期の療養場所とその関連要因の検討

村田玄, 宮下光令, 数間恵子

日本慢性看護学会誌　3　(1)　A78　2009/05/25

ISSN： 1882-2061
がん患者のQOLを向上させることを目的とした支持治療のあり方に関する研究

宮下光令

がん患者のQOLを向上させることを目的とした支持療法のあり方に関する研究平成20年度総括・分担研究報告書　1-13　2009
がん対策における管理評価指標群の策定とその計測システムの確立に関する研究緩和ケアにおける管理評価指標群の策定とそれに基づく計測に関する研究

宮下光令

がん対策における管理評価指標群の策定とその計測システムの確立に関する研究平成20年度総括・分担研究報告書　56-59　2009
成人がん患者と小児がん患者の家族に対する望ましい心理社会的支援のあり方に関する研究がん患者の家族のQOLの概念化に関する研究

宮下光令, 三條真紀子

成人がん患者と小児がん患者の家族に対する望ましい心理社会的支援のあり方に関する研究平成20年度総括・分担研究報告書　53-61　2009
緩和ケアプログラムによる地域介入研究評価測定に関する研究

宮下光令, 五十嵐歩

緩和ケアプログラムによる地域介入研究平成20年度総括研究報告書　30-34　2009
緩和ケア認定看護師の職務継続のために必要なフォローアップに関する調査

舩水裕子, 大島佐和子, 伊藤美智子, 宮下光令, 梅内美保子, 安藤秀明

日本がん看護学会誌　23　(Suppl.)　135-135　2009/01
Publisher: (一社)日本がん看護学会
ISSN： 0914-6423

eISSN： 2189-7565
全国緩和ケア認定看護師の活動の実態と希望するフォローアップに関する調査~第1報~

大島佐和子, 舩水裕子, 伊藤美智子, 宮下光令, 梅内美保子, 安藤秀明

日本がん看護学会誌　23　(Suppl.)　299-299　2009/01
Publisher: (一社)日本がん看護学会
ISSN： 0914-6423

eISSN： 2189-7565
がん終末期における療養場所の選択肢と在宅療養の実現可能性:J‐Hope Study

佐藤一樹, 宮下光令, 志真泰夫

日本がん看護学会誌　23　128　2009/01

ISSN： 0914-6423
遺族からみた望ましい死の達成の評価の関連要因

宮下光令, 佐藤一樹, 志真泰夫

日本がん看護学会誌　23　222　2009/01

ISSN： 0914-6423
緩和ケアに対する看護師の知識・態度・困難度に関連する要因

中澤葉宇子, 宮下光令, 梅田恵, 大谷木靖子, 小笠原利枝

日本がん看護学会誌　23　124　2009/01

ISSN： 0914-6423
緩和ケア・コンサルテーション―悩み多きコンサルテーションとその対応緩和ケア・コンサルテーションの現状と課題

宮下光令, 志真泰夫, 橋爪隆弘

緩和ケア　18　(6)　494-500　2008/11/15
Publisher: 青海社
ISSN： 1349-7138
均てん化へ向けたがん診療拠点病院における診療の質の客観的評価指標(Ql)の作成と評価

東尚弘, 向井博文, 宮下光令, 森田達也, 國土典宏, 長谷川潔, 杉原健一, 石黒めぐみ, 島田安博, 淺村尚生, 祖父江友孝

日本癌治療学会誌　43　(2)　892-892　2008/10/01
Publisher: (一社)日本癌治療学会
ISSN： 0021-4671
STAS‐Jの使用経験とこれからの課題2008

宮下光令, 中島信久

死の臨床　31　(2)　182　2008/09/02

ISSN： 0912-4292
地域における緩和ケアの質指標の同定

宮下光令, 大坂巌, 栗原幸江, 小原弘之, 山本亮, 梅田恵

死の臨床　31　(2)　288　2008/09/02

ISSN： 0912-4292
がん診療連携拠点病院の緩和ケアにおける役割と課題緩和ケアの提供体制に関する全国調査から

宮下光令

看護管理　18　(7)　553-559　2008/07/10
Publisher: 医学書院
DOI： 10.11477/mf.1686101240 　

ISSN： 0917-1355
がんの緩和医療日本人にとっての望ましい死

宮下光令

Pharma Med　26　(7)　29-33　2008/07/10

ISSN： 0289-5803
緩和ケア臨床・研究・教育ホームページプロジェクト (特集緩和ケア--これからの10年をみつめる) -- (研究プロジェクト)

宮下光令, 草島悦子

緩和医療学　10　(3)　271-274　2008/07
Publisher: 先端医学社
ISSN： 1345-5575
緩和ケア―これからの10年をみつめる研究プロジェクト 4)緩和ケアの質評価・実態調査

宮下光令

緩和医療学　10　(3)　235-240　2008/07/01

ISSN： 1345-5575
がん診療連携拠点病院緩和ケア提供機能に関する薬剤業務の実態調査(1)

杉浦宗敏, 宮下光令, 佐藤一樹, 森田達也, 恒藤暁, 的場元弘, 佐野元彦, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　13th　2008
がん診療連携拠点病院の緩和ケア提供機能に関する薬剤業務の実態調査(2)

佐野元彦, 宮下光令, 佐藤一樹, 森田達也, 恒藤暁, 的場元弘, 杉浦宗敏, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　13th　2008
がん患者のQOLを向上させることを目的とした支持治療のあり方に関する研究

宮下光令

がん患者のQOLを向上させることを目的とした支持治療のあり方に関する研究平成19年度総括・分担研究報告書　3-11　2008
がん対策における管理評価指標群の策定とその計測システムの確立に関する研究緩和ケアにおける管理評価指標群の策定

宮下光令

がん対策における管理評価指標群の策定とその計測システムの確立に関する研究平成19年度総括・分担研究報告書　17-19　2008
在宅ケア・デイホスピスを利用するがん患者および主介護者の生活の質とデイホスピスのニーズ,デイホスピスに対する満足度

宮下光令, 三澤知代, 河正子, 中山康子, 阿部まゆみ

日本がん看護学会誌　22　188　2008/01

ISSN： 0914-6423
看護学生の終末期看護演習・実習の変化と影響要因について―終末期患者に関わる態度の側面から―

茶園美香, 岩瀬恵美, 廣岡佳代, 三條真紀子, 宮下光令, 新幡智子, 久保美紀

日本がん看護学会誌　22　137　2008/01

ISSN： 0914-6423
終末期の療養場所移行の経験と医療者への家族支援ニーズ一般病棟での療養を選択した終末期がん患者の遺族への質的調査を通じて

三條真紀子, 宮下光令, 数間恵子

日本がん看護学会誌　22　129　2008/01

ISSN： 0914-6423
2004年の都道府県別在宅死亡割合と医療・社会的指標の関連

宮下光令, 白井由紀, 三條真紀子, 羽佐田知美, 佐藤一樹, 三澤知代

厚生の指標　54　(11)　44-49　2007/10/15

ISSN： 0452-6104
STAS‐Jの使用経験とこれからの課題2007

宮下光令

死の臨床　30　(2)　156　2007/10/15

ISSN： 0912-4292
STAS‐Jの使用経験とこれからの課題―STAS‐J導入の成功と継続使用のために―

宮下光令

死の臨床　30　(1)　042-044　2007/09/25

ISSN： 0912-4292
成人先天性心疾患患者がキャリーオーバーを経て疾患に対する認識を変化させていくプロセスに関する質的研究

落合亮太, 日下部智子, 宮下光令, 萱間真美, 数間恵子

J Cardiol　50　(Supplement 1)　508　2007/08/10

ISSN： 0914-5087
在宅緩和ケアを支える訪問看護ステーションの条件平成18年度厚生労働省老人保健健康増進等事業「訪問看護ステーションの業務基準に関する検討」がん緩和ケア小委員会報告書がん緩和ケア基準の作成とその経緯

福井小紀子, 宮下光令, 清水準一, 山岸暁美, 高沢洋子, 伊藤美緒子

コミュニティケア　9　(9)　24-33　2007/08/01
Publisher: 日本看護協会出版会
経口摂取ができなくなった時のケア―「点滴」と「点滴」以外にできること「点滴」以外にできること「口が渇いて仕方がない」という患者さんに出会ったら

宮下光令

緩和ケア　17　(3)　208-210　2007/05/15
Publisher: 青海社
ISSN： 1349-7138
STAS-J症状版の作成と評価者間信頼性の検討

宮下光令, 安田恵美, 馬場玲子, 岩瀬哲, 寺本量子, 中川恵一, 木澤義之, 志真泰夫

日本緩和医療学会総会プログラム・講演抄録集　12th　2007

ISSN： 1348-0871
特定疾患患者の生活の質(Quality of Life,QOL)の向上に関する研究 SEIQoL‐DWの妥当性検証に向けて現状と今後家族介護者のQOL調査を例に

大生定義, 秋山美紀, 宮下光令, 落合亮太, 小市理恵子, 福原俊一, 中島孝

特定疾患患者の生活の質(Quality of Life,QOL)の向上に関する研究平成18年度総括・分担研究報告書　94-96　2007
病院看護の予防機能発揮による効果的・効率的医療の提供に関する研究 C.退院支援大学病院で活動する緩和ケアチームの支援内容―参与観察を用いた質的分析―

笹原朋代, 三條真紀子, 梅田恵, 篠田淳子, 宮下光令, 河正子, 樋口比登実

病院看護の予防機能発揮による効果的・効率的医療の提供に関する研究平成16-18年度 No.16209064　239-250　2007
がん対策における管理評価指標群の策定とその計測システムの確立に関する研究緩和ケアにおける管理評価指標群の策定と計測システムの検討

宮下光令

がん対策における管理評価指標群の策定とその計測システムの確立に関する研究平成18年度総括・分担研究報告書　39-42　2007
「終末期ケアに関わる態度尺度」および「死のイメージ尺度」の開発

茶園美香, 岩瀬恵美, 廣岡佳代, 三條真紀子, 宮下光令

日本がん看護学会誌　21　150　2007/01

ISSN： 0914-6423
わが国の緩和ケア病棟の認知とイメージ―一般集団・緩和ケア遺族を対象とした全国調査―

三條真紀子, 宮下光令

死の臨床　29　(2)　206　2006/10/31

ISSN： 0912-4292
白血病/悪性リンパ腫患者への終末期ケアに対する遺族評価

白井由紀, 宮下光令, 河正子, 数間恵子, 佐野文明

死の臨床　29　(2)　212　2006/10/31

ISSN： 0912-4292
STAS‐Jの使用経験とこれからの課題

宮下光令

死の臨床　29　(2)　160　2006/10/31

ISSN： 0912-4292
ホスピス・緩和ケア病棟への紹介・入棟のバリア

宮下光令, 三條真紀子

死の臨床　29　(2)　205　2006/10/31

ISSN： 0912-4292
Preparing a version of the Nottingham Adjustment Scale (for psychological adjustment) tailored to osteoarthritis of the hip

80　(9)　574-575　2006/09/25

ISSN： 0021-5325
がん終末期の輸液管理に関して看護師が考えるべきこと―看護師の果たす役割―

宮下光令, 河正子

看護技術　52　(6)　527-529　2006/05/20
Publisher: メヂカルフレンド社
ISSN： 0449-752X
緩和ケアチームの現状と課題緩和ケアチームのオーディット

宮下光令, 笹原朋代

緩和医療学　8　(2)　111-118　2006/04/01

ISSN： 1345-5575
心理的適応を測定する尺度NAS-J変形性股関節症版の作成

小山友里江, 宮下光令, 鈴鴨よしみ, 数間恵子

日本看護科学学会学術集会講演集　26th　2006
質の高い緩和ケアを日本全国に普及させるために取り組むべき課題-日本緩和医療学会,日本ホスピス緩和ケア協会会員を対象とした調査-

宮下光令, 三條真紀子, 森田達也, 木澤義之, 志真泰夫, 下山直人, 恒藤暁, 平賀一陽, 平井啓, 佐藤一樹, 内富庸介

日本緩和医療学会総会プログラム・講演抄録集　11th　2006

ISSN： 1348-0871
緩和ケアの質マネジメントとその評価を考える STAS‐Jを用いた緩和ケアの自己評価

宮下光令, 笹原朋代

看護管理　15　(12)　993-998　2005/12/10

DOI： 10.11477/mf.1686100273 　

ISSN： 0917-1355
The outcome research of specified diseases: QOL, nursing burden, and economic evaluation group. Examination of the general-purpose nursing burden scale items on the basis of the qualitative research.

萱間真美, 秋山(大西)美紀, 宮下光令, 落合亮太, 山口桜, 山口亜紀, 宮本有紀, 大田章子, 大生定義, 三浦靖彦, 鈴鴨よしみ, 福原俊一

特定疾患のアウトカム研究:QOL、介護負担、経済評価班平成16年度総括・分担研究報告書　14-20　2005
The outcome research of specified diseases: QOL, nursing burden, and economic evaluation group. &lt;Nursing burden sensation&gt;. The situation of the family nursing for intractable neurological diseases, and the factors concerned in the nursing b

山口亜紀, 宮下光令, 成田有吾, 川田憲一, 萱間真美, 宮本有紀

特定疾患のアウトカム研究:QOL、介護負担、経済評価班平成16年度総括・分担研究報告書　95-105　2005
The report of the longitudinal survey of subjective quality of life by SF-36 in Mie prefecture of Japan.

成田有吾, 川田憲一, 葛原茂樹, 中井三智子, 山口亜紀, 宮下光令, 萱間真美, 藤田典子, 宮川一夫

特定疾患の地域支援体制の構築に関する研究班 2004年度研究報告書　139-142　2005
The outcome research of specified diseases: QOL, nursing burden, and economic evaluation group. &lt;Nursing burden sensation&gt;. Examination of the reliability and validity of the general-purpose nursing burden sensation scale.

宮下光令, 山口亜紀, 成田有吾, 川田憲一, 秋山美紀, 大田章子, 萱間真美, 鈴鴨よしみ, 福原俊一

特定疾患のアウトカム研究:QOL、介護負担、経済評価班平成16年度総括・分担研究報告書　92-94　2005
一般病棟の看護師のターミナルケア態度とその関連要因―Frommeltのターミナルケア態度尺度日本語版作成―

中井裕子, 宮下光令, 河正子

死の臨床　27　(2)　272　2004/11/10

ISSN： 0912-4292
ミスを経験した看護職者の行動変容とその要因再発を防ぎ,看護行為の安全性を向上させる対応を求めて

鈴木琴江, 宮下光令, 数間恵子

看護管理　14　(5)　401-406　2004/05/10
Publisher: 医学書院
DOI： 10.11477/mf.1686100731 　

ISSN： 0917-1355
緩和医療における輸液終末期がん患者の輸液に関する看護師の役割

宮下光令

緩和医療学　6　(2)　152-158　2004/04/01

ISSN： 1345-5575
Outcome research of intractable diseases. Commonalities and differences in patient care: part 1. Families of patients with ALS, Parkinson's disease, cerebrovascular disease, and of those receiving dialysis.

萱間真美, 宮下光令, 秋山(大西)美紀, 山口亜紀, 大生定義, 三浦靖彦, 成田有吾, 鈴鴨よしみ, 福原俊一

特定疾患のアウトカム研究:QOL、介護負担、経済評価班平成15年度総括・分担研究報告書　20-23　2004
Outcome research of intractable diseases. Reliability and validity of scale for caregiver's distress.

宮下光令, 萱間真美, 成田有吾, 川田憲一, 大西美紀, 山口亜紀, 大田章子, 鈴鴨よしみ, 福原俊一

特定疾患のアウトカム研究:QOL、介護負担、経済評価班平成15年度総括・分担研究報告書　87-89　2004
Outcome research of intractable diseases. Long-term transition of distress among caregivers.

宮下光令, 山口亜紀, 成田有吾, 川田憲一, 萱間真美

特定疾患のアウトカム研究:QOL、介護負担、経済評価班平成15年度総括・分担研究報告書　81-86　2004
糖尿病用食事関連QOL尺度の開発

佐藤栄子, 鈴鴨よしみ, 宮下光令, 数間恵子

日本糖尿病教育・看護学会誌　7　98-98　2003/08/20

ISSN： 1342-8497
緩和ケアの質をめぐって自己評価の実際クリニカル・オーディットとSTAS

宮下光令, 笹原朋代, 河正子, 志真泰夫

ターミナルケア　13　(2)　109-114　2003/03/15
Publisher: 三輪書店
ISSN： 0917-0359
Examination of the Zarit nursing burden feeling scale from the data of nuerologic intractable disease patients in Mie Prefecture.

宮下光令, 山口亜紀, 成田有吾, 大生定義, 萱間真美

特定疾患のアウトカム研究:QOL、介護負担、経済評価班平成14年度総括・分担研究報告書　77-87　2003
Qualitative research on the nursing burden feeling of Parkinson's disease and cerebral infarction.

宮下光令, 落合亮太, 阿部吉樹, 大田章子, 大生定義, 萱間真美

特定疾患のアウトカム研究:QOL、介護負担、経済評価班平成14年度総括・分担研究報告書　73-76　2003
An examination of the Zarit nursing burden sensation scale according to intractable neurological diseases patient data of Mie Prefecture.

宮下光令, 山口亜紀, 成田有吾, 大生定義, 萱間真美

三重県神経難病在宅ケアネットワーク推進に関わる患者QOLと介護負担度の研究研究報告書平成15年　16-31　2003
外来における看護の相談機能拡充・確立のための基礎的研究第1回外来における看護の相談・指導の実態

数間恵子, 小池智子, 高橋雪子, 原雅子, 長井浜江, 向井恵子, 宮下光令, 田中ゆき, 小林康司

看護　54　(15)　100-105　2002/12/01
Publisher: 日本看護協会出版会
ISSN： 0022-8362
院内の針刺し事故防止における意識の実態調査

新井田丸美, 柳田真純, 東野菜緒子, 都竹純子, 坂口美季, 立入ヒロミ, 宮下光令

Infect Control　11　(8)　918-922　2002/08/01
Publisher: メディカ出版
ISSN： 0919-1011
座談会日本の看護研究とEvidence-Based Nursing--臨床医学との比較でエビデンス,アウトカム評価,研究デザイン,インフラ整備について語る (特集 Evidence-Based Nursing誌とわが国の看護研究:研究デザインと生物統計学的側面から)

大橋靖雄, 数間恵子, 宮下光令

Quality nursing　7　(10)　828-837　2001/10
Publisher: 文光堂
ISSN： 1340-9875
心臓血管外科患者のじょく創発生要因

山口真美子, 熊谷恵, 小林純子, 小西香子, 小宮山一枝, 小松崎知子, 宮下光令

日本看護学会論文集成人看護　32nd　(Pt.1)　14-16　2001
Publisher: 日本看護協会出版会
ISSN： 1347-8192
老人福祉対策の都道府県,市町村間差の推移

加藤昌弘, 橋本修二, 宮下光令, 林正幸, 中村好一, 尾島俊之, 松村康弘, 福富和夫

厚生の指標　47　(4)　8-13　2000/04/15
Publisher: 厚生統計協会
ISSN： 0452-6104
保健・医療・福祉分野における地域指標の開発

尾島俊之, 中村好一, 橋本修二, 宮下光令, 林正幸, 加藤昌弘, 松村康弘, 福富和夫

厚生の指標　46　(15)　3-9　1999/12/15
Publisher: 厚生統計協会
ISSN： 0452-6104
Smoking rate differences by prefectures : From the survey results on national nutrition.

松村康弘, 中村好一, 林正幸, 加藤昌弘, 宮下光令, 尾島俊之, 福富和夫, 橋本修二

厚生の指標　46　(6)　23-28　1999/06/15
Publisher: 厚生統計協会
ISSN： 0452-6104
Proportion of old people needing care and average years of self-supporting Prefectural estimates based on existing statistics.

宮下光令, 橋本修二, 尾島俊之, 中村好一, 林正幸, 加藤昌弘, 福富和夫

厚生の指標　46　(5)　25-29　1999/05/15
Publisher: 厚生統計協会
ISSN： 0452-6104
Attitudes towards terminal care among the general population and medical practitioners in Japan.

宮下光令, 橋本修二, 河正子, 小島通代

日本公衆衛生雑誌　46　(5)　391-401　1999/05/15
Publisher: 日本公衆衛生学会
ISSN： 0546-1766
Consideration of healthy life expectancy. Comparison of prediction procedure of healthy life expectancy. Sullivan, Katz and Rogers methods.

橋本修二, 宮下光令, 辻一郎

厚生の指標　46　(4)　12-16　1999/04/15
Publisher: 厚生統計協会
ISSN： 0452-6104
入院時接遇に対する患者の意識と満足度に関する研究

森山ひとみ, 酒井百合子, 浦英子, 小野沢祐子, 宮下光令

日本看護学会論文集看護管理　30th　186-188　1999/03/03
Publisher: 日本看護協会出版会
ISSN： 1347-8184
Relative importance of indexes for evaluating community health care.

林正幸, 橋本修二, 加藤昌弘, 尾島俊之, 中村好一, 宮下光令, 福富和夫

福島県立医科大学看護学部紀要　(1)　33-48　1999/03

ISSN： 1344-6975
高齢者における要介護者割合と平均自立期間－既存統計による都道府県別推計－.

宮下光令, 橋本修二, 尾島俊之, 中村好一, 林正幸, 加藤昌弘, 福富和夫

厚生の指標.　46　(5)　25-9　1999
Publisher: 厚生統計協会
ISSN： 0452-6104
末期医療に対する一般集団と医療従事者の意識.

宮下光令, 橋本修二, 河正子, 小島通代

日本公衆衛生雑誌.　46　(5)　391-400　1999

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Books and Other Publications 8

がん対策基本法 : これまでの10年これからの10年

志真泰夫, 恒藤暁, 細川豊史, 宮下光令, 山崎章郎

青海社　2018

ISBN: 9784902249910
看取りケアプラクティス×エビデンス : 今日から活かせる72のエッセンス

宮下光令, 林ゑり子

南江堂　2018

ISBN: 9784524255429
小児緩和ケアの現状と展望

志真泰夫, 恒藤暁, 細川豊史, 宮下光令, 山崎章郎, 日本ホスピス, 緩和ケア研究振興財団, 日本ホスピス緩和ケア協会

青海社　2017

ISBN: 9784902249842
ナーシング・グラフィカ成人看護学7 緩和ケア

宮下光令

2012
ケアの根拠第2版看護の疑問に答える180のエビデンス

道又元裕

日本看護協会出版会　2012
精神腫瘍学

内富庸介, 小川朝生

医学書院　2011
看護学テキストNICE 緩和ケア

宮下光令

南江堂　2011
臨床と研究に役立つ緩和ケアのアセスメント・ツール

宮下光令

青海社　2008

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Presentations 283

一般市民におけるAdvance Care Planningに対する認識の実態調査

坂井志麻, 長江弘子, 原沢のぞみ, 岩崎孝子, 川原美紀, 片山陽子, 竹ノ内沙弥香, 池田真理, 伊藤真理, 田村恵子, 宮下光令

日本エンドオブライフケア学会学術集会プログラム・抄録集　2019/09
原発不明がん患者の医療に対する遺族の体験―J‐HOPE2016調査から得られたこと―

石田京子, 石田京子, 安藤詳子, 小松弘和, 森田達也, 内田恵, 明智龍男, 村田有希, 佐橋朋代, 五十嵐尚子, 志真泰夫, 宮下光令

日本がん看護学会誌(Web)　2018/01
急性期病院一般病棟における認知症看護の実態調査認知症の看護の実践評価と関連要因の探索

菅野雄介, 菅野雄介, 野畑宏之, 野畑宏之, 岩田愛雄, 比嘉謙介, 比嘉謙介, 佐山七生, 内村泰子, 大谷清子, 豊永香奈, 宮下光令, 小川朝生

日本老年看護学会学術集会抄録集　2017/06/01
Pain Management Index頻度計算時における分母と痛みのカットオフ値の多様性がNegative PMIのアウトカムに及ぼす影響

高橋理智, 高橋理智, 森田達也, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2017
「緩和ケア病棟」における「個室」や「大部屋」で過ごす影響:J‐HOPE2016

大谷弘行, 森田達也, 五十嵐尚子, 志真泰夫, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2017
造血器腫瘍患者の終末期に関連した意思決定に関する意識調査

李美玲, 李美玲, 今野朱美, 福原規子, 宮下光令, 張替秀郎

日本緩和医療学会学術大会プログラム・抄録集　2017
「家」で過ごす意味,「緩和ケア病棟」で過ごす意味:J‐HOPE2016

大谷弘行, 森田達也, 五十嵐尚子, 志真泰夫, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2017
がんサバイバーが感じるスティグマの頻度と関連因子

藤澤大介, 藤森麻衣子, 宮下光令

日本臨床死生学会大会プログラム・抄録集　2017
看護師の死にゆく患者への態度尺度「FATCOD‐Form‐B‐J」のカットオフ値の検討

酒井菜々子, 菅野喜久子, 鈴木聡, 青山真帆, 佐藤一樹, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2017
2014年の市町村別自宅死亡率と医療社会的指標との関連:地域相関研究

佐藤一樹, 佐藤一樹, 橋本孝太郎, 鈴木万祐子, 佐藤日菜, 河原正典, 青山真帆, 鈴木雅夫, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2017
全国大規模遺族調査に基づく緩和ケア病棟入院後1週間未満で死亡した患者の特徴

赤堀初音, 齊藤英一, 青山真帆, 佐藤一樹, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2017
原発不明がん患者の闘病に寄り添った家族の思い―J‐HOPE2016調査自由回答から得られたこと―

石田京子, 森田達也, 内田恵, 明智龍男, 安藤詳子, 小松弘和, 村田有希, 佐橋朋代, 五十嵐尚子, 志真泰夫, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2017
調査研究等の最新エビデンス

宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2017
進行がん患者に対するSpiPasを用いたスピリチュアルケアの有用性:前後比較2相試験

市原香織, 大内紗也子, 岡山幸子, 木下富貴子, 宮下光令, 森田達也, 田村恵子

日本緩和医療学会学術大会プログラム・抄録集　2017
がん患者における補完代替医療(2)~補完代替医療使用の関連要因についての検討~

鈴木梢, 森田達也, 森田達也, 田中桂子, 鄭陽, 亀井千那, 志賀泰夫, 志賀泰夫, 五十嵐尚子, 五十嵐尚子, 宮下光令, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2017
東北大学病院の看護師のがん看護に関する困難感の2010年から2016年にかけての変化

越野栞, 庄子由美, 斉藤明美, 大桐規子, 畠山里恵, 中條庸子, 飯沼由紀恵, 志田智子, 門間典子, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2017
苦痛のスクリーニングを外来は医師,病棟は看護師が実施している拠点病院の現状と課題

金澤麻衣子, 武田真恵, 中條庸子, 畠山里恵, 宮下光令, 井上彰

日本緩和医療学会学術大会プログラム・抄録集　2017
終末期せん妄による苦痛の評価尺度の開発と妥当性の検証

内田恵, 内田恵, 明智龍男, 明智龍男, 森田達也, 五十嵐尚子, 志真泰夫, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2017
がん患者の遺族における複雑性悲嘆のスクリーニング尺度であるBrief Grief Questionnaire(BGQ)とInventory of Complicated Grief(ICG)の比較(J‐HOPE2016研究)

五十嵐尚子, 青山真帆, 伊藤正哉, 中島聡美, 坂口幸弘, 森田達也, 志真泰夫, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2017
急性期病院に勤務する看護師のエンドオブライフ・ケアに対する態度とその関連要因に関する研究

菅野喜久子, 津田佐都子, 鈴木聡, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2017
がんの痛みの看護ケア実践尺度の開発と信頼性・妥当性の検討

高橋紀子, 渋谷久美子, 五十嵐尚子, 清水陽一, 青山真帆, 佐藤一樹, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2017
がん治療における経済的負担が治療の中止・変更に与える影響―全国遺族調査(J‐HOPE2016研究)

青山真帆, 五十嵐尚子, 森田達也, 志真泰夫, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2017
死別後の経済状況と遺族の複雑性悲嘆・うつとの関連―全国遺族調査(J‐HOPE2016研究)

青山真帆, 五十嵐尚子, 森田達也, 志真泰夫, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2017
家族内葛藤が遺族の抑うつ,複雑性悲嘆に与える影響:J‐HOPE2016付帯研究

浜野淳, 森田達也, 五十嵐尚子, 志真泰夫, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2017
がん患者における補完代替医療(1)~使用実態~

鈴木梢, 森田達也, 森田達也, 田中桂子, 鄭陽, 亀井千那, 志真泰夫, 志真泰夫, 五十嵐尚子, 五十嵐尚子, 宮下光令, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2017
乳がんサバイバーが再発不安を緩和するために行っていること

樅野香苗, 樅野香苗, 岩田広治, 山下年成, 新貝夫弥子, 向井未年子, 石田京子, 宮下光令, 明智龍男

日本緩和医療学会学術大会プログラム・抄録集　2017
がん患者の家族介護者のQOLに影響を与える要因―日本語版CQOLCを用いた検討―

杉山育子, 庄司春菜, 五十嵐尚子, 佐藤一樹, 高橋都, 宮下光令

日本がん看護学会誌　2017/01
東北大学病院の看護師のがん疼痛ケアに関する認識と実践状況

中條庸子, 宮下光令, 齋藤明美, 畠山里恵, 大桐規子, 志田智子, 阿部道代, 飯沼由紀恵, 庄子由美, 門間典子

日本がん看護学会誌　2017/01
原発性悪性脳腫瘍患者における終末期ケアの質の評価―ホスピス・緩和ケア病棟での多施設遺族調査―

杉山育子, 青山真帆, 佐藤一樹, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

日本がん看護学会誌　2017/01
宮城県のがん関連専門看護師・認定看護師が認識する宮城県のがん看護の達成度

宮下光令, 金愛子, 金愛子, 佐藤睦子, 佐藤睦子, 渋谷久美子, 渋谷久美子, 遠山優子, 遠山優子, 古川優子, 古川優子, 星久美, 星久美, 門間典子, 門間典子

日本がん看護学会誌　2017/01
終末期がん患者の家族が、患者の死を前提として行いたいことを達成するための望ましいケア

高尾鮎美, 荒尾晴惠, 山下亮子, 升谷英子, 森田也, 木澤義之, 恒藤暁, 志真泰夫, 青山真帆, 宮下光令

第1回関西緩和医療研究会プログラム抄録集　2016/11
終末期がん患者の家族が患者の死を前提として行いたい事に関する研究―緩和ケア病棟を利用した遺族に対する調査より―

山下亮子, 荒尾晴惠, 高尾鮎美, 升谷英子, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 青山真帆, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2016
乳がん患者の問題解決能力が再発脅威および不安・抑うつに与える影響

樅野香苗, 宮下光令, 岩田広治, 山下年成, 藤田崇史, 林裕倫, 角田伸行, 新貝夫弥子, 向井未年子, 明智龍男

日本サイコオンコロジー学会総会プログラム・抄録集　2016
デスカンファレンスで語られた内容の分析

大河弘子, 小松英樹, 秋山博実, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2016
日本人におけるがん疼痛治療の個別化された目標Personalized Pain Goalの検討

重野朋子, 舘田綾子, 森田達也, 岸野恵, 木澤義之, 佐藤悠子, 佐藤一樹, 細川豊史, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2016
未成年の子どもを持つがん患者の遺族の体験とサポートニーズに関する調査:J‐HOPE3

廣岡佳代, 大谷弘行, 三浦智史, 森田達也, 木澤義之, 恒藤暁, 志真康夫, 青山真帆, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2016
終末期がん患者へのリハビリテーションに関する家族の体験に関する研究

関根龍一, 関根龍一, 森田達也, 前田一石, 木澤義之, 恒藤暁, 志真泰夫, 青山真帆, 宮越浩一, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2016
乳がん患者の再発不安尺度日本語版Concerns about Recurrence Scale‐Japanese(CARS‐J)の信頼性・妥当性の検討

樅野香苗, 岩田広治, 山下年成, 新貝夫弥子, 向井未年子, 宮下光令, 明智龍男

日本緩和医療学会学術大会プログラム・抄録集　2016
在宅がん患者のQOLに影響を与える医療者の関わり:J‐HOPE3附帯研究

浜野淳, 森田達也, 福井小紀子, 木澤義之, 恒藤暁, 志真泰夫, 青山真帆, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2016
認知症高齢者の望ましい死の達成の遺族による評価とその関連要因

佐藤一樹, 菊地亜里沙, 宮下光令, 森田達也, 木下寛也

日本緩和医療学会学術大会プログラム・抄録集　2016
日本人遺族における死後観と悲嘆,抑うつとの関連

坂口幸弘, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 青山真帆, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2016
全国のがん診療連携拠点病院における認知症ケア提供体制に関する実態

菅野雄介, 菅野雄介, 野畑宏之, 岩田愛雄, 比嘉謙介, 佐山七生, 内村泰子, 大谷清子, 山中弘子, 豊永香奈, 宮下光令, 小川朝生, 小川朝生

日本緩和医療学会学術大会プログラム・抄録集　2016
ホスピス・緩和ケア病棟の遺族ケアに関する研究

北得美佐子, 水雲京, 石井京子, 月山淑, 川股知之, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 青山真帆, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2016
終末期がん患者を介護する家族の不安と抑うつの実態とその関連要因の検証に関する研究

佐竹宣明, 佐藤一樹, 中保利通, 井上彰, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2016
遺族調査の回収率の向上を目指した2×2×2ランダム化要因デザイン試験

宮下光令, 青山真帆, 佐藤一樹, 安部睦美, 首藤真理子, 岡本禎晃, 白土明美, 柳原一広, 山田祐司, 浜野淳, 森田達也

日本緩和医療学会学術大会プログラム・抄録集　2016
傾向スコア法によって調整した最期の療養場所とクオリティ・オブ・ケア,クオリティ・オブ・デスとの関連:J‐HOPE study3

羽多野裕, 羽多野裕, 青山真帆, 山口拓洋, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2016
DPCデータを用いたDPC算定病床におけるがん患者の緩和医療の質

佐藤悠子, 石岡千加史, 藤森研司, 石川光一, 佐藤一樹, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2016
宗教的背景のある施設において患者の望ましい死の達成度が高い理由

青山真帆, 青山真帆, 齊藤愛, 菅井真理, 森田達也, 森田達也, 木澤義之, 木澤義之, 恒藤暁, 恒藤暁, 志真泰夫, 志真泰夫, 宮下光令, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2016
J‐HOPE3研究の回収率に関わる要因

宮下光令, 青山真帆, 塚田成美, 新山裕仁, 升川研人, 山田瀬奈, 渡部夏織, 佐藤一樹, 森田達也, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2016
最期の療養場所を決定するときに重要視した要因

首藤真理子, 首藤真理子, 森田達也, 森田達也, 青山真帆, 青山真帆, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2016
がん診療連携拠点の緩和ケアチームの年間新規診療症例数の規定要因

宮下光令, 今井涼生, 佐藤一樹, 中澤葉宇子, 木澤義之, 森田達也

日本緩和医療学会学術大会プログラム・抄録集　2016
苦痛のスクリーニングと乳がん看護外来の運用

金澤麻衣子, 藤本亘史, 武田真恵, 畠山里恵, 杉山育子, 宮下光令, 井上彰

日本緩和医療学会学術大会プログラム・抄録集　2016
緩和ケア病棟紹介時の家族の見捨てられ感の研究(J‐HOPE3)

小田切拓也, 森田達也, 青山真帆, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2016
在宅死亡患者の受けた終末期ケアの質,終末期の望ましい死の達成,終末期の介護体験の遺族評価と在宅診療要因との関連

佐藤一樹, 橋本孝太郎, 宮下光令, 青山真帆, 鈴木雅夫

日本緩和医療学会学術大会プログラム・抄録集　2016
家族が患者の臨終に間に合わないことは,その後の複雑性悲嘆につながるか?:J‐HOPE3

大谷弘行, 森田達也, 吉田沙蘭, 木澤義之, 恒藤暁, 志真泰夫, 青山真帆, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2016
ホスピス・緩和ケア病棟の遺族ケアの改善点に関する研究

北得美佐子, 水雲京, 石井京子, 月山淑, 川股知之, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 青山真帆, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2016
認知症高齢者の終末期介護体験の遺族による評価その関連要因

佐藤一樹, 芹澤未有, 宮下光令, 森田達也, 木下寛也

日本緩和医療学会学術大会プログラム・抄録集　2016
大学病院入院中のがん患者のがんによる痛みの実態調査

岸野恵, 木澤義之, 佐藤悠子, 宮下光令, 森田達也, 細川豊史

日本緩和医療学会学術大会プログラム・抄録集　2016
終末期がん患者の家族が「もっと話しておけばよかった」「もっとあれをしておけばよかった」と思う原因は何か?

森雅紀, 吉田沙蘭, 塩崎麻里子, 馬場美華, 森田達也, 青山真帆, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2016
がん患者遺族の睡眠・飲酒の実態と悲嘆や抑うつとの関連

青山真帆, 坂口幸弘, 小川朝生, 藤澤大介, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2016
調査研究等の最新エビデンス

宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2016
遺族によるホスピス・緩和ケアの質の評価に関する研究3(J‐HOPE3)~遺族からみた研究プライオリティに関する研究~

坂下明大, 坂下明大, 森田達也, 青山真帆, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2016
在宅がん患者の精神症状と介護者の精神的つらさの関連について

小早川誠, 小川朝生, 金野倫子, 倉田明子, 青山真帆, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令

日本サイコオンコロジー学会総会プログラム・抄録集　2016
東北大学病院の外来・入院がん患者に対する苦痛スクリーニングの実施までのプロセスと試行結果

藤本亘史, 金澤麻衣子, 武田真恵, 畠山里恵, 杉山育子, 宮下光令, 井上彰

日本緩和医療学会学術大会プログラム・抄録集　2016
宮城県内のがん診療連携拠点病院におけるがん疼痛に関する多施設調査―施設間差と疼痛緩和が不十分な患者への対応の検討―

重野朋子, 藤本亘史, 早坂利恵, 高橋寛名, 紺野志保, 菅野喜久子, 綱田友江, 佐藤悠子, 佐藤一樹, 細川豊史, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2016
がん医療に携わる医療者の緩和ケアに関する知識・態度・困難感の変化に関する研究―がん対策基本計画策定前後比較結果―

中澤葉宇子, 加藤雅志, 宮下光令, 森田達也, 木澤義之

日本緩和医療学会学術大会プログラム・抄録集　2016
わが国における遺族調査の発展とJ‐HOPE3研究の概要

宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2016
希望する療養場所と実際の療養場所の一致が患者のquality of life,遺族の悲嘆・抑うつへ与える影響

首藤真理子, 首藤真理子, 森田達也, 森田達也, 青山真帆, 青山真帆, 木澤義之, 木澤義之, 恒藤暁, 恒藤暁, 志真泰夫, 志真泰夫, 宮下光令, 宮下光令

日本プライマリ・ケア連合学会学術大会抄録集　2016
遺族によるホスピス・緩和ケアの質の評価に関する研究(J‐HOPE3研究)の調査報告書の活用状況の実態

五十嵐尚子, 五十嵐尚子, 青山真帆, 青山真帆, 森田達也, 森田達也, 木澤義之, 木澤義之, 恒藤暁, 恒藤暁, 志真泰夫, 志真泰夫, 宮下光令, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2016
がん患者遺族の複雑性悲嘆とうつの混合とその関連要因

青山真帆, 青山真帆, 坂口幸弘, 小川朝生, 藤澤大介, 森田達也, 木澤義之, 恒藤暁, 志真泰夫, 宮下光令, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2016
在宅緩和ケアの質担保に向けた教育プログラムの開発

沖永美幸, 白川美弥子, 藤春千恵美, 佐伯由美, 矢津剛, 伊藤うらら, 田口敦子, 深堀浩樹, 山縣千尋, 菅野雄介, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2016
がん患者の療養生活における意思決定に関する家族の困難感

清水恵, 柳原一広, 青山真帆, 森田達也, 恒藤暁, 志真泰夫, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2016
わが国の緩和ケアの現状~がん領域の進歩,非がん領域の課題~

宮下光令

宮城県腎不全研究会会誌　2015/06/30
DPCデータを用いた東北大学病院の5大がん入院患者の終末期がん医療に関する調査

佐藤悠子, 宮下光令, 藤森研司, 中谷純, 藤本容子, 石岡千加史

日本内科学会雑誌　2015/02/20
遺族の評価による終末期ケアの質評価尺度Care Evaluation Scaleと終末期患者のQOL評価尺度Good Death Inventoryの非がん患者での信頼性・妥当性の検証

佐藤一樹, 宮下光令, 森田達也, 岩淵正博, 木下寛也

日本緩和医療学会学術大会プログラム・抄録集　2015
緩和ケア施策の達成度を評価するための指標の開発に関する研究

中澤葉宇子, 加藤雅志, 吉田沙蘭, 宮下光令, 森田達也, 木澤義之

日本緩和医療学会学術大会プログラム・抄録集　2015
東北大学病院における5大癌患者の終末期医療:DPCデータを用いた集計方法の検討

佐藤悠子, 宮下光令, 藤森研司, 中谷純, 藤本容子, 栗原誠, 佐藤一樹, 石岡千加史

日本緩和医療学会学術大会プログラム・抄録集　2015
医師に対するスピリチュアルケア研修の評価:前後比較試験

的場康徳, 村田久行, 森田達也, 宮下光令, 土屋静馬

日本緩和医療学会学術大会プログラム・抄録集　2015
大学病院入院中のがん患者の突出痛の頻度に関する予備調査

岸野恵, 木澤義之, 佐藤悠子, 宮下光令, 森田達也, 細川豊史

日本緩和医療学会学術大会プログラム・抄録集　2015
在宅緩和ケアの質担保に向けたチェックリストおよび教育プログラムの開発(第3報)

矢津剛, 白川美弥子, 沖永美幸, 藤春千恵美, 佐伯由美, 田口敦子, 横川詩織, 深堀浩樹, 菅野雄介, 佐藤一樹, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2015
在宅緩和ケアの質担保に向けたチェックリストおよび教育プログラムの開発(第1報)―文献検討―

田口敦子, 菅野雄介, 横川詩織, 白川美弥子, 沖永美幸, 藤春千恵美, 佐伯由美, 矢津剛, 深堀浩樹, 佐藤一樹, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2015
遺族による終末期患者の介護体験の評価尺度Caregiving Consequence Inventoryの改訂と非がん患者遺族での信頼性・妥当性の検証

佐藤一樹, 三條真紀子, 宮下光令, 森田達也, 岩淵正博, 木下寛也

日本緩和医療学会学術大会プログラム・抄録集　2015
苦痛緩和のための鎮静に関する家族への説明・ケアについての検討

池永昌之, 恒藤暁, 平井啓, 宮下光令, 森田達也

日本緩和医療学会学術大会プログラム・抄録集　2015
がん患者の望ましい死・死亡場所の希望と実際:コホート研究による検討

宮下光令, 今井涼生, 川上祥子, 加藤大基, 中野貴美子, 中川恵一

日本緩和医療学会学術大会プログラム・抄録集　2015
終末期医療に関する意思決定者の違いの関連要因と受ける医療やQuality of Lifeへの影響

岩淵正博, 佐藤一樹, 宮下光令, 森田達也, 木下寛也

日本緩和医療学会学術大会プログラム・抄録集　2015
在宅緩和ケアの質担保に向けたチェックリストおよび教育プログラムの開発(第2報)―訪問看護師調査による検討―

白川美弥子, 沖永美幸, 藤春千恵美, 佐伯由美, 横川詩織, 田口敦子, 深堀浩樹, 菅野雄介, 矢津剛, 佐藤一樹, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2015
日本人の望ましい死とその達成

宮下光令

北日本看護学会学術集会プログラム・抄録集　2014/08/01
造血細胞移植後のQOL測定尺度の計量心理学的検討:EORTCQLQ‐HDC29,FACT‐BMT

山花令子, 塚越真由美, 森文子, 宮下光令

日本造血細胞移植学会総会プログラム・抄録集　2014/02/14
東日本大震災の被災沿岸地域の医療者へのインタビュー調査に基づく災害時におけるがん患者の緩和ケア・在宅医療の在り方に関する研究

菅野喜久子, 木下寛也, 森田達也, 佐藤一樹, 清水恵, 秋山聖子, 村上雅彦, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2014
緩和ケア病棟入院料改定前後での緩和ケア病棟の利用状況の変化

佐藤一樹, 志真泰夫, 伊藤咲, 安部奈津子, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2014
看護師に対するELNEC‐Jコアカリキュラム看護師教育プログラムの有効性の検証:Wait list controlによる無作為化比較試験

新幡智子, 宮下光令, 梅田恵, 桑田美代子, 田村恵子, 木澤義之

日本緩和医療学会学術大会プログラム・抄録集　2014
遺族調査が遺族に与える負担と受益

竹内真帆, 吉田早希, 山田祐司, 柳原一広, 安部睦美, 白土明美, 首藤真理子, 岡本禎晃, 浜野淳, 森田達也, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2014
遺族の視点から臨終前後の患者と家族の看取りのケアの質を評価する尺度の開発と信頼性・妥当性の検証

菅野雄介, 佐藤一樹, 清水恵, 安藤秀明, 舩水裕子, 岸野恵, 前原絵美理, 高橋徹, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2014
MORECare statement:英国における終末期ケアサービスの評価方法の提言

宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2014
看取りのケアのクリニカルパスLiverpool Care Pathway(LCP)の英国での動向:Independent Review発表後の医療者のLCPに対するコメントに関する文献レビュー

菅野雄介, 佐藤一樹, 田口敦子, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2014
医療者から受けた看取りのケアの実践と遺族の望ましい看取りの達成との関連要因の探索

菅野雄介, 佐藤一樹, 清水恵, 安藤秀明, 舩水裕子, 岸野恵, 前原絵美理, 高橋徹, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2014
緩和ケアの構造・プロセス,アウトカム評価における家族による代理評価の信頼性の検証に関する研究

佐竹宣明, 中保利通, 佐藤一樹, 佐藤千穂子, 島田哲, 田島つかさ, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2014
終末期ケアの質と遺族の複雑性悲嘆の関連

宮島加耶, 藤澤大介, 吉村公雄, 伊藤正哉, 中島聡美, 白波瀬丈一郎, 三村將, 宮下光令

日本精神神経学会総会プログラム・抄録集　2014
遺族によるがん患者の死亡前の症状の評価

竹内真帆, 宮本蒼, 岡本禎晃, 山田祐司, 柳原一広, 安部睦美, 白土明美, 首藤真理子, 浜野淳, 森田達也, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2014
Caregiver Quality of Life Index‐Cancer(CQOLC)日本語版の信頼性・妥当性の検証

清水恵, 安藤早紀, 原田真里子, 久慈瑞希, 佐藤一樹, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2014
がん患者の遺族による緩和ケアの構造・プロセスの評価尺度Care Evaluation Scale ver2.0の信頼性・妥当性の検討

竹内真帆, 中畑美里, 平井啓, 山田祐司, 柳原一広, 安部睦美, 白土明美, 首藤真理子, 岡本禎晃, 浜野淳, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2014
終末期がん患者の呼吸困難に対する送風の支援の有効性についてのケースシリーズ研究

角甲純, 關本翌子, 小川朝生, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2014
European Organization for Research and Treatment of Cancer(EORTC) Quality of Life Questionnaire‐High dose Chemotherapy 29 (QLQ‐HDC29)日本語版の作成

山花令子, 塚田信弘, 高橋聡, 宮下光令

日本造血細胞移植学会総会プログラム・抄録集　2013/02/08
がん診療連携拠点病院緩和ケアチーム研修会の評価~研修後追跡調査結果~

中澤葉宇子, 木澤義之, 橋爪隆弘, 森田達也, 笹原朋代, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2013
緩和ケア病棟の診療体制と利用状況の平均在棟日数での違い

佐藤一樹, 志真泰夫, 羽川瞳, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2013
看護師による臨終前後の患者と家族の看取りのケアの質を評価する尺度の信頼性と妥当性の検証

菅野雄介, 安藤秀明, 舩水裕子, 岸野恵, 前原絵美理, 高橋徹, 清水恵, 佐藤一樹, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2013
がん患者の死亡場所に関連する要因死亡票の分析

五十嵐美幸, 宮下光令, 佐藤一樹, 清水恵, 川原礼子, 森田達也, 江口研二

日本緩和医療学会学術大会プログラム・抄録集　2013
医療用麻薬の使用に対する遺族の体験に基づいた認識と意向

新城拓也, 森田達也, 平井啓, 宮下光令, 清水恵, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2013
緩和ケア専門従事者の臨床現場の「質」評価に関する考察~「緩和ケア病棟臨床指標開発に関するパイロット調査」に付帯して実施したヒアリングから~

伊藤惠子, 宮下光令, 佐藤一樹, 林章敏, 東尚弘, 渡辺敏, 鈴木正寛, 關本翌子, 中村めぐみ

日本緩和医療学会学術大会プログラム・抄録集　2013
看護師による臨終前後の患者と家族の看取りのケアに関する実践と看取りのケアに対する困難感の関連要因の探索

菅野雄介, 安藤秀明, 舩水裕子, 岸野恵, 前原絵美理, 高橋徹, 清水恵, 佐藤一樹, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2013
悲嘆を経験する遺族の睡眠障害の実態調査

谷向仁, 足立浩祥, 平井啓, 松井智子, 宮下光令, 清水恵, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2013
看取りのケアの質を遺族・看護師の視点から評価する尺度の開発

宮下光令, 菅野雄介, 佐藤一樹, 清水恵, 五十嵐美幸, 菅野喜久子

日本緩和医療学会学術大会プログラム・抄録集　2013
がん患者遺族へのUnhelpful Support―A nationwide survey―

石田真弓, 大西秀樹, 川田聡, 遠山啓亮, 清水恵, 森田達也, 宮下光令, 内富庸介

日本サイコオンコロジー学会総会プログラム・抄録集　2013
看取りのケアのクリニカルパスLiverpool Care Pathway日本語版在宅バージョンの開発と実施可能性の検討

菅野雄介, 平原優美, 荒木和美, 松村優子, 八杉まゆみ, 川村幸子, 古賀友之, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2013
緩和ケア病棟入院中に患者と家族が交わす思いと言葉に関する量的研究(J‐HOPE2)~果たして思いは言葉にしないと伝わらないのか?~

中里和弘, 塩崎麻里子, 平井啓, 森田達也, 多田羅竜平, 市原香織, 清水恵, 宮下光令, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2013
救急外来で死別した家族による医療評価:一般市民への調査結果から

木下里美, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2013
複雑性悲嘆に対する終末期医療の質の影響

宮島加耶, 藤澤大介, 宮下光令, 吉村公雄, 白波瀬丈一郎, 三村將

日本緩和医療学会学術大会プログラム・抄録集　2013
在宅緩和ケアを受けた終末期がん患者の在宅診療中止の関連要因

佐藤一樹, 橋本孝太郎, 内海純子, 出水明, 藤本肇, 森井正智, 永沢譲, 宮下光令, 鈴木雅夫

日本緩和医療学会学術大会プログラム・抄録集　2013
2010年の全死亡およびがん死亡の都道府県別自宅死亡割合と医療社会的指標の地域相関分析

宮下光令, 五十嵐美幸, 佐藤一樹, 清水恵, 菅野雄介, 菅野喜久子, 川原礼子

日本緩和医療学会学術大会プログラム・抄録集　2013
進行がん患者の廃用症候群に対するリハビリテーションはQOLの維持に貢献している可能性がある:J‐REACT

緒方政美, 内山郁代, 閏間愛, 彦田由子, 宇田和晃, 宮越浩一, 関根龍一, 宮下光令, 森田達也

日本緩和医療学会学術大会プログラム・抄録集　2013
客観的身体機能と主観的QOLはリハビリ介入前後でどのように相関するか:J‐REACT

閏間愛, 彦田由子, 宇田和晃, 宮越浩一, 関根龍一, 緒方政美, 内山郁代, 宮下光令, 森田達也

日本緩和医療学会学術大会プログラム・抄録集　2013
在宅診療を受けた終末期がん患者の現状と在宅診療中止の実態

橋本孝太郎, 佐藤一樹, 内海純子, 出水明, 藤本肇, 森井正智, 永沢譲, 宮下光令, 鈴木雅夫

日本緩和医療学会学術大会プログラム・抄録集　2013
ご遺体へのケアを看護師が家族と一緒に行うことについての家族の体験・評価

山脇道晴, 森田達也, 清原恵美, 宮下光令, 清水恵, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2013
遺族によるケアの質の評価に関する研究J‐HOPE2‐study~日本ホスピス緩和ケア協会会員施設で亡くなった患者の遺族を対象とした全国的大規模質問紙調査~

清水恵, 宮下光令, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2013
終末期がん患者が「楽しみになることがある」ための医療者の支援~緩和ケア病棟の医師と看護師の回答の比較~

中野貴美子, 佐藤一樹, 片山はるみ, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2013
QODD(Quality of Dying and Death)によるICU看護師の看取りの評価

木下里美, 宮下光令

日本看護科学学会学術集会講演集　2012/11
Liverpool Care Pathwayの介護保険施設職員による試用とその評価

泉澤晴香, 深堀浩樹, 遠藤貴子, 宮下光令

日本老年看護学会学術集会抄録集　2012/06/15
緩和ケア病棟で提供される終末期がん医療の施設間差と施設背景の関連:多施設診療記録調査

佐藤一樹, 宮下光令, 森田達也, 嶋崎朱美, 鈴木里奈, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2012
一般市民から抽出したがん患者の遺族による終末期医療の評価:死亡場所別の検討

五十嵐美幸, 片倉梓, 佐藤一樹, 清水恵, 井上芙蓉子, 菅野雄介, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2012
急性期型緩和ケア病棟から自宅退院した終末期がん患者の平均在院日数に関連する要因

菅野雄介, 原田奈緒美, 伊藤友美, 西出芙美, 森岡のぞみ, 田村恵子, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2012
緩和ケア病棟で提供される終末期がん医療の施設間差による緩和ケアの質評価への影響

佐藤一樹, 宮下光令, 森田達也, 鈴木里奈, 嶋崎朱美, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2012
がん患者の疼痛とQOLの関連:横断研究による検討

宮下光令, 山田倫子, 高橋彩香, 和田信, 的場元弘

日本緩和医療学会学術大会プログラム・抄録集　2012
日本の医師の緩和ケアに関する知識に関連する要因:多変量解析による検討

宮下光令, 國分彩果, 森田達也, 内田健夫, 加藤雅志, 江口研二

日本緩和医療学会学術大会プログラム・抄録集　2012
OPTIM‐studyがわが国の緩和ケアの研究方法論にもたらすもの

宮下光令, 五十嵐歩, 佐藤一樹, 花田芙蓉子, 五十嵐美幸, 山口拓洋

日本緩和医療学会学術大会プログラム・抄録集　2012
がん医療に関わる当事者の死生観研究~患者・医師・看護師の三者比較の観点から~

中川恵一, 黒田佑次郎, 北沢裕, 小谷みどり, 宮下光令, 一ノ瀬正樹

日本緩和医療学会学術大会プログラム・抄録集　2012
PEACE研修会において緩和ケアの知識を測定するための尺度(PEACE‐Q33)の作成と信頼性・妥当性の検討

山本亮, 木澤義之, 佐藤哲観, 中澤葉宇子, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2012
終末期がん患者の家族介護者の医療者との説明・話し合いにおける選好:一般市民を対象とした全国的質問紙調査

清水恵, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2012
終末期がん患者が「明るさを失わずに過ごす」ための医療者の支援のあり方―緩和ケア病棟の医師・看護師を対象としたエキスパート・インタビュー調査―

中野貴美子, 佐藤一樹, 片山はるみ, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2012
OPTIMプロジェクト前後での病院から在宅診療への移行率と病院医師・看護師の在宅の視点の変化

白髭豊, 野田鋼稔, 北條美能留, 後藤慎一, 冨安志郎, 出口雅浩, 奥平定之, 安中正和, 平山美香, 宮下光令, 森田達也

日本緩和医療学会学術大会プログラム・抄録集　2012
一般市民から抽出したがん・脳卒中・心疾患の遺族による終末期医療の評価

宮下光令, 竹鼻靖子, 佐藤一樹, 清水恵, 井上芙蓉子, 菅野雄介, 五十嵐美幸

日本緩和医療学会学術大会プログラム・抄録集　2012
PEACE研修会受講により医師の緩和ケアに対する知識は向上するか?

山本亮, 木澤義之, 佐藤哲観, 大出幸子, 中澤葉宇子, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2012
終末期に希望する余命告知の方法~がん患者,一般集団,がん診療を行う医師,看護師1965名を対象とした調査から~

三條真紀子, 宮下光令, 川上祥子, 加藤大基, 中野貴美子, 中川恵一

日本緩和医療学会学術大会プログラム・抄録集　2011/06/27
緩和ケア病棟の遺族による質の評価は,死亡後の経過期間の影響を受けるか?:J‐HOPE study

宮下光令, 佐藤一樹, 森田達也, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2011/06/27
緩和ケア病棟の遺族の「医療用麻薬」「緩和ケア」「緩和ケア病棟」に対する認識の関連要因:J‐HOPE study

宮下光令, 森田達也, 佐藤一樹, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2011/06/27
J‐HOPE studyにおける遺族による緩和ケアの質評価とそれに関連する施設要因

宮下光令, 佐藤一樹, 森田達也, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2011/06/27
緩和ケア病棟で提供された終末期鎮静の関連要因と遺族による緩和ケアの質評価への影響

佐藤一樹, 宮下光令, 森田達也, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2011/06/27
がん専門病院に入院中の進行期固形がん患者における退院支援の必要性に対する関連要因の検討

清水陽一, 細矢美紀, 樋口由起子, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2011/06/27
がん診療連携拠点病院の緩和ケア機能の充足度:平成19‐21年度医療水準調査の結果

宮下光令, 木澤義之, 笹原朋代, 佐治重豊, 江口研二

日本緩和医療学会学術大会プログラム・抄録集　2011/06/27
緩和ケア病棟看護師によるLiverpool Care Pathway日本語版の有用性評価:緩和ケア病棟2施設におけるパイロットスタディからの検討

市原香織, 宮下光令, 福田かおり, 茅根義和, 清原恵美, 森田達也, 田村恵子, 葉山有香, 大石ふみ子

日本緩和医療学会学術大会プログラム・抄録集　2011/06/27
終末期に希望する療養場所と死亡場所~がん患者,一般集団,がん診療を行う医師,看護師1965名を対象とした調査から~

三條真紀子, 宮下光令, 川上祥子, 加藤大基, 中野貴美子, 中川恵一

日本緩和医療学会学術大会プログラム・抄録集　2011/06/27
一般外来通院中,外来化学療法室通院中,入院中の患者に対する緩和ケアの質の評価

宮下光令, 清水恵, 安藤秀明

日本緩和医療学会学術大会プログラム・抄録集　2011/06/27
主治医による死亡確認や臨終の立ち会いが,家族の心理に及ぼす影響についての調査研究

新城拓也, 森田達也, 平井啓, 宮下光令, 佐藤一樹, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2011/06/27
緩和ケア病棟における医療者―家族間の説明/話し合いのあり方

清水恵, 宮下光令, 白井由紀, 吉田沙蘭, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2011/06/27
がん患者に対する緩和ケアにおけるQOL評価

宮下光令

日本緩和医療薬学会年会プログラム・要旨集　2011
緩和ケア病棟で家族を介護した遺族の精神的成長感

安藤満代, 森田達也, 宮下光令, 三條真紀子, 志真泰夫

日本サイコオンコロジー学会総会プログラム・抄録集　2011
ビリーブメント・ライフレビュー(遺族回想法)の効果を説明する「思い出の精緻化モデル」

安藤満代, 森田達也, 宮下光令, 三條真紀子, 志真泰夫

日本サイコオンコロジー学会総会プログラム・抄録集　2011
多理論統合モデル(Trastheoretical Model:TTM)による遺族の語りからみられる死の受容過程

安藤満代, 森田達也, 宮下光令, 三條真紀子, 志真泰夫, 津田彰

日本サイコオンコロジー学会総会プログラム・抄録集　2011
乳がん患者のニードに基づいた看護師と精神腫瘍医の協働ケア介入の実行可能性と有用性の予備的検討

樅野香苗, 明智龍男, 奥山徹, 内田恵, 中口智博, 佐川竜一, 山下啓子, 遠山竜也, 宮下光令

日本サイコオンコロジー学会総会プログラム・抄録集　2011
集中治療室(ICU)で死を迎えたがん患者の遺族による医療・ケア評価:一般市民への調査結果から

木下里美, 宮下光令

日本看護科学学会学術集会講演集　2010/12
「看護キャリアプロモート支援システム開発」におけるニーズ調査報告第1報―看護職のキャリアに関する認識について―

早川ひと美, 門間典子, 佐々木百合花, 平野かよ子, 宮下光令, 朝倉京子, 岡村由紀子, 吉沢豊予子, 菅原美知子

日本看護管理学会年次大会講演抄録集　2010/08/09
緩和ケア病棟の遺族は追悼会や死別後の手紙をどうとらえているか?:44名のインタビュー調査

牟田理恵子, 三條真紀子, 宮下光令, 若林理恵子, 安藤悦子, 森田達也, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2010
「終末期がん患者の家族が大事にしたいと思うこと」の構成要素:家族と遺族を対象とした面接調査の結果から

三條真紀子, 宮下光令, 森田達也, 栗原幸江, 出野美那子, 恒藤暁, 志真泰夫, 平井啓

日本緩和医療学会学術大会プログラム・抄録集　2010
無作為化クロスオーバー試験による進行期がん患者の倦怠感に対するリフレクソロジーの有効性の検討

宮内貴子, 宮下光令, 山口拓洋

日本緩和医療学会学術大会プログラム・抄録集　2010
緩和ケア・医療用麻薬に関する患者,家族の知識とケアの質評価尺度および緩和ケアの準備状態との関連:OPTIM‐study

武林亨, 秋山美紀, 平井啓, 的場元弘, 森田達也, 宮下光令, 山岸暁美, 秋月伸哉, 白髭豊, 江口研二

日本緩和医療学会学術大会プログラム・抄録集　2010
がん患者に対する包括的QOLを測定する尺度の信頼性と妥当性の検討

宮下光令, 和田信, 森田達也, 的場元弘, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2010
集中治療室で死を迎えた患者の背景と療養生活の評価~一般集団から抽出した遺族の評価から

木下里美, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2010
がん医療に対する安心感尺度の作成と関連要因:OPTIM‐study

宮下光令, 森田達也, 秋山美紀, 秋月伸哉, 白髭豊, 江口研二

日本緩和医療学会学術大会プログラム・抄録集　2010
遺族から見た死前喘鳴に対する望ましいケア:J‐HOPE STUDY

清水陽一, 宮下光令, 森田達也, 佐藤一樹, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2010
地域の医療機関に勤務し,がん患者をケアする看護師の緩和ケアに関する知識,実践,困難感の実態とその関連要因:OPTIM‐study

佐藤一樹, 宮下光令, 五十嵐歩, 梅田恵, 石ケ森一枝, 木澤義之, 秋山美紀, 秋月伸哉, 森田達也, 白髭豊, 江口研二

日本緩和医療学会学術大会プログラム・抄録集　2010
在宅ホスピスケアを受けたがん患者の遺族の在宅療養開始時の意思決定過程:J‐HOPE Study

宮下光令, 平井啓, CHOI Ji Eun, 森田達也, 佐藤一樹, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2010
看取りのケアにおけるクリティカルパス:LCP(看取りのパス:リバプール・ケア・パスウエイ)日本語版の使用方法

宮下光令, 茅根義和, 市原香織

日本緩和医療学会学術大会プログラム・抄録集　2010
緩和ケアで家族を亡くされた遺族へのスピリチュアルケアとしての短期回想法の質的分析

安藤満代, 森田達也, 宮下光令, 三條真紀子, 志真泰夫

日本サイコオンコロジー学会総会プログラム・抄録集　2010
家族の視点からみた望ましい緩和ケアシステム:J‐HOPE Study

三條真紀子, 森田達也, 宮下光令, 佐藤一樹, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2010
終末期の療養場所を検討するがん患者の家族へのケアに関する基礎的研究:緩和ケアに従事する医療者への面接調査の結果から

三條真紀子, 笹原朋代, 木村理恵子, 牟田理恵子, 木澤義之, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2010
遺族からみた在宅終末期がん患者の家族介護者の困難感尺度の開発と関連要因の探索

石井容子, 宮下光令, 佐藤一樹, 小澤竹俊

日本緩和医療学会学術大会プログラム・抄録集　2010
終末期がん患者における死亡場所と死亡前の療養場所の特徴:OPTIM‐study

五十嵐歩, 森田達也, 宮下光令, 佐藤一樹, 秋山美紀, 秋月伸哉, 白髭豊, 江口研二

日本緩和医療学会学術大会プログラム・抄録集　2010
看護師に対するEnd‐of‐Lifeケアの教育に関する指導者講習会の評価尺度の開発とELNEC‐J指導者養成プログラムの評価

竹之内沙弥香, 宮下光令, 木澤義之, 田村恵子

日本緩和医療学会学術大会プログラム・抄録集　2010
診療記録から抽出する緩和ケアにおける診療の質の管理評価指標群(Quality Indicator)の作成と測定

宮下光令, 東尚弘, 森田達也, 祖父江友孝

日本緩和医療学会学術大会プログラム・抄録集　2010
外来進行がん患者の疼痛とQuality of Lifeに関する多施設調査:OPTIM‐study

山岸暁美, 森田達也, 宮下光令, 秋月伸哉, 白髭豊, 秋山美紀, 佐藤一樹, 加藤雅志, 江口研二

日本緩和医療学会学術大会プログラム・抄録集　2010
「希望をもちながらも,同時にこころ残りのないように準備しておく」ために医師や看護師は何ができるのか:J‐HOPE study

白土明美, 森田達也, 宮下光令, 赤澤輝和, 佐藤一樹, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2010
がん患者と遺族の緩和ケアに対する認識と準備性 OPTIM study

平井啓, 秋山美紀, 武林亨, 的場元弘, 宮下光令, 森田達也, 白髭豊, 秋月伸哉, 江口研二

日本緩和医療学会学術大会プログラム・抄録集　2010
がん診療連携拠点病院緩和ケアチームのコンサルテーション活動に関する実態調査

中澤葉宇子, 木澤義之, 森田達也, 笹原朋代, 宮下光令, 橋爪隆弘, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2010
ホスピス・緩和ケア病棟への入院検討時の家族のつらさと望ましい支援に関する質的研究:遺族への面接調査の結果から

三條真紀子, 塩崎麻里子, 吉田沙蘭, 森田達也, 宮下光令, 上別府圭子, 恒藤暁, 志真泰夫, 平井啓

日本緩和医療学会学術大会プログラム・抄録集　2010
がん患者に対する緩和ケアの構造・プロセスを評価する尺度(患者版Care Evaluation Scale)の信頼性と妥当性の検討

宮下光令, 和田信, 森田達也, 的場元弘, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2010
進行がん患者および遺族は在宅療養について「急な変化や夜間に対応できない」「病院と同じように苦痛を和らげられる」と思っているか?:OPTIM studyによる多施設調査

古村和恵, 山岸暁美, 森田達也, 宮下光令, 秋月伸哉, 白髭豊, 秋山美紀, 佐藤一樹, 加藤雅志, 江口研二

日本緩和医療学会学術大会プログラム・抄録集　2010
地域の病院(一般病棟,緩和ケア病棟),診療所のがん患者の遺族による緩和ケアの質の評価:OPTIM‐study

宮下光令, 森田達也, 佐藤一樹, 五十嵐歩, 秋山美紀, 秋月伸哉, 白髭豊, 江口研二

日本緩和医療学会学術大会プログラム・抄録集　2010
緩和ケア認定看護師の職場環境と活動状況に対する職務満足度とバーンアウト度について

舩水裕子, 大島佐和子, 伊藤美智子, 苅安真佐美, 安藤秀明, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2010
地域の医療機関に勤務する医師の緩和ケアに関する知識・実践・困難感は?がん対策のための戦略研究「緩和ケア普及のための地域プロジェクト」介入前調査から:OPTIM‐study

木澤義之, 宮下光令, 佐藤一樹, 森田達也, 江口研二

日本緩和医療学会学術大会プログラム・抄録集　2010
訪問看護師への在宅看取り強化プログラムの評価尺度の作成とその関連要因

石井容子, 宮下光令, 山岸暁美, 角田直枝

日本緩和医療学会学術大会プログラム・抄録集　2010
がん患者の遺族は,どのくらい介護負担感を感じているのか?:OPTIM‐studyによる施設調査

末田千恵, 山岸暁美, 森田達也, 宮下光令, 秋月伸哉, 白髭豊, 秋山美紀, 佐藤一樹, 加藤雅志, 江口研二

日本緩和医療学会学術大会プログラム・抄録集　2010
訪問看護師を対象とした全国的な在宅看取り強化プログラムの評価

宮下光令, 石井容子, 山岸暁美, 角田直枝

日本緩和医療学会学術大会プログラム・抄録集　2010
地域で療養生活を送ることに関する患者,家族の安心感とその要因:OPTIM‐study

秋山美紀, 武林亨, 平井啓, 的場元弘, 森田達也, 宮下光令, 山岸暁美, 白髭豊, 秋月伸哉, 江口研二

日本緩和医療学会学術大会プログラム・抄録集　2010
「緩和ケアの質の臨床指標(Quality Indicator)」は遺族から見て妥当なのか?緩和ケア病棟の遺族に対する質問紙調査から

宮下光令, 森田達也, 井上聡, 市川尭之, 佐藤一樹, 志真泰夫, 内富庸介

日本緩和医療学会学術大会プログラム・抄録集　2010
「終末期がん患者の家族が大事にしたいと思うこと」の概念化:一般集団・遺族1975名を対象とした全国調査の結果から

三條真紀子, 宮下光令, 森田達也, 栗原幸江, 上別府圭子, 平井啓

日本緩和医療学会学術大会プログラム・抄録集　2010
日本の医師97,961人に対する緩和ケアに関する知識の実態調査

宮下光令, 森田達也, 内田健夫, 加藤雅志, 江口研二

日本緩和医療学会学術大会プログラム・抄録集　2010
終末期のがん患者を介護した遺族の介護経験の評価および健康関連QOL:7994名の全国調査J‐HOPE Study

三條真紀子, 宮下光令, 森田達也, 佐藤一樹, 上別府圭子, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2010
J‐HOPE研究の概要とケアプロセス・アウトカムの評価

宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2010
緩和ケア病棟で提供された終末期がん医療の実態に関する多施設診療記録調査:J‐HOPE study

佐藤一樹, 宮下光令, 森田達也, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2010
終末期がん患者が「楽しみになることがある」ための医療者の支援のあり方―緩和ケア病棟の医師・看護師を対象としたエキスパート・インタビュー調査―

中野貴美子, 佐藤一樹, 宮下光令, 片山はるみ

日本緩和医療学会学術大会プログラム・抄録集　2010
J‐HOPE Study:全国156施設8163人のがん患者の遺族による多施設遺族調査

宮下光令

日本看護科学学会学術集会講演集　2009/11
緩和ケア認定看護師の職務満足度とバーンアウト度に影響を与える要因

大島佐和子, 伊藤美智子, 舩水裕子, 宮下光令, 梅内美保子

日本看護学会抄録集看護管理　2009/10/21
ホスピス・緩和ケア病棟で近親者を亡くした遺族の複雑性悲嘆,抑うつ,希死念慮:J‐HOPE study

坂口幸弘, 森田達也, 宮下光令, 佐藤一樹, 恒藤暁, 志真泰夫

日本サイコオンコロジー学会総会プログラム・抄録集　2009/09/05
遺族調査から見た終末期担癌患者に対する宗教的ケアの現状と有用性評価:J‐HOPE Study

岡本拓也, 安藤満代, 森田達也, 平井啓, 河村諒, 宮下光令, 佐藤一樹, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2009
全国のがん診療連携拠点病院,緩和ケア病棟,在宅ホスピスのがん患者の遺族8,163人によるがん終末期ケアの質の評価:J‐HOPE study

宮下光令, 森田達也, 佐藤一樹, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2009
STAS‐Jを用いたケアの質の向上への取り組み~協働における看護師の不全感に焦点をあてて~

谷村美希, 神田啓子, 中田由希子, 酒井篤子, 鈴木由美子, 宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2009
緩和医療の研究の実践

宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2009
外来化学療法中のがん患者の症状頻度と経時的フォローアップ

山岸暁美, 森田達也, 宮下光令, 田中(貴邑)冨久子

日本緩和医療学会学術大会プログラム・抄録集　2009
遺族ケアサービスに対する遺族のニーズとバリア:J‐HOPE study

坂口幸弘, 森田達也, 宮下光令, 佐藤一樹, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2009
在宅ホスピスを利用したがん患者の遺族の在宅療養と在宅死亡に対する意向とその関連要因に関する研究:J‐HOPE study

崔智恩, 宮下光令, 平井啓, 佐藤一樹, 森田達也, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2009
一般市民に対する緩和ケアに関する教育的介入の長期効果

佐藤一樹, 宮下光令, 森田達也, 鈴木雅夫

日本緩和医療学会学術大会プログラム・抄録集　2009
在宅療養中の終末期がん患者の主介護者に対する日本語版CRA(CRA‐J:Caregiver Reaction Assessment Scale)の信頼性・妥当性の検証

三澤知代, 宮下光令, 河正子, 安部幸志, 阿部まゆみ, 中山康子

日本緩和医療学会学術大会プログラム・抄録集　2009
遺族による在宅ケアの質の評価~当院における遺族への質問紙調査の結果から~

逢坂容子, 逢坂容子, 小澤竹俊, 宮下光令, 佐藤和子, 泉田知子, 国廣崇, 右京陽子, 三浦有子, 加藤紀子

日本緩和医療学会学術大会プログラム・抄録集　2009
生命予後告知に対する遺族の評価とその関連要因:J‐HOPE Study

吉田沙蘭, 平井啓, 森田達也, 宮下光令, 佐藤一樹, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2009
ICU(集中治療室)における終末期ケア困難感と関連要因

木下里美, 宮下光令

日本看護科学学会学術集会講演集　2008/11
看護師管理内服事故の分析~7:1看護配置における事故発生状況への影響~

鈴木早苗, 矢内富江, 浅野真紀, 宮下光令

日本看護学会抄録集看護管理　2008/10/30
J‐HOPE study(The Japan HOspice and Palliative care Evaluation study):研究デザインおよび参加施設の概要

宮下光令, 森田達也, 恒藤暁, 佐藤一樹, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2008
高齢者施設におけるがん患者への緩和ケアの実態OPTIM study

深堀浩樹, 宮下光令, 森田達也, 市川尭之, 秋月伸哉, 秋山美紀, 白髭豊, 江口研二

日本緩和医療学会学術大会プログラム・抄録集　2008
膀胱留置カテーテルの閉鎖式管理と外尿道口消毒に対する意識調査およびパンフレットの効果

月永さや香, 妻倉恵, 宮下光令

東京都看護協会看護研究学会プログラム・演題集録　2008
がん診療連携拠点病院の緩和ケア提供機能に関する薬剤業務の実態調査(2)

佐野元彦, 宮下光令, 佐藤一樹, 森田達也, 恒藤暁, 的場元弘, 杉浦宗敏, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2008
終末期のがん患者を介護した遺族による介護経験の評価尺度の作成

三條真紀子, 森田達也, 宮下光令, 塩崎麻里子, 佐藤一樹, 平井啓, 志真泰夫, 内富庸介

日本サイコオンコロジー学会総会プログラム・抄録集　2008
地域住民の緩和ケアの利用に対する準備性と各種メディアに対する信頼性OPTIM study

平井啓, 工藤直志, 塩崎麻里子, 山木照子, 秋山美紀, 的場元弘, 宮下光令, 森田達也, 秋月伸哉, 白髭豊, 江口研二

日本緩和医療学会学術大会プログラム・抄録集　2008
全国のがん診療連携拠点病院における緩和ケアチーム(PCT)の実態調査

宮下光令, 森田達也, 三澤知代, 佐藤一樹, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2008
がん患者と医療者の情報共有ツール「わたしのカルテ」の必要性に関する質問紙調査:OPTIM STUDY

古村和恵, 宮下光令, 森田達也, 山岸暁美, 井村千鶴, 前堀直美, 平山美香, 吉原律子, 秋月伸哉, 志真泰夫, 江口研二

日本緩和医療学会学術大会プログラム・抄録集　2008
遺族の評価による終末期がん患者のQOLを評価する尺度(GDI:Good Death Inventory)の信頼性と妥当性の検証

宮下光令, 森田達也, 佐藤一樹, 平井啓, 志真泰夫, 内富庸介

日本緩和医療学会学術大会プログラム・抄録集　2008
遺族調査からみる臨終前後の家族の経験と望ましいケア:J‐HOPE Study

新城拓也, 森田達也, 宮下光令, 佐藤一樹, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2008
一般市民および地域在住がん患者の療養死亡場所の希望:OPTIM study

山岸暁美, 宮下光令, 森田達也, 秋月伸哉, 秋山美紀, 白髭豊, 吉田沙蘭, 江口研二

日本緩和医療学会学術大会プログラム・抄録集　2008
ホスピス・緩和ケア病棟に関する望ましい情報提供のあり方:J‐HOPE Study

三條真紀子, 森田達也, 宮下光令, 佐藤一樹, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2008
緩和ケアに対する医療者の知識・態度・困難度を評価する尺度の作成と信頼性・妥当性の検証

中澤葉宇子, 宮下光令, 森田達也, 梅田恵, 大谷木靖子, 小笠原利枝

日本緩和医療学会学術大会プログラム・抄録集　2008
がん診療連携拠点病院における緩和ケアチームメンバーの緩和ケア提供に対する自己評価の実態

三澤知代, 宮下光令, 佐藤一樹, 森田達也, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2008
地域の医師・看護師の緩和医療の提供に関する自信および困難感OPTIM study

宮下光令, 森田達也, 市川尭之, 秋月伸哉, 秋山美紀, 白髭豊, 江口研二

日本緩和医療学会学術大会プログラム・抄録集　2008
遺族調査の結果からみた緩和ケアチームの介入時期と有用性:J‐HOPE study

藤本亘史, 森田達也, 宮下光令, 佐藤一樹, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2008
ホスピス・緩和ケア医療への入院を検討する時期の家族のつらさと望ましいケア:J‐HOPE Study

三條真紀子, 宮下光令, 森田達也, 佐藤一樹, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2008
がん診療連携拠点病院緩和ケア提供機能に関する薬剤業務の実態調査(1)

杉浦宗敏, 宮下光令, 佐藤一樹, 森田達也, 恒藤暁, 的場元弘, 佐野元彦, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2008
日本人にとっての望ましい死―終末期がん患者のQOLとスピリチュアリティー―

宮下光令

日本緩和医療学会学術大会プログラム・抄録集　2008
遺族の後悔に影響するホスピス・緩和ケア病棟への入院に関する意思決定要因の探索:J‐HOPE Study

塩崎麻里子, 平井啓, 道家瑠見子, 森田達也, 宮下光令, 佐藤一樹, 恒藤暁, 志真泰夫

日本緩和医療学会学術大会プログラム・抄録集　2008
一般市民のがん医療に対する安心感および医療用麻薬・緩和ケア病棟に対する認識OPTIM study

宮下光令, 森田達也, 吉田沙蘭, 三條真紀子, 秋月伸哉, 秋山美紀, 白髭豊, 江口研二

日本緩和医療学会学術大会プログラム・抄録集　2008
外来通院神経筋疾患患者の疼痛と健康関連QOLに関する実態調査

阿部吉樹, 宮下光令, 伊藤直美, 数間恵子

日本看護科学学会学術集会講演集　2007/11
網膜硝子体手術後の安全で確実な自己点眼指導の検討

新井崇子, 岸田由希, 宮下光令

日本看護学会抄録集成人看護2　2007/08/28
父親への退院指導による効果の検証

永井裕子, 江本明美, 坂元由紀子, 宮下光令

日本看護学会抄録集母性看護　2007/07/26
点滴スタンドに関わる事故を減少させるための院内パンフレットの作成とその効果の検証

上原訓子, 福里希海, 前中春美, 宍戸理恵, 石井敦子, 磯脇秀子, 宮下光令

東京都看護協会看護研究学会プログラム・演題集録　2007
診療記録から抽出する緩和ケアの質の指標(Quality Indicator)の同定:デルファイ変法による検討

宮下光令, 中村明澄, 森田達也, 尾藤誠司

日本緩和医療学会総会プログラム・講演抄録集　2007
STAS‐J症状版の作成と評価者間信頼性の検討

宮下光令, 安田恵美, 馬場玲子, 岩瀬哲, 寺本量子, 中川恵一, 木澤義之, 志真泰夫

日本緩和医療学会総会プログラム・講演抄録集　2007
大腸内視鏡検査中の苦痛に関連する要因の検討及び看護介入の有効性の検討

田代さとみ, 宮下光令

東京都看護協会看護研究学会プログラム・演題集録　2007
白血病/悪性リンパ腫患者の終末期の症状・治療内容の実態

白井由紀, 宮下光令, 河正子, 本倉徹, 佐野文明, 福田哲也, 押味和夫, 数間恵子

日本緩和医療学会総会プログラム・講演抄録集　2007
手術前日入院患者の手術前心理状態と手術前オリエンテーションの効果を知る

和田幸枝, 高田岬, 上野早苗, 宮下光令

東京都看護協会看護研究学会プログラム・演題集録　2007
ICU(集中治療室)における終末期ケア困難感尺度の信頼性妥当性

木下里美, 宮下光令

日本緩和医療学会総会プログラム・講演抄録集　2007
心理的適応を測定する尺度NAS‐J変形性股関節症版の作成

小山友里江, 宮下光令, 鈴鴨よしみ, 数間恵子

日本看護科学学会学術集会講演集　2006/11
質の高い緩和ケアを日本全国に普及させるために取り組むべき課題―日本緩和医療学会,日本ホスピス緩和ケア協会会員を対象とした調査―

宮下光令, 三條真紀子, 森田達也, 木澤義之, 志真泰夫, 下山直人, 恒藤暁, 平賀一陽, 平井啓, 佐藤一樹, 内富庸介

日本緩和医療学会総会プログラム・講演抄録集　2006
終末期がん患者における在宅緩和ケア移行に向けての現状と課題

前山悦子, 河正子, 玉井照枝, 成田憲史, 宮下光令, 数間恵子, 岡部健

日本緩和医療学会総会プログラム・講演抄録集　2006
一般集団における終末期在宅療養の実現可能性とその関連要因

佐藤一樹, 宮下光令, 森田達也, 鈴木雅夫

日本緩和医療学会総会プログラム・講演抄録集　2006
わが国における終末期のQOL (3) 終末期ケアに関する選好とその関連要因―一般集団・緩和ケア遺族を対象とした全国調査―

三條真紀子, 宮下光令, 森田達也, 平井啓, 河正子, 内富庸介

日本緩和医療学会総会プログラム・講演抄録集　2006
大学病院の緩和ケアチームに求められる支援―がん患者の退院時における動態・意識調査―

橋口さおり, 木村理恵子, 茶園美香, 須山郁子, 中村直行, 津崎晃一, 武田純三, 宮下光令, 佐藤一樹, 大西幸, 小杉志都子

日本緩和医療学会総会プログラム・講演抄録集　2006
わが国における終末期のQOL (2) 終末期のQOLの概念化―一般集団・緩和ケア遺族を対象とした全国調査―

宮下光令, 三條真紀子, 平井啓, 森田達也, 内富庸介

日本緩和医療学会総会プログラム・講演抄録集　2006
一大学病院における緩和ケアチームの支援内容―参加観察による質的分析―

笹原朋代, 梅田恵, 樋口比登実, 篠田淳子, 三條真紀子, 宮下光令, 河正子

日本緩和医療学会総会プログラム・講演抄録集　2006
遺族による東大病院緩和ケア病床のケア評価

梅内美保子, 宮下光令, 小川幸恵, 川原睦実, 河正子, 中川恵一

日本緩和医療学会総会プログラム・講演抄録集　2006
わが国における終末期のQOL (1) 終末期のQOLの構成要素

平井啓, 宮下光令, 三条真紀子, 森田達也, 内富庸介

日本緩和医療学会総会プログラム・講演抄録集　2006
一大学病院における緩和ケアチームの活動評価

笹原朋代, 梅田恵, 樋口比登実, 篠田淳子, 宮下光令, 河正子

日本緩和医療学会総会プログラム・講演抄録集　2005
緩和ケア病棟における在宅移行割合とその関連因子についての分析

荒井和子, 宮下光令, 笹原朋代, 山田陽介, 大和田真知子, 河正子, 向山雄人

日本緩和医療学会総会プログラム・講演抄録集　2005
在宅終末期がん患者家族員(主介護者)の看取り体験の実態

羽佐田知美, 前山悦子, 白井由紀, 河正子, 日野真理子, 玉井照枝, 宮下光令, 数間恵子, 岡部健

日本緩和医療学会総会プログラム・講演抄録集　2005
わが国における緩和ケアチームの実態調査―第2報

西田茂史, 木村理恵子, 河正子, 宮下光令, 笹原朋代, 白井由紀, 黒子幸一, 斉藤真理, 白土辰子, 高宮有介

日本緩和医療学会総会プログラム・講演抄録集　2005
保存療法を受けている変形性股関節症患者のQuality of Lifeに関する研究

小山友里江, 宮下光令, 入江慎治, 数間恵子

日本看護科学学会学術集会講演集　2004/12/04
外来通院中にオピオイド投与が開始されたがん性とう痛患者のとう痛マネジメント

木村理恵子, 橋口さおり, 宮下光令, 白井由紀, 笹原朋代, 河正子, 数間恵子

日本緩和医療学会総会プログラム・講演抄録集　2004/06/17
糖尿病食事関連QOLに関わる要因の探索

佐藤栄子, 宮下光令, 数間恵子

日本看護科学学会学術集会講演集　2003/12/06
在宅療養早期の終末期がん患者の在宅療養継続意思と介護者の在宅介護継続意思の検討

今村由香, 宮下光令, 河正子, 数間恵子, 岡本直幸

日本公衆衛生学会総会抄録集　2003/10/15
白内障手術におけるリスクマネージメント

矢野里香, 山口ゆき, 宮嶋富美子, 山本真由美, 鈴木めぐみ, 宮下光令

関東甲信越地区看護研究学会　2003/09
C型肝炎から肝細胞癌に移行し局所療法を受けている患者のQOL

岡村幸恵, 高橋洋美, 長田鮎美, 高嶋佳代, 安部崇子, 佐藤登貴江, 宮下光令

日本看護学会抄録集成人看護2　2003/08/28
C型肝炎から肝細胞癌に移行し局所療法を受けている患者のQOL

岡村幸恵, 高嶋佳代, 高橋洋美, 長田鮎美, 安部崇子, 佐藤登貴江, 宮下光令

日本看護学会論文集成人看護2　2003
光照射が入院患者の睡眠に与える効果

関根麻子, 奥加奈子, 大浦恵子, 矢内富江, 大森明子, 宮下光令

日本看護学会抄録集成人看護2　2002/08/29
よい緩和ケア・ホスピスケアの認識度に関する調査結果

安達勇, 田中桂子, 大坂巌, 西崎久純, 林佐保里, 田島絹子, 宮下光令, 平井啓

日本緩和医療学会総会プログラム・講演抄録集　2002/06/28
終末期がん患者の在宅緩和ケア実践の実態と推進課題

今村由香, 小沢竹俊, 杉下知子, 宮下光令, 河正子

日本緩和医療学会総会プログラム・講演抄録集　2002/06/28
一般病院における終末期がん患者のケアに対する看護職の困難感と関連要因

笹原朋代, 佐藤一樹, 宮下光令, 河正子, 数間恵子

日本緩和医療学会総会プログラム・講演抄録集　2002/06/28
ホスピス・緩和ケア施設における多職種が参加するチームケアの現状

前山悦子, 小沢竹俊, 中神百合子, 二見典子, 宮下光令, 今村由香, 河正子

日本緩和医療学会総会プログラム・講演抄録集　2002/06/28
心臓血管外科患者のじょくそう発生要因

山口真美子, 熊谷恵, 小林純子, 小西香子, 小宮山一枝, 小松崎知子, 宮下光令

日本看護学会抄録集成人看護1　2001/09/25
わが国の看護研究の研究デザインと統計手法の集計

宮下光令, 笹原朋代, 数間恵子

日本看護科学学会学術集会講演集　2000/12/08
オストメイトのQOL測定

伊藤直美, 宮下光令, 河正子

日本ストーマリハビリテーション学会誌　2000/07/30
保健医療福祉の地域指標の開発第5報指標の妥当性に関する調査

林正幸, 宮下光令, 橋本修二, 尾島俊之, 中村好一, 加藤昌弘, 松村康弘, 福富和夫

日本公衆衛生学会総会抄録集　1999/10/15
保健医療福祉の地域指標の開発第6報要介護者割合と平均自立期間の性質

宮下光令, 橋本修二, 尾島俊之, 中村好一, 林正幸, 加藤昌弘, 松村康弘, 福富和夫

日本公衆衛生学会総会抄録集　1999/10/15
入院時接遇に対する患者の意識と満足度に関する研究

森山ひとみ, 酒井百合子, 浦英子, 小野沢祐子, 宮下光令

日本看護学会抄録集看護管理　1999/10/07
Phase I/II study of vinorelbine, mitomycin, and cisplatin for stage IIIB or IV non-small-cell lung cancer

Kiyoyuki Furuse, Masaaki Kawahara, Yutaka Nishiwaki, Masahiro Fukuoka, Minoru Takada, Mitsunori Miyashita, Yasuo Ohashi

Journal of Clinical Oncology　1999/01/01

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Purpose: To determine the maximum-tolerated doses (MTDs) of vinorelbine (VRB), mitomycin (MMC), and cisplatin (P), given in two courses every 28 days to previously untreated patients with stage IIIB or IV non-small-cell lung cancer (NSCLC). Patients and Methods: At least three or four patients were entered at each dose level. The starting dose was 20 mg/m2for VRB on days 1 and 8 and 4 mg/m2for MMC on day 1, with a fixed dose of P 80 mg/m2on day 1 every 4 weeks. MMC was increased to 6 mg/m2at dose level 2 and subsequently to 8 mg/m2at dose level 4. At dose level 3, VRB was increased to 25 mg/m2. Twenty-five patients were entered onto the phase I study and 19 patients were entered onto phase II study. Results: Nadir leukocyte and platelet counts decreased at each dose level. At dose levels 1 and 2, the dose-limiting toxicity (DLT) was not seen, but at dose levels 3 and 4, DLT was encountered in two patients. Nearly half the patients at dose level 4 had dose reduction due to grade 4 leukopenia. A mathematic model of all toxicity suggested that dose level 4 (VRB 25 mg/m2on days 1 and 8 and MMC 8 mg/m2and P 80 mg/m2on day 1, every 4 weeks) would be the recommended dose for phase II study at which grade 4 toxicity is expected in ≤ 25% of patients over two courses. Of the 25 assessable patients in the phase I study, 13 achieved a partial response and one had a complete response for a response rate of 56.0%. Of the 19 assessable patients in the phase II study, 12 had a partial response (63.2%; 95% confidence interval, 38.4% to 83.7%). Grade 3 and 4 leukopenia was observed in 19 (100%), and grade 3 thrombocytopenia was seen in seven (36.8%). Median survival time was 10.7 months and the 1-year survival rate was 43.2% in the 44 assessable patients. Conclusion: The VRB/MMC/P regimen is effective against NSCLC, and its efficacy should be confirmed through a randomized study.
保健医療福祉の地域指標の開発第3報地域のニーズ調査

林正幸, 橋本修二, 宮下光令, 尾島俊之, 中村好一, 加藤昌弘, 福富和夫

日本公衆衛生学会総会抄録集　1998/10
保健医療福祉の地域指標の開発第2報指標とその精度,地域間差

中村正子, 尾島俊之, 中村好一, 橋本修二, 宮下光令, 林正幸, 加藤昌弘, 福富和夫

日本公衆衛生学会総会抄録集　1998/10
保健医療福祉の地域指標の開発第4報要介護者割合の算定

宮下光令, 橋本修二, 尾島俊之, 中村好一, 林正幸, 加藤昌弘, 福富和夫

日本公衆衛生学会総会抄録集　1998/10
保健医療福祉の地域指標の開発第1報開発の流れと提案

橋本修二, 宮下光令, 尾島俊之, 中村好一, 林正幸, 加藤昌弘, 福富和夫

日本公衆衛生学会総会抄録集　1998/10

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Research Projects 54

がん患者への緩和ケアにePROを活用するシステム構築に関するランダム化比較試験

伊藤奈央, 宮下光令

Offer Organization: 日本学術振興会

System: 科学研究費助成事業

Category: 基盤研究(C)

Institution: 岩手医科大学

2025/04/01 - 2029/03/31
Development of a Long-Term Support Model for Preventing Prolonged Grief Disorder among Bereaved Families in the Emergency Departments

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Scientific Research (C)

Institution: Shinshu University

2024/04/01 - 2027/03/31
Usefulness of artificial endocrine pancreas with closed-loop glycemic control system in patients undergoing cardiovascular surgery: a prospective randomized controlled trial

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Scientific Research (B)

Institution: Tohoku University

2023/04/01 - 2027/03/31
心臓外科領域の周術期看護における新たな血糖管理方法の包括的検証：無作為化比較試験

佐々木康之輔, 前田恵, 齋木佳克, 宮武ミドリ, 宮下光令

Offer Organization: 日本学術振興会

System: 科学研究費助成事業

Category: 基盤研究(B)

Institution: 東北大学

2023/04/01 - 2027/03/31
高齢者施設における終末期ケアの質改善に向けた介入プログラムの開発

廣岡佳代, 深堀浩樹, 宮下光令

Offer Organization: 日本学術振興会

System: 科学研究費助成事業

Category: 基盤研究(C)

Institution: 東京医科歯科大学

2022/04/01 - 2027/03/31
Development of telehome Monitoring-based system that contributes to the prevention and early detection of complications in patients with implantable ventricular assist devices.

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Challenging Research (Exploratory)

Institution: Tohoku University

2023/06/30 - 2026/03/31
Implementation and Evaluation of the Japanese ACP Model to Value Patients' Wishes: A Randomized Controlled Trial

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Scientific Research (B)

Institution: Kyoto University

2022/04/01 - 2026/03/31
International multicenter study on palliative sedation for terminally ill patients

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Scientific Research (B)

Institution: Kyoto University

2022/04/01 - 2026/03/31
A study to establish evidence on terminally ill patients using real-word data

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Challenging Research (Pioneering)

Institution: Kyoto University

2021/07/09 - 2026/03/31
高齢者施設・住まいにおける避けられる救急搬送・入院を削減する複雑介入の開発

深堀浩樹, 遠藤拓郎, 井上修一, 大河原啓文, 山岸暁美, 松本佐知子, 山川みやえ, 那須佳津美, 宮下光令, 真志田祐理子, 宮川祥子

Offer Organization: 日本学術振興会

System: 科学研究費助成事業

Category: 基盤研究(B)

Institution: 慶應義塾大学

2024/04/01 - 2025/03/31
自然言語処理を用いた電子カルテからの緩和ケアのQuality Indicatorの算出

宮下光令, 中山雅晴, 升川研人, 横田慎一郎

Offer Organization: 日本学術振興会

System: 科学研究費助成事業

Category: 挑戦的研究(萌芽)

Institution: 東北大学

2023/06/30 - 2025/03/31
IT技術を活用し高齢患者から患者報告型アウトカムを簡便に収集する方法の開発

宮下真子, 宮下光令

Offer Organization: 日本学術振興会

System: 科学研究費助成事業

Category: 基盤研究(C)

Institution: 東北文化学園大学

2022/04/01 - 2025/03/31
Regional disparity between end-of-life care: epidemiological research using big data

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Scientific Research (C)

Institution: Nagoya University

2021/04/01 - 2025/03/31
患者報告型アウトカムの臨床活用の有効性を検証するクラスター・ランダム化比較試験

宮下光令, 田村恵子, 青山真帆, 堀江良樹, 山口拓洋, 森田達也

Offer Organization: 日本学術振興会

System: 科学研究費助成事業

Category: 基盤研究(B)

Institution: 東北大学

2021/04/01 - 2025/03/31

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海外では患者報告型アウトカム（PRO: Patient Reported Outcome）の日常的な臨床活用の有効性が検証されているが、わが国ではPROの日常的な臨床活用は普及していない。本研究では緩和ケア病棟・ホスピス住宅・外来化学療法の3つの臨床セッティングにおいて、それぞれ独立したStepped-Wedgeクラスター・ランダム化比較試験を実施し、日常的にPROを臨床活用することの有効性の検証を行う予定である。 2021年度は当初の予定では緩和ケア病棟・ホスピス住宅においてパイロット調査を行い、本調査の方法の計画を確定させる予定であった。それぞれ患者報告型アウトカムはIPOS（Integrated Palliative Care Outcome Scale）を使用し、評価項目としてEORTC-QLQ-C15PALおよび患者とスタッフのコミュニケーションを測定する尺度を利用する予定である。パイロット調査対象施設に訪問し、現場スタッフとの議論によって調査計画を確定し、研究倫理審査の承認が得られた。しかし、COVID-19によりパイロットを予定していたホスピス住宅に外部の研究者が入ることが困難になり、また、パイロットを予定していた緩和ケア病棟はCOVID-19により病棟閉鎖になったため、パイロット試験を行うことができなかった。すでにパイロット調査の準備はできているため、次年度に研究者が施設に入ることが可能になり次第、パイロット調査を実施する予定である。研究全体の進捗もCOVID-19の感染流行状況次第ではあるものの、1~2年遅れる見込みである。
専門家レベルの緩和ケアAIプログラムの開発と検証～終末期の苦痛を一掃する

森雅紀, 山口崇, 田村恵子, 山口拓洋, 木澤義之, 宮下光令, 田上恵太

Offer Organization: 日本学術振興会

System: 科学研究費助成事業

Category: 挑戦的研究(開拓)

Institution: 聖隷クリストファー大学

2020/07/30 - 2025/03/31

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超高齢多死社会を迎えた日本では、緩和ケアを全国に普及させる画期的な手段の開発が求められる。本研究では、多くの終末期患者の苦痛を緩和するAIプログラムを開発する。令和3年度までは、最近のAI研究に関する文献・書籍をレビューし、AI研究に関わる医療者・研究者と情報共有を行うことで、緩和ケアへのAIの活用に関する現状把握を行ってきた。緩和ケア専門家の推奨は多岐にわたるが、そのようなAIプログラムの開発や類する研究は先例がないことを確認した。したがって、大規模にデータを取得するに先立ち、対象となる苦痛を絞り、想定したデータ構造から解析が可能か、臨床的に意味のある結果が抽出できるかを検討するパイロットが必要であることを確認した。国内外において特に終末期に頻度が高く、十分な緩和が得られていない苦痛として、痛みと呼吸困難を主な対象とすることを検討した。令和3年度は、痛みに対する専門的緩和ケアのデータをAI開発のパイロットとして取得した。多施設の緩和ケアチーム・緩和ケア病棟で痛みに対して専門的な治療を行った424人の患者を対象に計1498日分のデータを収集した。入力用のデータとして、登録時情報から得られる変数（74種類）と毎日記載の調査票から得られる変数（AIデータ含め35種類）を用いた。出力用のデータとして行うべき緩和ケアの推奨リストを取得した（16種類）。ランダムフォレスト、勾配ブースティング回帰木、ロジスティック回帰による多クラス分類、ニューラルネットワークの手法を用いて、インプットからアウトプットの予測精度を確認した。その結果、各出力データの出現頻度は概ね低く手法を問わず予測精度は大差ないこと、その中でも頻度が比較的高い項目が本試験での出力データの候補になるという見通しをつけた（定時オピオイドの増量、オピオイドの変更、非オピオイドの使用、鎮痛補助薬の使用など）。
高齢者施設・住まいにおける避けられる救急搬送・入院を削減する複雑介入の開発

深堀浩樹, 宮川祥子, 遠藤拓郎, 井上修一, 山岸暁美, 山川みやえ, 宮下光令

Offer Organization: 日本学術振興会

System: 科学研究費助成事業

Category: 基盤研究(B)

Institution: 慶應義塾大学

2020/04/01 - 2025/03/31

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本研究では、高齢者施設・住まい（特別養護老人ホームや介護付き有料老人ホーム）からの避けられる救急搬送・入院を削減するための、多職種および入居者・家族を対象とした複数の要素からなる介入（複雑介入：Complex Intervention）を開発して介入研究を行い、有用性と実行可能性を検討する。今年度までの研究実績として、高齢者施設・住まいからの避けられる救急搬送・入院を予防するための看護師の実践に関するインタビュー調査を行った。インタビュー調査の成果は、今後学術誌へ投稿する予定である。また、インタビューの結果を踏まえて多職種の研究組織による介入ツールの開発に着手しており、現在開発段階にある。次年度は、介入ツールの開発の継続と、介入対象者による実施可能性の検討、対象施設のリクルート、フィールド調整、研究デザインの構築を実施し、その後の介入の実行可能性調査、専門職からの評価、介入研究による効果の検証につなげる。介入ツールの開発のために必要な高齢者施設・住まいの入居者・家族・施設職員への介入ツールについての調査・研究も実施する予定である。さらに、介入ツールの開発と並行し、開発した介入ツールを公開するためのWebページを作成した。開発した介入ツールは順次Webページにアップロードし更新していく予定である。
ICU・ERにおける緩和ケアアンメットニーズ解消ケアプログラムの開発

加藤茜, 木澤義之, 山勢博彰, 宮下光令

Offer Organization: 日本学術振興会

System: 科学研究費助成事業

Category: 基盤研究(C)

Institution: 信州大学

2021/04/01 - 2024/03/31

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研究課題であるICU・ERにおける緩和ケアのアンメットニーズを調査するに先立ち、まずは現状どの程度ICUやERで医療を受ける患者やその家族が医療に満足しているのかを明らかにする必要があると考えた。そのため、2021年度はICUにおける患者満足度を測定する尺度の日本語版作成に取り組んだ。作成者より翻訳許可を得たうえで、トランスレーション・バックトランスレーションを行った。その後、クリティカルケアに精通しているエキスパートを多職種から抽出し、エキスパートパネルを実施した。エキスパートパネルにより、項目修正を行い、再度バックトランスレーションを行い、作成者に確認を行った。次の段階として、医療者・非医療者を対象に意味の了解さ、回答の容易さを調査し、1回修正を行った。その後、バイリンガルテストを海外で勤務している医師・看護師・理学療法・助産師など計５名に対して実施し、日本語版と英語版の回答の一致率を確認した。重みづけΚ係数は0.52と中程度であることが確認できた。現在は、次の段階としてICUの患者を中心にパイロット調査を行う準備を進めている段階である。なお、ICUやERの患者特性を配慮し、家族代理評価可能性も同時に検証する予定である。くわえて、クリティカルケア領域は患者に意識がなく、家族が代理意思決定などを行うことも少なくない。そのため、患者とは独立して家族の視点から患者満足度を評価してもらい、患者との一致率を確認することで家族の代理評価可能性も一緒に検証することを予定している。このパイロット調査が終了次第、全国のICUやERにおいて調査を行うとともに、評価が低かった患者やその家族から聞き取り調査を行い、満足できなかった要因を明らかにしていく計画である。
進行性疾患の患者と家族の食に関する苦悩への心理社会的アプローチと多職種連携ケア

天野晃滋, 小山田隼佑, 宮下光令

Offer Organization: 日本学術振興会

System: 科学研究費助成事業

Category: 基盤研究(C)

Institution: 国立研究開発法人国立がん研究センター

2021/04/01 - 2024/03/31

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進行がん患者と家族の食に関する苦悩の評価尺度開発の最終解析を終えて論文化を進めている。既存のがん悪液質のQOL尺度であるFunctional Assessment of Anorexia/Cachexia Therapy Anorexia Cachexia Subscale (FAACT ACS)を用い、日本の進行がん患者を評価した論文をJCSM Rapid Communications（英文・査読あり）に投稿し受理された。進行がん患者の点滴での栄養水分補給に関する信念と認識についての多施設アンケート調査をPalliative Medicine Reports（英文・査読あり）に投稿中である。また、全国のがん診療連携拠点病院の医療者（医師・薬剤師・看護師・管理栄養士・リハビリ療法士・心理士・ソーシャルワーカー）を対象に、がん悪液質の多職種ケアの認識について調査を実施し、論文化を進めている。これらの結果をもとにがん悪液質の患者と家族に対する多職種ケアの開発を進めていく。
Effectiveness of good death care pathway on patient quality of death and dying

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Scientific Research (B)

2020/04/01 - 2024/03/31
自然言語処理を用いた身体的・精神的・社会的・スピリチュアルな苦痛の評価

宮下光令, 田辺公一, 青山真帆, 中山雅晴, 嶋田和貴, 横田慎一郎

Offer Organization: 日本学術振興会

System: 科学研究費助成事業

Category: 挑戦的研究(萌芽)

Institution: 東北大学

2021/07/09 - 2023/03/31

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がん患者は痛みなどの身体的苦痛、不安や抑うつなどの精神的苦痛、仕事や家庭の問題などの社会的苦痛、生きる意味や死の恐怖などのスピリチュアルな苦痛といった相互に関連する苦痛を抱えている我々はすでに自然言語処理を用いて電子カルテデータから身体的苦痛の有無の評価には施行していたが、身体的苦痛や精神的苦痛の強さの評価、社会的・スピリチュアルな苦痛の有無の評価は未解決であった。そこで、本研究では自然言語処理を用いて電子カルテデータからがん患者の身体的・精神的・社会的・スピリチュアルな苦痛の強さをリアルタイムに評価するシステムの開発に挑戦している。本年度は、自然言語処理を用いて電子カルテデータからがん患者の身体的・精神的・社会的・スピリチュアルな苦痛の有無を評価するシステムの開発を行った。データは2018年~2020年の東北大学病院入院・外来のがん患者の診療記録であり、前処理を行ったのちに、プログラミング言語Python、Googleで開発され自然言語領域における性能の高さが注目されているBERTなどを用いた自然言語処理および機械学習により分析した。結果として、がん患者の身体的・精神的苦痛の強さを評価すること、社会的・スピリチュアルな苦痛の有無を判定するシステムの開発に成功した。海外の先行研究では、身体症状の抽出のみにとどまっており、同じデータを用いて社会的苦痛やスピリチュアルな苦痛に拡大することは、世界でも初めての成果と考えられる。次年度は社会的・スピリチュアルな苦痛の強さの評価と身体的・精神的苦痛のデータを含めた経時データ分析、これらをリアルタイムに評価するシステムの開発に挑戦する予定である。
終末期がん患者の倦怠感軽減ケアプログラムの開発と臨床応用

細川舞, 宮下光令, 柏葉英美, 高屋敷麻理子

Offer Organization: 日本学術振興会

System: 科学研究費助成事業

Category: 基盤研究(C)

Institution: 岩手県立大学

2020/04/01 - 2023/03/31

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終末期のがん患者は，様々な影響によりがんに関連した倦怠感（cancer-related fatigue：CRF）が生じている．死亡直前期には95％以上の終末期がん患者がCRFを経験しているといわれているため，その症状緩和は，患者のQOLを保つためにも重要なケアである．本研究の目的は，終末期がん患者のCRF軽減のための，足浴およびハンドケア介入について，臨床研究の相に沿って，ランダム化比較試験（RCT）（第Ⅰ～Ⅲ相）で比較し，効果を検証することを目的とする．また，臨床応用できるように看護師向け教育材料を作成し，その効果についてランダム化比較試験(第Ⅳ相)を行い一般化および普及可能性についても検証することを目的としている． 2021年度は，2名の調査を実施したが，調査実施施設の新型コロナウイルス感染症の流行状況により，一時中断となっている．効果を示すことができるだけのデータの築盛をすることはできなかったが，ケア介入実施後の対象者の反応として，ケアに対する好印象な意見が聞かれた．また倦怠感評価尺度では，ケア後の倦怠感数値の減少があった．今後はさらに調査実施を進めていく．
非がん高齢患者に対する患者立脚型緩和ケアアウトカム尺度IPOSの信頼性・妥当性

宮下真子, 尾崎章子, 宮下光令

Offer Organization: 日本学術振興会

System: 科学研究費助成事業

Category: 基盤研究(C)

Institution: 東北文化学園大学

2019/04/01 - 2023/03/31

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IPOS（Integrated Palliative care Outcome Scale）は国際的に広く用いられている緩和ケアの患者報告型アウトカム尺度であり、スタッフ版も用意されている。わが国ではがん患者を対象にした信頼性・妥当性の検討が既に終了している。本研究の目的はIPOSの非がん患者に対する信頼性・妥当性の検討である。 2019年度は研究計画書を作成し、東北大学大学院医学系研究科倫理委員会倫理委員会の承認を受けたのちに、まず、エキスパートパネルによるIPOSの非がん患者への適用についての検討を行ったのちに、慢性心不全、COPD、慢性肝不全、腎不全、神経難病、フレイルなどで予後が1年以内と予測される非がん患者とその患者を看護する看護師を対象にパイロット調査を実施した。 2020年度はこのパイロット調査の結果を踏まえて修正したIPOS調査票および作成したIPOS使用マニュアルを用いて慢性心不全、COPD、慢性肝不全、腎不全、神経難病、フレイルなどの非がん患者を対象に信頼性・妥当性検討の本調査を開始した。COVID-19の影響で調査フィールドに入ることが困難な施設が多く、現時点での症例集積状況は120例にとどまっている。200例以上の症例集積を目標に現在も新規施設の開拓、倫理申請などを行い、症例集積を続けている。COVID-19の感染拡大が収束しないために目標症例に達成するまでに時間を要したため、集積した症例の解析が期間内に終了できなかった。このため、次年度まで研究機関を延長することになった。
がん患者の家族に対する「死別と喪失の準備」に関する支援モデルの開発

安藤詳子, 杉田豊子, 杉村鮎美, 佐藤一樹, 門林道子, 宮下光令

Offer Organization: 日本学術振興会

System: 科学研究費助成事業

Category: 基盤研究(C)

Institution: 名古屋大学

2019/04/01 - 2023/03/31

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がん年間死亡者数は増え続け、がん患者の家族は、患者の余命を告知され死別の刻を覚悟しつつ喪失の悲嘆を感じながら、葬儀や相続のこと、家族のこれからを心配している。病棟看護師は家族の状況や気持ちを配慮し手助けできる立場に在り、また、がん相談支援センターMSWとの連携で、死別に向けてより具体的に家族を支援できると考える。本研究は、その可能性に着目し支援モデルの開発を目指した。初年度、計画通り、全国のがん診療連携拠点病院の病棟看護師とがん相談支援センター相談員に自記式質問紙調査を実施した。病棟看護師の分析から「看護師主体」と「看護師と他職種の連携」による家族支援に大きく2分された支援の構造を見出し、因子との関連要因について、コミュニケーションスキル・認定看護師/専門看護師への相談・がん専門相談員との連携・医師との協働等を明らかにした。 2年目、予定の病棟看護師・ＭＳＷグループインタビューはCovid-19の影響で実施できず、初年度末に実施したがん専門相談員(看護師・MSW)の調査解析を進めた。 3年目、予定通り、J-HOPE研究2018結果と本調査結果を照合し、社会学者の見地から死別と喪失に関する社会学的解釈を試みた。著書「成人がん看護学」の第7章における「2.がん患者の家族に対する“死別と喪失”に向けた準備に関する支援(2-1.患者の予後を理解するための支援)(2-2.療養場所の選択に関わる支援)(2-3.死別に伴う手続きや死別後の悲嘆への支援)(2-4.家族と患者の関係性を強める支援)(2-5.家族を気遣い安心感と信頼をもたらす支援)(2-6.家族の悲嘆反応を考慮し、環境を整え傾聴して関わる支援)(2/7.家族自身のための時間を大切にし、患者と共に過ごせるような支援)(2-8.家族が見取りに際し十分にお別れできるような支援)」「3.死別の悲しみから生きる力へ」に構成して論述した。
アドバンス・ケア・プランニングを始める時期が客観的にわかる方法の開発と効果の検証

浜野淳, 香川璃奈, 讃岐勝, 山口拓洋, 竹内文乃, 宮下光令, 森田達也

Offer Organization: 日本学術振興会

System: 科学研究費助成事業

Category: 基盤研究(B)

Institution: 筑波大学

2019/04/01 - 2023/03/31

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本研究は、進行がん患者に対してACPを開始する適切なタイミングが判断できる予後予測指標の開発と効果の検証を行う。本研究の研究課題は以下の3つである。①血液検査データのみを用いて、進行がん患者の生命予後30日・60日・90日を高い精度で予測する指標を開発・検証する。（すでに申請者らが実施可能であるFractional polynomial modelという方法を用いる）②実際に、開発された指標で予測された個々の患者の生存確率が自動的に電子カルテに表示されるシステムを用いた場合の、臨床的な効果（例：ACP実施率）を検証する。③同じ手法を用いて心不全患者において、客観的に予後が予測できる指標を開発する。 2020年度は、①血液検査データのみを用いて、進行がん患者の生命予後30日・60日・90日を高い精度で予測する指標を開発・検証するという研究課題について、約2000人の進行がん患者のデータをFractional polynomial modelで解析した。その結果、申請者らが以前に異なるデータベースを用いて開発・検証した時と同等の精度を持つ生命予後予測モデルを開発することができた。この結果、血液検査データのみを用いて、精度の高い生命予後予測モデルを開発する手法が確立したと考えられた。また、この手法を用いることによって、生命予後だけでなく、身体機能予後の予測も可能になると考えられた。よって、2021年度は、実臨床における臨床的な効果を測定する方法の開発・検証、心不全患者など進行がん患者以外の患者において、精度の高い予後予測モデル開発の検証、そして、発展的に身体機能予後の予測方法について検証していく。
International study on pallaitive sedation in terminally ill patients

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Scientific Research (B)

Institution: Kyoto University

2019/04/01 - 2023/03/31
Development of a support group program for bereaved families who lost their spouse to cancer

Watanabe Miwa

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Scientific Research (C)

2018/04/01 - 2022/03/31

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The purpose of this study was to develop a support group program for bereaved families who lost their spouses to cancer. The bereaved family questionnaire survey was conducted on 187 hospice and palliative care units. The investigation revealed relationships between post-bereavement coping behaviors of families who have lost spouses to cancer and complicated grief and major depressive disorder. In addition, the current status and needs of bereaved family care have been clarified. Literature studies have revealed summary in domestic and international support group programs. Based on the results, we created a draft support group program for the bereaved family who lost their spouse to cancer.
Nursing Care Provided to Cancer Patients at the End of Life and bereaved family members' Evaluation of the Quality of Care

Mitsunori Miyashita

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Scientific Research (C)

Institution: Tohoku University

2018/04/01 - 2022/03/31

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This study analyzed a large-scale post-bereavement survey data to examine the relationship between nursing care and the assessment of quality of care. The survey of was conducted from July 2018 to March 2019. The primary results are as follows.(1) Almost all care generally considered desirable for dyspnea in terminal cancer patients was practiced, and bereaved families rated it highly. (2) Bereaved family members of patients with cancer of unknown primary cause were distressed by the following: "I felt flustered because it is difficult to obtain a diagnosis," "It was difficult to obtain information about the patient's disease," and "It was difficult for others to understand the characteristics of the cancer. (3) The depression was higher for those with less favorable family functioning, but it was not associated with grief.
Philosophical development of clinical ethics system and contribution to super-aged society and medical and healthcare education programs

SHIMIZU Tetsuro

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Scientific Research (A)

Institution: Iwate University of Health and Medical Sciences

2018/04/01 - 2022/03/31

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We tried to analyze the ethics in our society using the two principles of human relationship: "live by helping each other" and "live and let live," and recognized that, e.g., Paternalism, besides Aristocracy, was natural and even might have been appropriate in societies where the former principle was dominant, while respect for autonomy is absolutely recognized in those where the latter one is dominant. In Japanese society nowadays, by contrast, a balance between the two principles should be sought, which can be actualized in medical contexts by our version of shared decision-making. "Post healthy life-span" is the period when elderly people are living with frailty. It is said to last for about ten years on average. The period is appropriately understood as "end-of-life period" and advance care planning (ACP) for this period should be promoted. We made support tools for elderly people's ACP, as well as contributed to some authorized guidelines for ACP.
The Innovation of Advance Care Planning with Patients and Families: Supporting Happiness at the End of Life

Mori Masanori

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Scientific Research (B)

Institution: Seirei Christopher University

2018/04/01 - 2022/03/31

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To develop culturally appropriate advance care planning (ACP), we conducted Delphi research on consensus building with researchers from Asian countries. We identified ACP definitions and 84 recommendation items in 6 domains ([Recommended elements of ACP] [Recommended consideration for person-centered and family-based approach in ACP] [Recommended roles and tasks] [Recommended timing of ACP] [Recommended elements of policy and regulation] [Recommended evaluations of ACP]). We showed that ACP that focuses on the individual and considers the family is important in Asia including Japan. Next, we developed a Japanese version of ACP using video in collaboration with patients and their families, and established an online intervention that can be used even in the COVID-19 pandemic. We confirmed its feasibility and usefulness among patients and families, and attempted regional implementation.
Establishment and system development of a nursing quality assessment method to evaluate nursing practice from positive aspects

Takada Nozomu

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Scientific Research (C)

Institution: Tohoku University

2018/04/01 - 2021/03/31

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The purpose of this study was to examine a new method of assessing nursing quality. Considering the fact that nursing quality assessment tends to be biased toward the incidence of negative events as an issue, we attempted to assess nursing quality from positive aspects. As a result, we focused on patient-centeredness, which is one aspect of healthcare quality. The ability of patients to enjoy patient-centered medical care is an important issue for nursing. In order to measure patient-centeredness, the concept of patient experience was introduced. Patient experience is the patient's own assessment of whether or not they have had a desirable experience while receiving medical care. In this research project, we developed a web-based survey system to measure patient experience, and implemented and evaluated the system in a clinical setting.
Survey on quality of end-of-life care and place of death by using nationwide administrative data

Sato Kazuki

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Scientific Research (B)

Institution: Nagoya University

2018/04/01 - 2021/03/31

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We clarified the actual conditions of terminal care and life of non-cancer patients in Japan from NDB sampling dataset and vital statistics. The high level of life-prolonging treatment administered at the end of life of a chronic disease is considered excessive medical care. Life-prolonging treatment was more common for non-cancer diseases compared to cancer. This was particularly common in heart failure, but the mix of acute and chronic disease was a challenge in the evaluation. Palliative treatment was very infrequent outside of cancer. Home deaths show no upward trend for any cause of death other than cancer. Analysis by medical region also showed that only a few medical regions showed an increase in home deaths for causes of death other than cancer.
Combined study of drug therapy for appetite loss and fatigue due to cancer cachexia

Inoue Akira

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Scientific Research (B)

Institution: Tohoku University

2017/04/01 - 2021/03/31

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"Prospective intervention study comparing different dosages of steroid therapy" was conducted in a multicenter collaborative study group (UMIN000022448). Although progress was delayed due to the spread of COVID-19 infection, the trial is scheduled to be completed by the end of this year, and evidence of steroid treatment for anorexia will be established for the first time in Japan. On the other hand, large-scale nationwide registry studies have identified factors that can predict "time to incapacity" and "time to immobility" in end-of-life cancer patients, and research studies include loss of appetite. It was shown that high QOL can be obtained by setting individual goals for each patient and coping with them.
Good Death in people with dementia

Miyashita Mitsunori

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Scientific Research (B)

Institution: Tohoku University

2016/07/19 - 2020/03/31

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The aim of this study was to determine what the Good Death is in people with dementia and whether it is being achieved. As a result of the literature review, interview and questionnaire surveys, the components of Good Death in patients with dementia were categorized into four factors: “comfort, security and safety,” “relationships,” “independence,” and “the ability to maintain their individuality and lack of constraint.” A survey of bereaved families found that, overall, Good Death was more frequently achieved in people with dementia.
Developing an integrated care pathway for end-of-life care in long term care facilities

FUKAHORI Hiroki

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Challenging Exploratory Research

2016/04/01 - 2020/03/31

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We have developed an intervention to improve end-of-life (EOL) care in long-term-care facilities, including fee-based homes for elderly. The intervention is named the EOL Care Tool. The EOL Care Tool consisted of four components: end-of-life care education, structured documents, regular conferences, and managers’ support. We evaluated the EOL care tool by surveys for care workers and nurses. The results indicated that the tool is useful for EOL care in long-term-care facilities.
Building a Japanese-style ACP intervention model based on dialogues and establishing evidence in collaboration with citizens and professionals

Nagae Hiroko

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Scientific Research (A)

2015/04/01 - 2020/03/31

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The purpose of this study is to construct a Japanese-style ACP intervention model that reflects the Japanese lifestyle and values, and to demonstrate its effect. In order to achieve this purpose, ① ACP was conceptualized and categorized as a statement of intention support. ② Developed the readiness for ACP scale. ③ Two pilot studies verified the development of educational intervention programs and the adequacy of the readiness for ACP scale. As a result of this research, it was shown that Japanese-style ACP is important to support intention expression, and the ACP readiness that leads to "speaking" and "writing", which is an expression of intention, is useful as an evaluation of that stage. The pre- and post-assessment of the program significantly increased the participants' ACP readiness, demonstrating the validity of the program.
Efficacy of Advance Care Planning including spiritual care intervention

Yoshiyuki Kizawa, Tamura Keiko, Yamaguchi Takuhiro, Mori Masanori, Yamaguchi Takashi

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Scientific Research (B)

Institution: Kobe University

2016/04/01 - 2019/03/31

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 We have developed a program forthe trigger of ACP duscussion using video materials. ACP interventions were performed a total of three times at the Pancreatic Cancer Class at National Cancer Center Hospital. A total of more than 30 people with cancer patients and their families participated. About 90% of the respondents answered that it was "useful" and "want to think from now on". Even in qualitative research, positive opinions were obtained, such as "I wanted to live with goals such as hot spring and travel". ACP's motivational intervention, which incorporates spiritual care, has been shown to (1) be highly likely to be effective and quantitative and (2) to support not only treatment decision support but also awareness of the meaning of life and continuously support It is qualitatively suggested that showing posture can contribute to the mechanism of the effect.
Philosophical confirmation of the system of clinical ethical case analysis and its practical application in clinical and educational contexts

SHIMIZU Tetsuro

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Scientific Research (A)

2015/04/01 - 2019/03/31

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Our working hypothesis is the ethics of unity and difference. The former embodies attitudes of mutual support based on the belief that people are companions. The latter embodies attitudes of mutual non-interference based on the belief that people are strangers. The two ethics are mingled with balance and construct individual and social ethics. When we started our research, our agreements are: (1) Ethical judgement is made based on a doer's attitude associated by their assessment of the situation, which association results in their action; (2) The three principles in clinical ethics are respect for human beings, beneficence, and social appropriateness; (3) Shared process of decision-making; (4) Medical treatments should be performed directly towards the biological life, to improve the life as a human being. Through our research, we succeeded at confirming the working hypothesis and putting the system of clinical ethical case analysis into practical use based on the agreed four theories.
Quality of palliative care in Cancer Patients(Fostering Joint International Research)

Miyashita Mitsunori

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Fund for the Promotion of Joint International Research (Fostering Joint International Research)

Institution: Tohoku University

2016 - 2019

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I visited King's College London, Cicely Saunders Institute, UK from 27 September 2017 to 31 March 2018 to conduct international collaborative research activities. The main outcomes were the understanding and data analysis of the bereavement survey method using the death certification, the development and implementation of the Japanese version of the VOICES-SF questionnaire used in the UK, and the development and dissemination of the Japanese version of the Integrated Palliative Care Outcome Scale (IPOS), a quality assessment scale for palliative care in the UK.
End-of-life discussion between advanced cancer patients and physicians.

MIYASHITA MITSUNORI

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Challenging Exploratory Research

Institution: Tohoku University

2015/04/01 - 2018/03/31

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This survey aimed to evaluate the association between patients’ perceptions of curability and physicians’ disclosures of incurability. In this cross-sectional, multicenter, observational study in Japan, we asked patients with unresectable/recurrent solid cancers about their perceptions of incurability. Among 135 included and surveyed patients, 39%, 33%, and 23% responded that their cancer was incurable, curable, or “I don’t know” or “I don’t wish to answer,” respectively. No significant association was observed between patients' perceptions of curability and physician-reported disclosures of incurability. In this Japanese population, many patients with unresectable/recurrent solid cancers perceived that their cancers were incurable. However, such perceptions did not appear to be significantly affected by physician-reported disclosures. We recommend additional research to determine the best disclosure method to ensure that patients truly understand their disease status.
Effects of end-of-life discussions on the mental health of bereaved family members and quality of patient death and care

Yamaguchi Takashi, Miyashita Mitsunori, Morita Tatsuya

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Young Scientists (B)

Institution: Kobe University

2014/04/01 - 2017/03/31

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End-of-life (EOL) discussions are crucial for providing appropriate care to patients with advanced cancer at the end of their lives. To explore associations between EOL discussions and bereaved families’ depression and complicated grief, as well as the quality of patient death and EOL care, we conducted nationwide questionnaire survey of bereaved family members.80.6% of the respondents reported that they had EOL discussions.bereaved family members who had EOL discussions had a lower frequently of depression and complicated grief. EOL discussions were associated with better quality of death and EOL care.
Mixed-methods study of a rehabilitation program for advanced cancer patients.

MORITA Tatsuya, OHNO Ryo, MIYAKOSHI Koichi

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Scientific Research (C)

Institution: Seirei Christopher University

2014/04/01 - 2017/03/31

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A mix-method study was performed on 309 patients with advanced cancer. All patients received physical rehabilitation programs, and were evaluated 1 week later. Improvement on the FIM measures was observed in 57% of all patients. Predictors of improvement included involvement of palliative care team, CRP, grasping power, and clinical impression of the therapists. A qualitative study identified patient-perceived benefits of rehabilitation program.
The development of quality evaluation method for palliative care for cancer patients.

MIYASHITA MITSUNORI

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Scientific Research (B)

Institution: Tohoku University

2013/04/01 - 2017/03/31

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For post-bereavement survey, we developed and revised care evaluation scale which rate quality of palliative care from bereaved family member's perspective. In addition, we analyzed the 12652 persons data of 246 institution data from multi-institutional post-bereavement survey J-HOPE3 and J-HOPE2016. We had no significant correlation from analysis of quality indicators and post-bereavement family survey from retrospective analysis of another data set. We conducted the analysis of receipt data of Tohoku University Hospital, national database sampling data set, and national DPC data set and established analyzing methodology.
Establishment of a peer review system using patient records for outcome evaluation of medical education

Kameoka Junichi, KANATSUKA HIROSHI, ISHII SEIICHI, MIYASHITA MITSUNORI

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Scientific Research (C)

Institution: Tohoku University

2013/04/01 - 2016/03/31

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We examined criterion validity of our peer review system of medical records as an outcome evaluation of medical education. We randomly selected 65 patients (five per senior resident) who were seen by 13 senior residents in three hospitals in Kanto and Chubu regions. Five reviewers visited the hospitals and evaluated outpatient medical records based on an evaluation sheet, of which reliability has been established. Independently, program directors of the 13 senior residents evaluated their clinical performances. The correlation coefficients of “history taking (r=0.509)”, “clinical reasoning (r=0.585)” and “overall assessment (r=0.306)” were high, while those of “physical examination (r=0.132)” and “attitude towards patients and family members (r=0.132)” were low. We have established criterion validity of major items in our peer review system, but we also clarified that some items were difficult to evaluate by reading medical records.
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MIYASHITA Mistusnori, FUKAHORI Hiroki, SHIWAKU Hitoshi, SATO Kazuki

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Challenging Exploratory Research

Institution: Tohoku University

2013/04/01 - 2015/03/31

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We developed "process of end-of-life care evaluation scale from bereaved family perspective, " "outcome of end-of-life care evaluation scale from bereaved family perspective, " "process of end-of-life care evaluation scale from nurse, " and "nurses' difficulty of end-of-life care scale ." In addition, we developed checklist of end-of-life care and educational slide set for end-of-life nursing care. Finally, we developed pamphlet for family caring for dying children.
がん対策に資するがん患者の療養生活の質の評価方法の確立に関する研究

宮下光令, 森田達也, 加藤雅志, 藤澤大介, 的場元弘, 中保利通

Offer Organization: 厚生労働省

System: 厚生労働省研究事業厚生労働科学研究費補助金(厚生科研費)

2010/04 - 2012/03
Development of nurse-led clinical path for end-of-life care

MIYASHITA Mitsunori, SHIWKU Hitoshi, FUKAHORI Hiroki, KINOSHITA Satomi

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Challenging Exploratory Research

Institution: Tohoku University

2011 - 2012

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We developed clinical pathways for end-of-life care in hospital setting, home care setting, facility care setting, pediatric setting, and intensive care unit setting thorough literature review, chart review, pilot testing in clinical practice ,and interview for nurses.
A cohort study to describe preference of end-of-life care in cancer patients.

MIYASHITA Mitsunori

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Young Scientists (B)

Institution: The University of Tokyo

2008 - 2010

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The purpose of this study is to clarify preference of end-of-life care in cancer patients in outpatient clinic setting and explore longitudinal change. Three thousand and ten patients were recruited in the cohort. In the baseline survey, we clarified preference of end-of-life care in cancer patients. Some items were different from physician and nurse. In the longitudinal follow-up, most items did not change however preference of anti-cancer therapy decreased.
「望ましい死」の達成を測定する尺度の開発と全国実態調査

宮下光令

Offer Organization: 日本学術振興会

System: 科学研究費助成事業

Category: 若手研究(B)

Institution: 東京大学

2006 - 2007

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平成19年度研究では、平成18年度研究で作成した信頼性・妥当性が保障された遺族調査用尺度である「望ましい死」の達成を測定する尺度(Good Death Inventory)を用いて、全国における遺族調査を行い「望ましい死」の達成状況を調査した。全国調査には100の緩和ケア病棟と14の在宅ケア施設が参加した。有効発送数は緩和ケア病棟で8094人、在宅ケア施設では435人であり、有効回答数は緩和ケア病棟で5602人(69%)、在宅ケア施設では294人(68%)であった。「望ましい死」が達成されたという回答は、緩和ケア病棟では、からだの苦痛がなく過ごせた(81%)、望んだ場所で過ごせた(69%)、医師を信頼していた(83%)、家族や友人と十分な時間が過ごせた(73%)、人として大切にされていた(92%)であった(抜粋)。同様に在宅ケア施設では、からだの苦痛がなく過ごせた(72%)、望んだ場所で過ごせた(94%)、医師を信頼していた(88%)、家族や友人と十分な時間が過ごせた(82%)、人として大切にされていた(96%)であった(抜粋)。本研究の結果、わが国の緩和ケア病棟・在宅ケア施設における「望まし死」の達成の現状と、今後改善が必要な点が明らかになった。本調査の結果は、調査参加施設に全国の分布とともにフィードバックした。各施設における質保証・質改善に向けた取り組みの基礎資料となることが期待される。今後は「望ましい死」の達成を実現するための治療やケアの検討が必要である。
造血器悪性腫瘍患者・家族の終末期の実態把握と具体的支援の検討

河正子, 本倉徹, 宮下光令

Offer Organization: 日本学術振興会

System: 科学研究費助成事業

Category: 基盤研究(C)

Institution: 東京大学

2005 - 2006

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調査に先立ち、4施設の倫理委員会の審査・承認を得た(2005年7月〜2006年2月) 1.質問紙調査(2005年11月〜実施中) 大学病院血液内科で治療をうけ、過去半年-2年半前に死亡した白血病/悪性リンパ腫患者の遺族(主介護者)を対象とした。遺族5名への予備調査により内容妥当性、実施可能性を検討したのち調査を実施した。施設担当者が調査可能であると判断した対象に質問紙を送付した。調査項目は、Care Evaluation Scale 28(ホスピス・緩和ケア病棟ケアに対する評価尺度)、ケア満足度、遺族ケアニーズ、CES-D(抑うつ)、対象者背景などとした。 4施設の倫理委員会から実施許可を得、2施設で調査を終了した(回収率51.5%)。Care Evaluation Scale 28得点は、全国の緩和ケア病棟で行われた先行研究に比べ、全ドメインで(ケア評価が)低い傾向がみられる。今後、残り2施設の調査結果とあわせ、分析を進めていく。 2.診療記録調査(2005年11月〜実施中) 大学病院血液内科で治療をうけ、過去半年-2年半前に死亡した白血病/悪性リンパ腫患者を対象とした。質問紙調査の除外基準に遺族が該当したもの、調査依頼書類が不達のものは除外した。予備調査により評価者間信頼性、実施可能性を検討した診療記録調査票と診療記録閲覧マニュアルを用い、調査を実施した。調査は、造血器悪性腫瘍患者のケア経験を有する看護師複数名により行い、分類などの不明点を話し合える体制をとった。また、診療記録情報の記載内容の不明点など、調査担当者だけでは判断しかねる場合、施設担当者と検討した。調査項目は、死亡前1ヵ月間の治療方針、治療内容、症状、日常生活動作の変化と、DNR/CPRについての同意の有無、死亡場所、最終入院期間中の外泊の有無などとした。3施設で並行して調査を継続している。残る1施設は、対象者確定次第開始する。
Study on developing programs of palliative day care for advanced cancer patients in the home care situation.

KAWA Masako, MIYASHITA Mitsunori

Offer Organization: Japan Society for the Promotion of Science

System: Grants-in-Aid for Scientific Research

Category: Grant-in-Aid for Scientific Research (C)

Institution: The University of Tokyo

2002 - 2004

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The current study resulted in the following observations. The findings are to be used in deciding the possibility of complementing the existing services and introducing day care programs. 1.Information on day care programs in the UK and Japan Palliative day care services (day hospices) in the UK play a role in bridging palliative care institutions, GPs and hospitals. Although such services are in dire need in Japan because of the shorter length of stay in hospitals by patients and the dearth of systems offering home care, only a few trials have been started as palliative day care programs. 2.Need for continuous palliative care of patients with malignant cancer Through investigations with patients who have malignant cancer, their families and the bereaved, the following was suggested : 1)While the patient is still in the hospital to receive treatment, it is necessary to offer guidance and consideration directed toward home care (e.g., in response to possible changes in symptoms and support for care that enables self control). 2)Systems should be organized so that the place where patients and their families can obtain information and receive counseling will be prepared and day care may be made available. 3)In comparison with the operation of an English-type day hospice, there is a need to search for a style that is more in tune with the situation in Japan, e.g., consideration should be given to the convenience of transportation and to the disease or disease stage of the patient who would participate together. 3.Trial to develop a "palliative day care data base" to evaluate a day care program that has been organized in a certain community The current evaluating format is available and useful to improve care programs ; but pertinent parameters are to be selected after accumulating more data continually.
緩和ケアにおける看護ケアの医療経済学的研究

宮下光令

Offer Organization: 日本学術振興会

System: 科学研究費助成事業

Category: 若手研究(B)

Institution: 東京大学

2001 - 2002

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緩和ケアに対する経済分析はマクロ的なものや、一般病棟などのがん患者を対象としたものが多く、緩和ケア病棟の入院患者を詳細に検討したものは殆どない。そこで、関東のある病院の協力を得て、病院内にある緩和ケア病棟の収支、レセプトに関する分析を行った。病棟全体の収支に関しては、平成13年4月から平成15年1月までのデータを対象とした。また、個々のレセプトに対する分析は平成14年4月から平成15年1月のデータを対象とした。該当期間の平均患者数は14.0人であった。緩和ケア病棟の収支に関する分析では、まず緩和ケア病棟入院料と室料・緩和ケア病棟入院料を用いなかった場合(ここでは出来高と呼ぶ)に関する分析を行った。期間中の月平均収入は緩和ケア入院料で1729.4万円、室料164.9万円、出来高で995.7万であった。緩和ケア入院料と出来高の比は入院患者数と若干の相関があった。次に、人件費、薬剤・検査等(投薬、注射、処置、手術、検査など)、原価償却費(概算)などに関する分析を行った。さらに、患者個人に関するデータを診療録等から取得し、属性、症状などの背景情報と出来高の関連を検討し、入院からの日数別の比較、(死亡)退院前の日数での比較などを行った。症状が多い・特に痛みが強い患者に関しては薬剤費が高く、他の疾患でみられるほどの死亡前の医療費の上昇傾向はみられなかった。このような対象に対して、レセプトデータの詳細な検討は他にはなく、意義深いデータが得られたと考えられる。
緩和ケア病棟における臨床看護実践の評価に関する研究

宮下光令

Offer Organization: 日本学術振興会

System: 科学研究費助成事業

Category: 奨励研究(A)

Institution: 東京大学

1999 - 2000

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緩和ケアのClinical Auditの道具として英国で開発され、世界的に広く用いられているSTAS(Support Team Assessment Schedule)の臨床適用を行った。調査対象は首都圏の2つの緩和ケア(ホスピス)病棟であり、全入院患者それぞれに対して週1-3回看護婦が評価した。 STASの項目別得点はA病棟で痛み以外の症状、患者の不安、スピリチュアリティーの順に得点が高く、B病棟では患者の不安、スピリチュアリティー、痛み以外の症状で平均得点が高かった。欠損の出現状況は必須項目において患者の病状理解、家族の病状理解などでやや割合が大きい傾向にあった。看護職対象のアンケートでは、STASの定期的に記入する必要がない項目と答えた回答は、追加項目の「無駄にした時間」において割合が高かったが、その他の項目ではあまりあまり回答が見られなかった。有用であった項目に関しては、患者・家族の不安、患者・家族の病状認識、スピリチュアリティーで割合がやや高い傾向にあった。自由回答の記述からは、「日頃見過ごしてしまっていた部分について深く考えるきっかけとなった」といった肯定的な意見もあったものの、病棟の限られたカンファレンスの時間をこの記入に割くことに対する負担の問題が多く指摘された。看護職対象のアンケートに見られるようにSTASに関して肯定的な意見も少なくないものの、日常的なSTASへの記入による日常看護業務への負荷の問題が大きい。日常的な利用を考えると、たとえば測定頻度や必須項目のみを扱うなど業務負荷を軽減する方策を検討する必要がある。いくつかの項目で病棟間の違いがみられたが、これらは、患者層の違い、病棟の多忙さの違いなどから単純に比較は難しい。緩和ケア病棟をめぐる状況はさまざまであり、日常的なAuditの実施にはこれらに注意して検討を進める必要があると考えられた。
緩和ケアに関すること Competitive

System: 共同研究
Research on palliative care Competitive

System: Cooperative Research

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