OBJECTIVE: To compare patient characteristics and end-of-life treatment between designated cancer care hospitals and non-designated hospitals, focusing on non-designated hospitals. METHODS: We used the National Database from 2013 to 2015, provided by the Ministry of Health, Labor and Welfare. RESULTS: We analyzed 491 964 patients of cancer descendants (designated hospitals, 164 063 and non-designated hospitals, 327 901). Non-designated hospitals treated older patients, specifically aged 85 years or older (non-designated hospitals: 26% vs designated hospitals: 11%), and fewer patients without comorbidities (32% vs 45%). Regarding end-of-life treatment in the last two weeks, non-designated hospitals had lower palliative care team fees (1% vs 11%; Relative Risk = 0.14), slightly lower use of strong opioids (53% vs 65%; RR = 0.81), and less use of antipsychotics (23% vs 37%; RR = 0.63). Non-designated hospitals used anticancer drugs less frequently (5% vs 10%; RR = 0.51), however, the use of intravenous hydration over 250 mL/day was higher (55% vs 37%; RR = 2.27). In non-designated hospitals, although ICU admission was less frequent (1% vs 5%; RR = 0.27), there was no difference in cardiopulmonary resuscitation (5% vs 5%; RR = 1.02). CONCLUSIONS: Non-designated hospitals treat more complex patients. In addition, non-designated hospitals had low palliative care team fees, low opioid and other essential drug prescriptions; however, the frequency of artificial hydration was higher. Although non-designated hospitals provided a lower frequency of end-of-life aggressive treatment, no difference was observed in life-sustaining treatments.

BackgroundSocial media provides a novel data source for understanding palliative care from the perspectives of patients and their family caregivers. Nonetheless, no study has examined palliative care-related information on Japanese social media. This study aimed to identify the characteristics of palliative care information on Japanese social media.MethodsPosts published on X (formerly Twitter) during the first week of each month from January to June 2024 that included 1 or more of the following terms were manually collected: "palliative care," "end-of-life care," or "palliative medicine." Posts were analyzed inductively. A Japanese sentiment analysis model was applied to assign a sentiment score (0-1) to each post, with higher scores indicating more positive sentiment. The top 50 posts with the highest sentiment scores and the bottom 50 posts were further analyzed using the same qualitative approach.ResultsIn total, 4689 posts were collected; of these, 3806 (81.2%) were related to palliative care. Thirteen categories were identified. The most frequent category was "general explanations about palliative care" (n = 1,280, 27.3%), followed by "sharing information about palliative care services" (n = 757, 16.1%). Posts with the lowest sentiment scores included "opinions or demands toward end-of-life care systems," "opinions or demands towards medical practice and dissemination of palliative care," and "reporting experiences of patients and informal caregivers."ConclusionJapanese social media platforms may provide valuable insights into family caregivers' experiences, potentially representing a resource for assessing the palliative care quality. Future studies should evaluate the validity of palliative care-related information on social media.

Background/Objectives: The global nursing shortage encompasses issues such as the uneven nurse distribution in low- and middle-income countries, nurse outflow to other countries, and nurse retirement in developed countries, necessitating effective retention strategies. Our objective was to clarify the changes in facility selection reasons among Japanese nurses after changing jobs and the personal attributes influencing facility selection. Methods: In January 2023, an online survey was conducted among licensed practical nurses, registered nurses, midwives, and public health nurses in Japan. The survey items included personal attributes (age and sex), information on ≤five employment facilities, and facility selection reasons. The variations in facility selection reasons by facility number were analyzed using a generalized linear model with a binomial distribution. A logistic regression analysis was conducted with personal attributes and reasons for workplace selection as the independent and dependent variables, respectively. Results: In total, 721 participants were included; 90.8% selected hospitals as their first place of employment. As nurses changed jobs, they increasingly selected non-hospital facilities, including nursing homes, nursery schools, and government agencies. With multiple job changes, the facility selection reasons included "good location for commuting", "good salary", and "convenient working style". Among personal attributes, "age", "sex", "age at employment at the facility", "educational background", "number of children", and "living alone" influenced workplace choice reasons. Conclusions: Considering the study results, country-specific demographic trends, medical policy changes, and nursing-shortage-related causes, medical facility managers and policymakers should devise appropriate employment conditions and develop recruitment strategies, especially for situations with severe nursing shortages. Nurses can learn from the career choices of others to manage their own careers.