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Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Jan, 2022;30 (1): 931-940.

Appropriate referral timing to specialized palliative care service: survey of bereaved families of cancer patients who died in palliative care units.

Keita Tagami, Kento Masukawa, Akira Inoue, Tatsuya Morita, Yusuke Hiratsuka, Mamiko Sato, Katsura Kohata, Noriaki Satake, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita
Author Information
  1. Keita Tagami: Department of Palliative Medicine, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan. keita.tagami.d7@tohoku.ac.jp. ORCID
  2. Kento Masukawa: Department of Palliative Nursing, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
  3. Akira Inoue: Department of Palliative Medicine, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
  4. Tatsuya Morita: Department of Palliative and Supportive Care, Palliative Care Team, Seirei Mikatahara General Hospital, 3453 Mikatahara-cho, Kita-ku, Hamamatsu, Shizuoka, 433-8558, Japan.
  5. Yusuke Hiratsuka: Department of Palliative Medicine, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
  6. Mamiko Sato: Department of Palliative Medicine, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
  7. Katsura Kohata: Department of Palliative Medicine, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
  8. Noriaki Satake: Department of Palliative Medicine, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
  9. Yoshiyuki Kizawa: Department of Palliative Medicine, Kobe University Hospital, 1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
  10. Satoru Tsuneto: Department of Human Health Sciences, Kyoto University Graduate School of Medicine, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.
  11. Yasuo Shima: Tsukuba Medical Center Hospital, 1-3-1, Amakubo, Tsukuba, Ibaraki, 305-8558, Japan.
  12. Mitsunori Miyashita: Department of Palliative Nursing, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
PMID: 34417885 DOI: 10.1007/s00520-021-06493-2

Abstract

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.

Keywords

Cancer patient experience Early palliative care Integration of oncology and palliative care Referral timing of palliative care Specialized palliative care

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Grants

  1. 20EA1009/Ministry of Health, Labour and Welfare

MeSH Term

Hospice and Palliative Care Nursing
Humans
Neoplasms
Palliative Care
Referral and Consultation
Surveys and Questionnaires
Journal Article
Article has an altmetric score of 13

Word Cloud

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