Progressive Development and Enhancement of Palliative Care Services in Japan: Nationwide Surveys of Designated Cancer Care Hospitals for Three Consecutive Years

Abstract Context Policymaking plays an important role in national palliative care services. The Japanese Cancer Control Act was implemented in 2006. Objectives To evaluate changes in the structure and processes of palliative care services after implementation of the Cancer Control Act. Methods We co...

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Published in:Journal of pain and symptom management 2014-09, Vol.48 (3), p.364-373
Main Authors: Maeda, Isseki, MD, PhD, Tsuneto, Satoru, MD, PhD, Miyashita, Mitsunori, RN, PhD, Morita, Tatsuya, MD, Umeda, Megumi, RN, PHN, MSN, OCNS, Motoyama, Miwa, MD, Kosako, Fumie, RN, OCNS, Hama, Yoshihisa, MD, Kizawa, Yoshiyuki, MD, Sasahara, Tomoyo, RN, PhD, Eguchi, Kenji, MD
Format: Article
Language:English
Subjects:
Anesthesia & Perioperative Care
Cancer Care Facilities - legislation & jurisprudence
Cancer Care Facilities - manpower
designated cancer care hospital
Education, Professional
Humans
Japan
nationwide survey
Pain Medicine
Palliative Care - legislation & jurisprudence
Palliative Care - manpower
Palliative Care - methods
palliative care education
Palliative care services
Patient Care Team
regional medical cooperation
Surveys and Questionnaires
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cited_by cdi_FETCH-LOGICAL-c553t-d2e5cf35db3d051739ee788083cf8654abccd3c85b8683c6614d163a6f0464823
cites cdi_FETCH-LOGICAL-c553t-d2e5cf35db3d051739ee788083cf8654abccd3c85b8683c6614d163a6f0464823
container_end_page 373
container_issue 3
container_start_page 364
container_title Journal of pain and symptom management
container_volume 48
creator Maeda, Isseki, MD, PhD
Tsuneto, Satoru, MD, PhD
Miyashita, Mitsunori, RN, PhD
Morita, Tatsuya, MD
Umeda, Megumi, RN, PHN, MSN, OCNS
Motoyama, Miwa, MD
Kosako, Fumie, RN, OCNS
Hama, Yoshihisa, MD
Kizawa, Yoshiyuki, MD
Sasahara, Tomoyo, RN, PhD
Eguchi, Kenji, MD
description Abstract Context Policymaking plays an important role in national palliative care services. The Japanese Cancer Control Act was implemented in 2006. Objectives To evaluate changes in the structure and processes of palliative care services after implementation of the Cancer Control Act. Methods We conducted annual nationwide surveys in designated cancer care hospitals (DCCHs, n  = 349) between 2008 and 2010. The 65-item questionnaire was divided into seven domains: institutional framework, information to patient and family, practice of palliative care, activities of the palliative care teams (PCTs), members of PCTs, regional medical cooperation, and education. Increasing trends were tested using generalized estimating equation models. Results The response rates were ≥99%. All domains showed an increasing trend ( P  
doi_str_mv 10.1016/j.jpainsymman.2013.09.017
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The Japanese Cancer Control Act was implemented in 2006. Objectives To evaluate changes in the structure and processes of palliative care services after implementation of the Cancer Control Act. Methods We conducted annual nationwide surveys in designated cancer care hospitals (DCCHs, n  = 349) between 2008 and 2010. The 65-item questionnaire was divided into seven domains: institutional framework, information to patient and family, practice of palliative care, activities of the palliative care teams (PCTs), members of PCTs, regional medical cooperation, and education. Increasing trends were tested using generalized estimating equation models. Results The response rates were ≥99%. All domains showed an increasing trend ( P  &lt; 0.001). There were significant increases in full-time PCT physicians (27.4%–45.7%, P trend  &lt; 0.001), full-time PCT nurses (38.9%–88.0%, P trend  &lt; 0.001), and the median number of annual referrals to PCTs (60–80 patients, P  &lt; 0.001). Essential drugs were available in most DCCHs from baseline. Although outpatient clinics increased significantly (27.0%–58.9%, P trend  &lt; 0.001), community outreach programs did not (9.0%–12.6%, P  = 0.05). Basic education was actively introduced for in-hospital physicians and nurses (78.2% and 91.4% in 2010), but often unavailable for regional health care providers (basic education for regional physicians and nurses: 63.9% and 71.1% in 2010). Conclusion The Cancer Control Act promoted the development and enhancement of palliative care services in DCCHs. Regional medical cooperation and education are the future challenges of palliative care in Japan.</description><identifier>ISSN: 0885-3924</identifier><identifier>EISSN: 1873-6513</identifier><identifier>DOI: 10.1016/j.jpainsymman.2013.09.017</identifier><identifier>PMID: 24439846</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Anesthesia &amp; Perioperative Care ; Cancer Care Facilities - legislation &amp; jurisprudence ; Cancer Care Facilities - manpower ; designated cancer care hospital ; Education, Professional ; Humans ; Japan ; nationwide survey ; Pain Medicine ; Palliative Care - legislation &amp; jurisprudence ; Palliative Care - manpower ; Palliative Care - methods ; palliative care education ; Palliative care services ; Patient Care Team ; regional medical cooperation ; Surveys and Questionnaires</subject><ispartof>Journal of pain and symptom management, 2014-09, Vol.48 (3), p.364-373</ispartof><rights>American Academy of Hospice and Palliative Medicine</rights><rights>2014 American Academy of Hospice and Palliative Medicine</rights><rights>Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c553t-d2e5cf35db3d051739ee788083cf8654abccd3c85b8683c6614d163a6f0464823</citedby><cites>FETCH-LOGICAL-c553t-d2e5cf35db3d051739ee788083cf8654abccd3c85b8683c6614d163a6f0464823</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24439846$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Maeda, Isseki, MD, PhD</creatorcontrib><creatorcontrib>Tsuneto, Satoru, MD, PhD</creatorcontrib><creatorcontrib>Miyashita, Mitsunori, RN, PhD</creatorcontrib><creatorcontrib>Morita, Tatsuya, MD</creatorcontrib><creatorcontrib>Umeda, Megumi, RN, PHN, MSN, OCNS</creatorcontrib><creatorcontrib>Motoyama, Miwa, MD</creatorcontrib><creatorcontrib>Kosako, Fumie, RN, OCNS</creatorcontrib><creatorcontrib>Hama, Yoshihisa, MD</creatorcontrib><creatorcontrib>Kizawa, Yoshiyuki, MD</creatorcontrib><creatorcontrib>Sasahara, Tomoyo, RN, PhD</creatorcontrib><creatorcontrib>Eguchi, Kenji, MD</creatorcontrib><title>Progressive Development and Enhancement of Palliative Care Services in Japan: Nationwide Surveys of Designated Cancer Care Hospitals for Three Consecutive Years</title><title>Journal of pain and symptom management</title><addtitle>J Pain Symptom Manage</addtitle><description>Abstract Context Policymaking plays an important role in national palliative care services. The Japanese Cancer Control Act was implemented in 2006. Objectives To evaluate changes in the structure and processes of palliative care services after implementation of the Cancer Control Act. Methods We conducted annual nationwide surveys in designated cancer care hospitals (DCCHs, n  = 349) between 2008 and 2010. The 65-item questionnaire was divided into seven domains: institutional framework, information to patient and family, practice of palliative care, activities of the palliative care teams (PCTs), members of PCTs, regional medical cooperation, and education. Increasing trends were tested using generalized estimating equation models. Results The response rates were ≥99%. All domains showed an increasing trend ( P  &lt; 0.001). There were significant increases in full-time PCT physicians (27.4%–45.7%, P trend  &lt; 0.001), full-time PCT nurses (38.9%–88.0%, P trend  &lt; 0.001), and the median number of annual referrals to PCTs (60–80 patients, P  &lt; 0.001). Essential drugs were available in most DCCHs from baseline. Although outpatient clinics increased significantly (27.0%–58.9%, P trend  &lt; 0.001), community outreach programs did not (9.0%–12.6%, P  = 0.05). Basic education was actively introduced for in-hospital physicians and nurses (78.2% and 91.4% in 2010), but often unavailable for regional health care providers (basic education for regional physicians and nurses: 63.9% and 71.1% in 2010). Conclusion The Cancer Control Act promoted the development and enhancement of palliative care services in DCCHs. 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The Japanese Cancer Control Act was implemented in 2006. Objectives To evaluate changes in the structure and processes of palliative care services after implementation of the Cancer Control Act. Methods We conducted annual nationwide surveys in designated cancer care hospitals (DCCHs, n  = 349) between 2008 and 2010. The 65-item questionnaire was divided into seven domains: institutional framework, information to patient and family, practice of palliative care, activities of the palliative care teams (PCTs), members of PCTs, regional medical cooperation, and education. Increasing trends were tested using generalized estimating equation models. Results The response rates were ≥99%. All domains showed an increasing trend ( P  &lt; 0.001). There were significant increases in full-time PCT physicians (27.4%–45.7%, P trend  &lt; 0.001), full-time PCT nurses (38.9%–88.0%, P trend  &lt; 0.001), and the median number of annual referrals to PCTs (60–80 patients, P  &lt; 0.001). Essential drugs were available in most DCCHs from baseline. Although outpatient clinics increased significantly (27.0%–58.9%, P trend  &lt; 0.001), community outreach programs did not (9.0%–12.6%, P  = 0.05). Basic education was actively introduced for in-hospital physicians and nurses (78.2% and 91.4% in 2010), but often unavailable for regional health care providers (basic education for regional physicians and nurses: 63.9% and 71.1% in 2010). Conclusion The Cancer Control Act promoted the development and enhancement of palliative care services in DCCHs. Regional medical cooperation and education are the future challenges of palliative care in Japan.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>24439846</pmid><doi>10.1016/j.jpainsymman.2013.09.017</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record>
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source ScienceDirect Freedom Collection 2022-2024
subjects Anesthesia & Perioperative Care
Cancer Care Facilities - legislation & jurisprudence
Cancer Care Facilities - manpower
designated cancer care hospital
Education, Professional
Humans
Japan
nationwide survey
Pain Medicine
Palliative Care - legislation & jurisprudence
Palliative Care - manpower
Palliative Care - methods
palliative care education
Palliative care services
Patient Care Team
regional medical cooperation
Surveys and Questionnaires
title Progressive Development and Enhancement of Palliative Care Services in Japan: Nationwide Surveys of Designated Cancer Care Hospitals for Three Consecutive Years
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