TY - JOUR
T1 - Appropriate referral timing to specialized palliative care service
T2 - survey of bereaved families of cancer patients who died in palliative care units
AU - Tagami, Keita
AU - Masukawa, Kento
AU - Inoue, Akira
AU - Morita, Tatsuya
AU - Hiratsuka, Yusuke
AU - Sato, Mamiko
AU - Kohata, Katsura
AU - Satake, Noriaki
AU - Kizawa, Yoshiyuki
AU - Tsuneto, Satoru
AU - Shima, Yasuo
AU - Miyashita, Mitsunori
N1 - Funding Information:
This work was supported by the Ministry of Health, Labor, and Welfare in Japan (Health Labor Science Research Grant 20EA1009). We would like to thank Editage ( www.editage.com ) for the English language editing.
Funding Information:
This study was part of Japan Hospice and Palliative Evaluation Study 4, funded by the Japan Hospice Palliative Care Foundation and the corporation of Hospice Palliative Care Japan. The authors declare no conflicts of interest.
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2022/1
Y1 - 2022/1
N2 - 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.
AB - 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.
KW - Cancer patient experience
KW - Early palliative care
KW - Integration of oncology and palliative care
KW - Referral timing of palliative care
KW - Specialized palliative care
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U2 - 10.1007/s00520-021-06493-2
DO - 10.1007/s00520-021-06493-2
M3 - Article
C2 - 34417885
AN - SCOPUS:85113133054
VL - 30
SP - 931
EP - 940
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
SN - 0941-4355
IS - 1
ER -