TY - JOUR
T1 - Japanese physicians’ attitudes toward end-of-life discussion with pediatric patients with cancer
AU - Yoshida, Saran
AU - Ogawa, Chitose
AU - Shimizu, Ken
AU - Kobayashi, Mariko
AU - Inoguchi, Hironobu
AU - Oshima, Yoshio
AU - Dotani, Chikako
AU - Nakahara, Rika
AU - Kato, Masashi
N1 - Funding Information:
Funding This study was supported by JSPS KAKENHI Grant Number 26780408.
Publisher Copyright:
© 2018, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Purpose: We explored pediatricians’ practices and attitudes concerning end-of-life discussions (EOLds) with pediatric patients with cancer, and identified the determinants of pediatricians’ positive attitude toward having EOLds with pediatric patients. Methods: A multicenter questionnaire survey was conducted with 127 pediatricians specializing in the treatment of pediatric cancer. Results: Forty-two percent of participants reported that EOLds should be held with the young group of children (6–9 years old), 68% with the middle group (10–15 years old), and 93% with the old group (16–18 years old). Meanwhile, 6, 20, and 35% of participants answered that they “always” or “usually” discussed the incurability of the disease with the young, middle, and old groups, respectively; for the patient’s imminent death, the rates were 2, 11, and 24%. Pediatricians’ attitude that they “should have” EOLds with the young group was predicted by more clinical experience (odds ratio [OR] 1.077; p = 0.007), more confidence in addressing children’s anxiety after EOLd (OR 1.756; p = 0.050), weaker belief in the demand for EOLd (OR 0.456; p = 0.015), weaker belief in the necessity of the EOLd for children to enjoy their time until death (OR, 0.506; p = 0.021), and weaker belief in the importance of maintaining a good relationship with the parents (OR 0.381; p = 0.025). Conclusions: While pediatricians nearly reached consensus on EOLds for the old group, EOLds with the young group remain a controversial subject. While pediatricians who supported EOLds believed in their effectiveness or necessity, those who were against EOLds tended to consider the benefits of not engaging in them.
AB - Purpose: We explored pediatricians’ practices and attitudes concerning end-of-life discussions (EOLds) with pediatric patients with cancer, and identified the determinants of pediatricians’ positive attitude toward having EOLds with pediatric patients. Methods: A multicenter questionnaire survey was conducted with 127 pediatricians specializing in the treatment of pediatric cancer. Results: Forty-two percent of participants reported that EOLds should be held with the young group of children (6–9 years old), 68% with the middle group (10–15 years old), and 93% with the old group (16–18 years old). Meanwhile, 6, 20, and 35% of participants answered that they “always” or “usually” discussed the incurability of the disease with the young, middle, and old groups, respectively; for the patient’s imminent death, the rates were 2, 11, and 24%. Pediatricians’ attitude that they “should have” EOLds with the young group was predicted by more clinical experience (odds ratio [OR] 1.077; p = 0.007), more confidence in addressing children’s anxiety after EOLd (OR 1.756; p = 0.050), weaker belief in the demand for EOLd (OR 0.456; p = 0.015), weaker belief in the necessity of the EOLd for children to enjoy their time until death (OR, 0.506; p = 0.021), and weaker belief in the importance of maintaining a good relationship with the parents (OR 0.381; p = 0.025). Conclusions: While pediatricians nearly reached consensus on EOLds for the old group, EOLds with the young group remain a controversial subject. While pediatricians who supported EOLds believed in their effectiveness or necessity, those who were against EOLds tended to consider the benefits of not engaging in them.
KW - Attitude
KW - Communication
KW - End-of-life discussion
KW - Palliative care
UR - http://www.scopus.com/inward/record.url?scp=85047132866&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85047132866&partnerID=8YFLogxK
U2 - 10.1007/s00520-018-4254-6
DO - 10.1007/s00520-018-4254-6
M3 - Article
C2 - 29774476
AN - SCOPUS:85047132866
VL - 26
SP - 3861
EP - 3871
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
SN - 0941-4355
IS - 11
ER -