End-of-Life Discussions and Their Timing for Patients With Cardiovascular Diseases ― From the Perspective of Bereaved Family Members ―
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- Shinada Keitaro
- Division of Cardiology, Department of Medicine, Keio University School of Medicine
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- Kohno Takashi
- Division of Cardiology, Department of Medicine, Keio University School of Medicine Department of Cardiovascular Medicine, Kyorin University Faculty of Medicine
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- Fukuda Keiichi
- Division of Cardiology, Department of Medicine, Keio University School of Medicine
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- Higashitani Michiaki
- Department of Cardiology, Tokyo Medical University Ibaraki Medical Center
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- Kawamatsu Naoto
- Department of Cardiology, Mito Saiseikai General Hospital
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- Kitai Takeshi
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
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- Shibata Tatsuhiro
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine
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- Takei Makoto
- Department of Cardiology, Tokyo Saiseikai Central Hospital
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- Nochioka Kotaro
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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- Nakazawa Gaku
- Department of Cardiology, Tokai University School of Medicine Department of Cardiology, Kindai University Faculty of Medicine
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- Shiomi Hiroki
- Department of Cardiology, Kyoto University Graduate School of Medicine
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- Miyashita Mitsunori
- Division of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine
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- Mizuno Atsushi
- Department of Cardiology, St. Luke’s International Hospital
抄録
<p>Background: Enhanced discussions regarding end-of-life (EOL) are crucial to provide appropriate care for seriously ill patients. However, the current status of EOL discussions, especially their timing and influencing factors, among patients with cardiovascular diseases (CVD) remains unknown.</p><p>Methods and Results: We conducted a cross-sectional questionnaire survey of bereaved family members of CVD patients who died at 10 tertiary care institutes in Japan. In all, 286 bereaved family members (38.2% male; median age 66.0 [interquartile range 58.0–73.0] years) of CVD patients were enrolled; of these, 200 (69.9%) reported that their families had had EOL discussions with physicians. The major topic discussed was resuscitation (79.0%), and 21.5% discussed the place of EOL care. Most discussions were held during hospitalization of the patient (88.2%). More than half (57.1%) the discussions were initiated less than 1 month before the patient died, and 22.6% of family members felt that this timing of EOL discussions was late. Bereaved family members’ perception of late EOL discussions was associated with the family members aggressive attitude towards life-prolonging treatment, less preparedness for bereavement, and less satisfaction with EOL care.</p><p>Conclusions: Approximately 70% of bereaved family members of CVD patients had EOL discussions, which were often held shortly before the patient died. Further research is required to establish an ideal approach to EOL discussions at an appropriate time, which may improve the quality of EOL care.</p>
収録刊行物
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- Circulation Journal
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Circulation Journal 88 (1), 135-143, 2023-12-25
一般社団法人 日本循環器学会