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Advance care planning in patients with serious illness

Research Project

Project/Area Number 16K08878
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Research Field Medical sociology
Research InstitutionNagoya City University

Principal Investigator

Okuyama Toru  名古屋市立大学, 医薬学総合研究院(医学), 教授 (80349349)

Project Period (FY) 2016-04-01 – 2023-03-31
Project Status Completed (Fiscal Year 2022)
Budget Amount *help
¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000)
Fiscal Year 2019: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2018: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2017: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2016: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Keywordsがん / 精神腫瘍学 / 緩和ケア / アドバンスケアプランニング / QOL / 抑うつ / インフォームドコンセント / アドバンス・ケア・プランニング / 肺癌 / コミュニケーション / 意思決定能力 / 化学療法 / 意思決定支援 / 医療・福祉
Outline of Final Research Achievements

We conducted a multicenter, collaborative, longitudinal observational study among 200 patients with advanced lung cancer and their caregivers. Results showed that: 1) 54% and 44% of patients correctly understood that their cancer was incurable and that the goal of chemotherapy was not to completely cure the cancer, respectively; 2) patients who were explained the repeatedly incurable nature of their cancer demonstrated a more accurate understanding of their prognosis compared to those who were only explained once; 3) patients with accurate prognostic understanding had a significantly lower preference for life-prolonging treatments; and 4) the presence or absence of discussions regarding end-of-life care was not associated with patients' quality of life, depression, or actual end-of-life care. Based on the results of this study, the importance of conducting iterative and ongoing end-of-life discussions has been suggested.

Academic Significance and Societal Importance of the Research Achievements

我が国において、重い病気にかかった際、予め医療者と患者さんが終末期における過ごし方について話し合った方が良いのかどうかは明らかになっていません。
200名の進行がん患者さんとそのご家族を対象とした調査の結果、医療者と患者さんが病状や終末期について話し合うことは、短期的には患者さんがご自身の病気をよく理解し、延命治療の希望が減るなどの意義があるものの、実際の終末期ケアには大きな影響を及ぼしていませんでした。
終末期におけ過ごし方とは、病の経過の中で1回のみ行うというよりは反復して実施し、その時々の患者さん・ご家族の意向に応じてケアを計画していくことが必要と思われることが示唆されました。

Report

(8 results)
  • 2022 Annual Research Report   Final Research Report ( PDF )
  • 2021 Research-status Report
  • 2020 Research-status Report
  • 2019 Research-status Report
  • 2018 Research-status Report
  • 2017 Research-status Report
  • 2016 Research-status Report
  • Research Products

    (2 results)

All 2022 2021

All Journal Article (1 results) (of which Peer Reviewed: 1 results,  Open Access: 1 results) Presentation (1 results)

  • [Journal Article] Prognostic Awareness and Discussions of Incurability in Patients with Pretreated Non-Small Cell Lung Cancer and Caregivers: A Prospective Cohort Study2022

    • Author(s)
      Hasegawa Takaaki、Okuyama Toru、Uemura Takehiro、Matsuda Yoshinobu、Otani Hiroyuki、Shimizu Junichi、Horio Yoshitsugu、Watanabe Naohiro、Yamaguchi Teppei、Fukuda Satoshi、Oguri Tetsuya、Maeno Ken、Tamiya Akihiro、Nosaki Kaname、Fukumitsu Kensuke、Akechi Tatsuo
    • Journal Title

      The Oncologist

      Volume: 27 Issue: 11 Pages: 982-990

    • DOI

      10.1093/oncolo/oyac178

    • Related Report
      2022 Annual Research Report
    • Peer Reviewed / Open Access
  • [Presentation] 進行・再発非小細胞肺がん患者と主介護者 における病状理解:多施設共同観察研究2021

    • Author(s)
      長谷川貴昭、奥山 徹、上村剛大、松田能宣、大谷弘行、清水淳市、堀尾芳嗣、渡辺尚宏、山口哲平、福田悟史、小栗鉄也、前野健、田宮朗裕、野崎要、福光研介、 明智龍男
    • Organizer
      第34回日本サイコオンコロジー学会
    • Related Report
      2021 Research-status Report

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Published: 2016-04-21   Modified: 2024-01-30  

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