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Effectiveness of Family Care by Reconsidering the Normal Process of Death in Terminal Delirium

Research Project

Project/Area Number 17K19875
Research Category

Grant-in-Aid for Challenging Research (Exploratory)

Allocation TypeMulti-year Fund
Research Field Society medicine, Nursing, and related fields
Research InstitutionNational Hospital Organization, Kyushu Cancer Center

Principal Investigator

Otani Hiroyuki  独立行政法人国立病院機構(九州がんセンター臨床研究センター), その他部局等, 緩和治療科医師 (10600067)

Co-Investigator(Kenkyū-buntansha) 森田 達也  聖隷クリストファー大学, 看護学研究科, 臨床教授 (70513000)
Project Period (FY) 2017-06-30 – 2021-03-31
Project Status Completed (Fiscal Year 2020)
Budget Amount *help
¥6,240,000 (Direct Cost: ¥4,800,000、Indirect Cost: ¥1,440,000)
Fiscal Year 2019: ¥2,470,000 (Direct Cost: ¥1,900,000、Indirect Cost: ¥570,000)
Fiscal Year 2018: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
Fiscal Year 2017: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
Keywordsせん妄 / お迎え / 家族ケア
Outline of Final Research Achievements

The purpose of this study is to clarify whether care that incorporates the perspective that "terminal delirium" is not a disease but part of the normal process of death (death bed visions) can ease the pain of family members. The purpose of this study is to clarify the following A pilot study in a single-center palliative care ward revealed that medical professionals and family members were resistant to the idea of treating "delirium at the end of life" as a "death bed visions" phenomenon. However, a large-scale fact-finding survey (questionnaire survey) revealed that care that incorporates the perspective that "terminal delirium" is not a disease but part of the normal dying process is appropriate. The feasibility of a randomized trial may not be significantly related to physicians' perceptions, and barriers to interventional trials need to be identified.

Academic Significance and Societal Importance of the Research Achievements

現在の医学では、「終末期せん妄」のケアは医学的なモデルに基づいて原因の治療と説明と精神的なサポートにとどまっている。しかし、「終末期せん妄」を亡くなる自然の現象としてその患者の体験に肯定的な意味づけをすることによって、医学的に触れてはいけないとされてきたことを、ケアの中核に捉えることで死を看取るという文化の醸成にもつながるかもしれない。次期DSM(精神障害の診断および統計マニュアル)改訂の際は死前の幻覚(超常的な臨死体験)を診断名としての「せん妄(delirium)」ではなく「正常な死の過程」であるという別次元の議論が深まることを期待する。

Report

(5 results)
  • 2020 Annual Research Report   Final Research Report ( PDF )
  • 2019 Research-status Report
  • 2018 Research-status Report
  • 2017 Research-status Report
  • Research Products

    (30 results)

All 2021 2020 2019 2018 2017

All Journal Article (18 results) (of which Peer Reviewed: 13 results,  Open Access: 5 results) Presentation (6 results) (of which Invited: 2 results) Book (6 results)

  • [Journal Article] Comparison between patient-reported and clinician-reported outcomes: Validation of the Japanese version of the Integrated Palliative care Outcome Scale for staff2021

    • Author(s)
      Sakurai H, Miyashita M, Morita T, et al.
    • Journal Title

      Palliat Support Care

      Volume: 5 Issue: 6 Pages: 1-7

    • DOI

      10.1017/s1478951521000018

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] A Nationwide Survey of Bereaved Family Members’ Perception of the Place Patients Spent Their Final Days: Is the Inpatient Hospice2020

    • Author(s)
      Otani H, et al.
    • Journal Title

      Palliative Medicine Reports

      Volume: 1 Issue: 1 Pages: 174-178

    • DOI

      10.1089/pmr.2020.0058

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Predictors of duloxetine response in patients with neuropathic cancer pain: a secondary analysis of a randomized controlled trial-JORTC-PAL08 (DIRECT) study2020

    • Author(s)
      Matsuoka H, Otani H, et al.
    • Journal Title

      Support Care Cancer

      Volume: 28 Issue: 6 Pages: 2931-2939

    • DOI

      10.1007/s00520-019-05138-9

    • Related Report
      2020 Annual Research Report 2019 Research-status Report
    • Peer Reviewed
  • [Journal Article] Accuracy of the Palliative Prognostic Score With or Without Clinicians' Prediction of Survival in Patients With Far Advanced Cancer2020

    • Author(s)
      Seok-Joon Yoon, Otani H, et al.
    • Journal Title

      J Pain Symptom Manage

      Volume: Online ahead of print. Issue: 6 Pages: 1180-1187

    • DOI

      10.1016/j.jpainsymman.2020.10.019

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed
  • [Journal Article] 遺族の声を臨床に生かす J-HOPE2016研究(多施設遺族調査)からの学び 患者が終末期に過ごした環境における遺族の経験に関する研究2020

    • Author(s)
      大谷弘行
    • Journal Title

      がん看護

      Volume: 25 Pages: 267-272

    • Related Report
      2020 Annual Research Report 2019 Research-status Report
  • [Journal Article] 臨床の場で活かすコミュニケーションスキル:「技術」が「態度」に変わる時2020

    • Author(s)
      大谷弘行
    • Journal Title

      緩和ケア

      Volume: 30 Pages: 323-325

    • Related Report
      2020 Annual Research Report
  • [Journal Article] Validation of the Integrated Palliative care Outcome Scale (IPOS) - Japanese Version.2019

    • Author(s)
      Sakurai H, Otani H,et al
    • Journal Title

      Jpn J Clin Oncol.

      Volume: 印刷中 Issue: 3 Pages: 257-262

    • DOI

      10.1093/jjco/hyy203

    • Related Report
      2019 Research-status Report 2018 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Adding a Wider Range and "Hope for the Best, and Prepare for the Worst" Statement: Preferences of Patients with Cancer for Prognostic Communication.2019

    • Author(s)
      Mori M, Otani H,et al
    • Journal Title

      Oncologist.

      Volume: 印刷中 Issue: 9 Pages: e943-e952

    • DOI

      10.1634/theoncologist.2018-0643

    • Related Report
      2019 Research-status Report 2018 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] The Effects of Adding Reassurance Statements: Cancer Patients' Preferences for Phrases in End-of-Life Discussions.2019

    • Author(s)
      Mori M, Fujimori M, Ishiki H, Nishi T, Hamano J, Otani H, Uneno Y, Oba A, Morita T, Uchitomi Y.
    • Journal Title

      J Pain Symptom Manage.

      Volume: 57 Issue: 6 Pages: 1121-1129

    • DOI

      10.1016/j.jpainsymman.2019.02.019

    • Related Report
      2019 Research-status Report 2018 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Additive Duloxetine for Cancer-Related Neuropathic Pain Nonresponsive or Intolerant to Opioid-Pregabalin Therapy: A Randomized Controlled Trial (JORTC-PAL08).2019

    • Author(s)
      Matsuoka H, Iwase S, Miyaji T, Kawaguchi T, Ariyoshi K, Oyamada S, Satomi E, Ishiki H, Hasuo H, Sakuma H, Tokoro A, Shinomiya T, Otani H, Ohtake Y, Tsukuura H, Matsumoto Y, Hasegawa Y, Kataoka Y, Otsuka M, Sakai K, Matsuda Y, Morita T, Koyama A, Yamaguchi T.
    • Journal Title

      J Pain Symptom Manage

      Volume: 58 Issue: 4 Pages: 645-653

    • DOI

      10.1016/j.jpainsymman.2019.06.020

    • Related Report
      2019 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] 【アドバンスケア・プランニング 光と影】PROs(患者報告アウトカム)をきっかけとした病院現場主体のACP実践~行動経済学アプローチ:ACPコミュニケーション促進のための患者だけでなく医療者へのさりげないナッジ2019

    • Author(s)
      大谷弘行
    • Journal Title

      緩和ケア

      Volume: 29 Pages: 214-216

    • Related Report
      2019 Research-status Report
  • [Journal Article] End-of-life experiences of family caregivers of deceased patients with cancer: A nation-wide survey2018

    • Author(s)
      Hirooka K, Otani H,et al
    • Journal Title

      Psycho-Oncology

      Volume: 27 Issue: 1 Pages: 272-278

    • DOI

      10.1002/pon.4504

    • Related Report
      2018 Research-status Report 2017 Research-status Report
    • Peer Reviewed
  • [Journal Article] Physician behavior toward death pronouncement in palliative care units2018

    • Author(s)
      Hatano Y, Otani H,et al
    • Journal Title

      Journal of Palliative Medicine

      Volume: 21 Issue: 3 Pages: 368-372

    • DOI

      10.1089/jpm.2017.0239

    • Related Report
      2018 Research-status Report 2017 Research-status Report
    • Peer Reviewed
  • [Journal Article] A combination of routine laboratory findings and vital signs can predict survival of advanced cancer patients without physician evaluation: a fractional polynomial model.2018

    • Author(s)
      Hamano J, Otani H,et al
    • Journal Title

      Eur J Cancer.

      Volume: 105 Pages: 50-60

    • Related Report
      2018 Research-status Report
    • Peer Reviewed
  • [Journal Article] 遺族の声を臨床に生かす J-HOPE3研究(多施設遺族調査)からの学び(第7回) 臨終期の課題 (付帯12)家族の臨終に間に合うことの意義や負担に関する研究2018

    • Author(s)
      大谷弘行
    • Journal Title

      がん看護

      Volume: 23 Pages: 515-517

    • Related Report
      2018 Research-status Report
  • [Journal Article] The death of patients with terminal cancer: the distress experienced by their children and medical professionals who provide the children with support care.2017

    • Author(s)
      Otani H
    • Journal Title

      BMJ Supportive & Palliative Care

      Volume: 印刷中 Issue: 2 Pages: 183-188

    • DOI

      10.1136/bmjspcare-2014-000811

    • Related Report
      2019 Research-status Report 2017 Research-status Report
    • Peer Reviewed
  • [Journal Article] Meaningful communication prior to death, but not presence at the time of death itself, is associated with better outcomes on measures of depression and complicated grief among bereaved family members of cancer patients.2017

    • Author(s)
      Otani H
    • Journal Title

      J Pain Symptom Manage.

      Volume: 54 Issue: 3 Pages: 1442-1452

    • DOI

      10.1016/j.jpainsymman.2017.07.010

    • Related Report
      2017 Research-status Report
    • Peer Reviewed
  • [Journal Article] 終末期の意思決定の考え方2017

    • Author(s)
      大谷弘行
    • Journal Title

      精神科

      Volume: 31 Pages: 302-306

    • Related Report
      2017 Research-status Report
  • [Presentation] 終末期せん妄は、病気なのか?正常な死の過程なのか?2020

    • Author(s)
      大谷 弘行
    • Organizer
      第26回日本緩和医療学会学術大会
    • Related Report
      2020 Annual Research Report
  • [Presentation] 死亡直前のせん妄2020

    • Author(s)
      大谷 弘行
    • Organizer
      第18回日本臨床腫瘍学会学術集会
    • Related Report
      2020 Annual Research Report
    • Invited
  • [Presentation] 緩和ケア Up To Date~論文を臨床に生かす~2020

    • Author(s)
      大谷 弘行
    • Organizer
      第2回日本緩和医療学会専門医セミナー
    • Related Report
      2020 Annual Research Report
    • Invited
  • [Presentation] 「家」で過ごす意味、「緩和ケア病棟」で過ごす意味2017

    • Author(s)
      大谷弘行
    • Organizer
      第22回日本緩和医療学会学術大会
    • Related Report
      2017 Research-status Report
  • [Presentation] 死亡前14日間・30日間の化学療法施行率の低下(年次変化)~何が影響したのか?~2017

    • Author(s)
      大谷弘行
    • Organizer
      第22回日本緩和医療学会学術大会
    • Related Report
      2017 Research-status Report
  • [Presentation] 「緩和ケア病棟」における「個室」や「大部屋」で過ごす影響2017

    • Author(s)
      大谷弘行
    • Organizer
      第22回日本緩和医療学会学術大会
    • Related Report
      2017 Research-status Report
  • [Book] がん治療医が本当に知りたかった 緩和ケアのレシピ2020

    • Author(s)
      大谷弘行
    • Total Pages
      340
    • Publisher
      メディカルビュー社
    • ISBN
      9784758318105
    • Related Report
      2020 Annual Research Report
  • [Book] 抗がん剤をいつやめるか?どうやめるか?2020

    • Author(s)
      大谷弘行
    • Total Pages
      238
    • Publisher
      日本医事新報社
    • ISBN
      9784784963829
    • Related Report
      2019 Research-status Report
  • [Book] 誰も教えてくれなかった 婦人科がん薬物療法 改訂第2版2020

    • Author(s)
      大谷弘行
    • Total Pages
      196
    • Publisher
      メディカルビュー社
    • ISBN
      9784758318099
    • Related Report
      2019 Research-status Report
  • [Book] 専門家をめざす人のための緩和医療学(改訂第2版)2019

    • Author(s)
      大谷弘行
    • Total Pages
      468
    • Publisher
      南江堂
    • ISBN
      9784524241651
    • Related Report
      2019 Research-status Report
  • [Book] がん診療スタンダードマニュアル:がん薬物療法からサポーティブケアまで2019

    • Author(s)
      大谷弘行
    • Total Pages
      688
    • Publisher
      シーニュ
    • ISBN
      9784990950569
    • Related Report
      2019 Research-status Report
  • [Book] 在宅医療バイブル2018

    • Author(s)
      大谷弘行
    • Total Pages
      656
    • Publisher
      日本医事新報社
    • Related Report
      2017 Research-status Report

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Published: 2017-07-21   Modified: 2022-01-27  

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