| Project/Area Number |
18K17480
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| Research Category |
Grant-in-Aid for Early-Career Scientists
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| Allocation Type | Multi-year Fund |
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| Review Section |
Basic Section 58060:Clinical nursing-related
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| Research Institution | Tohoku University |
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Principal Investigator |
Aoyama Maho 東北大学, 医学系研究科, 講師 (30781786)
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| Project Period (FY) |
2018-04-01 – 2023-03-31
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| Project Status |
Completed (Fiscal Year 2022)
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| Budget Amount *help |
¥3,640,000 (Direct Cost: ¥2,800,000、Indirect Cost: ¥840,000)
Fiscal Year 2020: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2019: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2018: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
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| Keywords | 健康格差 / 社会経済的地位 / 終末期ケア / 遺族ケア / ケアの質 / グリーフ / Good death / ケアの質評価 / がん / 終末期 / 緩和ケア / QOL |
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| Outline of Final Research Achievements |
The primary objective of this study was to determine the impact of socioeconomic status (SES) on (1) treatment choice and quality of life of cancer patients and (2) mental health (depression and complicated grief) of bereaved families. In total, 8,126 data from the nationwide multi-center bereavement survey conducted in 2018 (the Japan Hospice and Palliative Care Evaluation Study 4: J-HOPE4) were obtained and analyzed. The data was obtained and analyzed for 8,126 bereaved families. The main results were as follows: (1) Patient's desired death was related to the patient's annual income, whether or not the patient lived with a family member, living arrangements during treatment, and other factors. (2) Depression of the bereaved family members was related to their relationship with the deceased, current household income, and other factors. (3) The percentage of patients who discontinued or changed standard treatment for cancer due to financial reasons was 11%.
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| Academic Significance and Societal Importance of the Research Achievements |
社会経済的地位の違いによる健康格差は医療・公衆衛生学分野で広く明らかになっているものの、緩和ケア/終末期ケアにおけるアウトカムである終末期がん患者のQuality of Life (QOL)や遺族の精神的健康に与える影響は明らかでなく、具体的なアセスメント方法や支援方法が明らかではなかった。本研究で患者の望ましい死の達成度や遺族のうつ・複雑性悲嘆の関連要因を示したことで、医療者や行政が注視・改善すべき、がん患者および家族/遺族の社会経済的な要因、特に介入し、改善可能な要因について明らかになった。
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