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End-of-life care desired by children and family

Research Project

Project/Area Number 20H01665
Research Category

Grant-in-Aid for Scientific Research (B)

Allocation TypeSingle-year Grants
Section一般
Review Section Basic Section 09030:Childhood and nursery/pre-school education-related
Research InstitutionNational Center for Child Health and Development

Principal Investigator

Yotani Nobuyuki  国立研究開発法人国立成育医療研究センター, 総合診療部, 診療部長 (70593127)

Co-Investigator(Kenkyū-buntansha) 名古屋 祐子  宮城大学, 看護学群, 准教授 (00631087)
新城 大輔  東京医科歯科大学, 大学院医歯学総合研究科, 准教授 (10707285)
加藤 元博  東京大学, 医学部附属病院, 教授 (40708690)
吉田 沙蘭  東北大学, 教育学研究科, 准教授 (70636331)
諫山 哲哉  国立研究開発法人国立成育医療研究センター, 周産期・母性診療センター, 診療部長 (80818146)
Project Period (FY) 2020-04-01 – 2024-03-31
Project Status Completed (Fiscal Year 2023)
Budget Amount *help
¥12,740,000 (Direct Cost: ¥9,800,000、Indirect Cost: ¥2,940,000)
Fiscal Year 2023: ¥3,770,000 (Direct Cost: ¥2,900,000、Indirect Cost: ¥870,000)
Fiscal Year 2022: ¥3,250,000 (Direct Cost: ¥2,500,000、Indirect Cost: ¥750,000)
Fiscal Year 2021: ¥2,210,000 (Direct Cost: ¥1,700,000、Indirect Cost: ¥510,000)
Fiscal Year 2020: ¥3,510,000 (Direct Cost: ¥2,700,000、Indirect Cost: ¥810,000)
Keywords終末期治療 / PICU / NICU / 神経疾患 / 小児がん / アドバンス・ケア・プランニング / ICU / 症状評価 / 脳性麻痺 / 遺族調査 / 小児終末期 / DPC / 終末期 / 疼痛評価 / 希望 / 積極的治療 / 緩和ケア / 終末期医療 / 医療費支払いデータベース / こども
Outline of Research at the Start

本研究の目的は、患者・家族が望む「よりよいこどもの最期」とは何かを明らかにすることである。具体的には①医療費支払いデータベースの解析及び②多施設共同データベース作成を行い、終末期の積極的治療及び緩和医療の実態を明らかにした上で、③遺族調査をもとに患者・家族が望む「小児終末期医療・ケアのあり方」および「よりよい最期に関連する項目」を明らかにする。本研究によって、当事者が望む小児終末期医療と実態のギャップを明らかにし、小児終末期医療の診療レベルの底上げや、治癒が望めない病気を持つこどもと家族のQOLの向上に貢献したい。

Outline of Final Research Achievements

The aim of this study is to clarify what children and families desire as a "better end-of-life care for children". To clarify the status of pediatric end-of-life care, we used DPC data and demographic statistics to clarify the actual status of end-of-life treatment and place of care for children with pediatric oncology, PICU, NICU, and pediatric neurological diseases. In addition, we clarified the actual situation of evaluation of children's symptoms by nurses in PICU and oncology. The survey of bereaved families was not carried out. Instead, we translated and widely distributed a guidebook on pediatric advance care planning prepared by a group in the Netherlands.

Academic Significance and Societal Importance of the Research Achievements

これまで明らかでなかった小児患者の終末期の実態について、ビックデータを用いて疾患別に明らかにすることができた。これを基盤として、小児終末期医療の在り方について検討することができる。
遺族調査については、実現可能性を検討し課題が明らかになった。また、小児アドバンス・ケア・プランニングの冊子作製は、今後これを用いて研修会を実施し広く普及啓発を行っていく。

Report

(5 results)
  • 2023 Annual Research Report   Final Research Report ( PDF )
  • 2022 Annual Research Report
  • 2021 Annual Research Report
  • 2020 Annual Research Report
  • Research Products

    (25 results)

All 2024 2023 2022 2021 2020

All Journal Article (12 results) (of which Peer Reviewed: 8 results,  Open Access: 2 results) Presentation (13 results) (of which Int'l Joint Research: 4 results,  Invited: 7 results)

  • [Journal Article] Current status of pediatric palliative care and decision making in Japan2024

    • Author(s)
      Yotani Nobuyuki
    • Journal Title

      Current Problems in Pediatric and Adolescent Health Care

      Volume: 54 Issue: 1 Pages: 101557-101557

    • DOI

      10.1016/j.cppeds.2024.101557

    • Related Report
      2023 Annual Research Report
  • [Journal Article] Gabapentin for treatment of apnea in infants with trisomy 13 and 182023

    • Author(s)
      Yotani Nobuyuki、Isayama Tetsuya、Ito Yushi
    • Journal Title

      Pediatrics International

      Volume: 65 Issue: 1

    • DOI

      10.1111/ped.15646

    • Related Report
      2023 Annual Research Report
  • [Journal Article] これからの小児緩和ケアについて考える 10年先を見据えて2023

    • Author(s)
      余谷暢之
    • Journal Title

      日本臨床麻酔学会誌

      Volume: 43 Pages: 258-263

    • Related Report
      2023 Annual Research Report
  • [Journal Article] 重篤な疾患をもつ子ども・家族とこれからについて話し合う 小児領域におけるアドバンス・ケア・プランニングの実践2023

    • Author(s)
      余谷暢之
    • Journal Title

      小児保健研究

      Volume: 82 Pages: 255-257

    • Related Report
      2023 Annual Research Report
  • [Journal Article] A Neonate with Mucopolysaccharidosis Type VII with Intractable Ascites2023

    • Author(s)
      Fukui Kana、Amari Shoichiro、Yotani Nobuyuki、Kosaki Rika、Hata Kenichiro、Kosuga Motomichi、Sago Haruhiko、Isayama Tetsuya、Ito Yushi
    • Journal Title

      American Journal of Perinatology Reports

      Volume: 13 Issue: 01 Pages: e25-e28

    • DOI

      10.1055/a-2028-7784

    • Related Report
      2022 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Nurses' perception of pediatric pain and pain assessment in the Japanese <scp>PICU</scp>2023

    • Author(s)
      Tsuboi Kaoru、Tsuboi Norihiko、Yamashita Kana、Nakagawa Satoshi、Yotani Nobuyuki
    • Journal Title

      Pediatrics International

      Volume: 65 Issue: 1

    • DOI

      10.1111/ped.15499

    • Related Report
      2022 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Current status of intensive end-of-life care in children with hematologic malignancy: a population-based study2021

    • Author(s)
      Yotani N, Shinjo D, Kato M,Matsumoto K,Fushimi K, Kizawa Y
    • Journal Title

      BMC Palliat Care

      Volume: 20 Pages: 82-82

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Factors associated with high care burden of primary caregivers of children with medical complexity after completing a discharge-support program in a recovery center.2021

    • Author(s)
      Fuyuki M, Yotani N, Kondo M, Iijima Y, Wada H, Takemoto K, Funato M, Ito K, Shintaku H, Hamazaki T.
    • Journal Title

      Brain Dev.

      Volume: 43 Pages: 988-996

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Development of a Proxy Quality-of-Life Rating Scale for the End-of-Life Care of Pediatric Cancer Patients Evaluated from a Nurse's Perspective2020

    • Author(s)
      Nagoya Yuko、Miyashita Mitsunori、Irie Wataru、Yotani Nobuyuki、Shiwaku Hitoshi
    • Journal Title

      Journal of Palliative Medicine

      Volume: 23 Issue: 1 Pages: 82-89

    • DOI

      10.1089/jpm.2018.0598

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Withholding and withdrawal of life-sustaining treatments for neonate in Japan: Are hospital practices associated with physicians' beliefs, practices, or perceived barriers?2020

    • Author(s)
      Yotani Nobuyuki、Nabetani Makoto、Feudtner Chris、Honda Junko、Kizawa Yoshiyuki、Iijima Kazumoto
    • Journal Title

      Early Human Development

      Volume: 141 Pages: 104931-104931

    • DOI

      10.1016/j.earlhumdev.2019.104931

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed
  • [Journal Article] 終末期にある小児がん患者のQOLと関連要因─看護師によるQOL代理評価尺度を用いて─2020

    • Author(s)
      名古屋 祐子, 宮下 光令, 入江 亘, 余谷 暢之, 塩飽 仁
    • Journal Title

      Palliat Care Res

      Volume: 15 Pages: 53-64

    • NAID

      130007829108

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed
  • [Journal Article] 小児専門施設における医療用麻薬の使用実態と特徴2020

    • Author(s)
      小野寺 祐里香, 余谷 暢之, 歌野 智之, 牧山 稔, 山谷 明正
    • Journal Title

      日本小児臨床薬理学会雑誌

      Volume: 32 Pages: 109-113

    • NAID

      40022369177

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed
  • [Presentation] 周産期・新生児領域の緩和ケアの実践 ~家族になることを支えるために~2024

    • Author(s)
      余谷暢之
    • Organizer
      第 36 回京滋新生児成育研究会
    • Related Report
      2023 Annual Research Report
    • Invited
  • [Presentation] こどもたちのLifeを支える~こどもたちに緩和ケアを届けるために大切にしたいこと~2023

    • Author(s)
      余谷暢之
    • Organizer
      第5回日本緩和医療学会北海道支部学術大会
    • Related Report
      2023 Annual Research Report
    • Invited
  • [Presentation] 重症心身障害児者の医療における代理意思決定支援について考える~本人を主語に関わるために~2023

    • Author(s)
      余谷暢之
    • Organizer
      第48回日本重症心身障害学会学術集会
    • Related Report
      2023 Annual Research Report
    • Invited
  • [Presentation] Influencing Factors for Cardiopulmonary Resuscitations Performance in Japan's Neonatal Intensive Care Units: A Population-based Study2023

    • Author(s)
      Kazuto Ueda, Saori Kuratani, Yusuke Seino, Daisuke Shinjo, Chisato Miyakoshi, Kiyohide Fushimi, Yoshiaki Sato, Yoshiyuki Takahashi, Nobuyuki Yotani
    • Organizer
      15th Asia Pacific Hospice Palliative Care Conference 2023
    • Related Report
      2023 Annual Research Report
    • Int'l Joint Research
  • [Presentation] 胎児期からの緩和ケアの実践2022

    • Author(s)
      余谷 暢之, 甘利 昭一郎, 杉林 里佳, 室本 仁, 小澤 克典, 和田 誠司, 和田 友香, 諫山 哲哉, 伊藤 裕司, 窪田 満, 左合 治彦
    • Organizer
      第125回日本小児科学会学術集会
    • Related Report
      2022 Annual Research Report
  • [Presentation] NICUでの終末期の積極的治療の差し控え・中止 18年間の後方視的検討2022

    • Author(s)
      伊東 藍, 余谷 暢之, 生田 泰久, 甘利 昭一郎, 丸山 秀彦, 伊藤 裕司, 諫山 哲哉
    • Organizer
      第58回日本周産期・新生児医学会学術集会
    • Related Report
      2022 Annual Research Report
  • [Presentation] “Pediatric Palliative Care in Japan: Past and Future Prospects”2022

    • Author(s)
      Yotani N
    • Organizer
      Korean Society of Hospice Palliative Care
    • Related Report
      2022 Annual Research Report
    • Int'l Joint Research / Invited
  • [Presentation] 終末期にある小児がんの子どもの親の希望 診療録を用いた後方視調査2021

    • Author(s)
      名古屋 祐子, 入江 亘, 高山 温子, 余谷 暢之
    • Organizer
      第63回日本小児血液・がん学会学術集会
    • Related Report
      2021 Annual Research Report
  • [Presentation] 小児がん患者に対する痛みの看護についての知識、実践、困難感に関する調査 単施設での検討2021

    • Author(s)
      木須 彩, 坂本 謙一, 江丸 由里子, 會田 麻里絵, 余谷 暢之
    • Organizer
      第63回日本小児血液・がん学会学術集会
    • Related Report
      2021 Annual Research Report
  • [Presentation] Specialist palliative care service for children with life-threatening conditions in Japan2021

    • Author(s)
      Yotani N
    • Organizer
      14th Asia Pacific Hospice Palliative Care Conference
    • Related Report
      2021 Annual Research Report
    • Int'l Joint Research / Invited
  • [Presentation] Advance care planning for children with life-limiting conditions2021

    • Author(s)
      Yotani N
    • Organizer
      The 28th Annual Spring Meeting of Korean Society of Neonatology
    • Related Report
      2021 Annual Research Report
    • Int'l Joint Research / Invited
  • [Presentation] 遺伝性・先天性の疾患を持つこども・家族とこれからについて話し合う2021

    • Author(s)
      余谷暢之
    • Organizer
      第43回日本小児遺伝子学会学術集会
    • Related Report
      2020 Annual Research Report
    • Invited
  • [Presentation] わが国の新生児医療における治療中止・差し控えの現状 全国調査の結果から2020

    • Author(s)
      余谷 暢之, 鍋谷 まこと, 飯島 一誠
    • Organizer
      第123回日本小児科学会学術集会
    • Related Report
      2020 Annual Research Report

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Published: 2020-04-28   Modified: 2025-01-30  

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