Support for unfinished business of patients with terminal cancer provided simultaneously with the start of advance care planning

2022 Fiscal Year Final Research Report

• Project/Area Number: 20K10804
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 58060:Clinical nursing-related
• Research Institution: Yamaguchi University
• Principal Investigator: TANAKA Aiko 山口大学, 大学院医学系研究科, 教授 (10285447)
• Co-Investigator(Kenkyū-buntansha): 藪本 知二 山口県立大学, 社会福祉学部, 教授 (30244768) ; 永田 千鶴 山口大学, 大学院医学系研究科, 教授 (50299666)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Keywords: 人生の最終段階のケア / アドバンスケアプランニング / チーム医療 / 生活関係の清算 / 遣り残しの仕事 / 看護師

Outline of Final Research Achievements

This study aimed at developing a method of support for patients with terminal cancer need to complete their unfinished business. Using interviews with physicians, nurses, care manager, medical social workers (MSW), and attorneys, as well as the content of simulation meeting as a framework, a questionnaire survey was conducted with general ward nurses and visiting nurses nationwide.
Responses were obtained from 722 nurses. The results showed that patients consulted with the nurses about the issues of wanting to go home, worrying about family-related problems, managing homeownership, and worrying about succession of their business. Nurses were in the position of listening to the patients’ concerns and MSWs and care managers played an important role in dealing with these concerns and distresses. The study suggests that nurses were responsible for sharing the patients’ issues with the care team including MSWs and care managers.

Free Research Field

基礎看護学

Academic Significance and Societal Importance of the Research Achievements

人生の最終段階にある患者の中には「生活関係の清算が進まない」ことに苦悩する人がある。本研究の目的は、アドバンスケアプランニング（ACP)と同時に、患者の生活関係の清算への支援ニードを把握して、必要に応じた支援を行う方法を実際に検討することにあった。このことは、生活者としての患者が生活関連のやり残した課題を全うして最期まで自分らしい人生を送ることや遺された人へのグリーフケアへ繋がる。
今回の調査で患者の要望があれば弁護士等の介入や多職種に繋ぐための看護師の役割を明確にした。以上は、ACPとともに患者に今後の意向を確認することや、2025年以降の多死時代等の社会的課題にも解決の道筋を見出した。