Development of a home-based end-of-life care program for chronically ill patients led by home-visit nurses

2023 Fiscal Year Final Research Report

• Project/Area Number: 20K19288
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 58080:Gerontological nursing and community health nursing-related
• Research Institution: Tokyo University of Technology
• Principal Investigator: Asaumi Kurumi 東京工科大学, 医療保健学部, 講師 (90735367)
• Project Period (FY): 2020-04-01 – 2024-03-31
• Keywords: 訪問看護 / エンドオブライフケア / 終末期の話し合い

Outline of Final Research Achievements

While more than 60% of the population would like to spend their final days at home, the actual death rate at home is only approximately 10%. Improving the quality of end-of-life (EOL) discussions, which are central to EOL care, is a necessary step to closing this gap. This study conducted a baseline survey and explored effective interventions to develop an EOL care program led by home-visit nurses. In the first phase, interviews revealed that the timing of EOL discussions, differed between patients with cancer and those with non-cancer. In the second phase, a national questionnaire survey was used to develop a scale to determine the optimal timing for home-visit nurses to initiate EOL discussions with patients with cancer and their caregivers. The subsequent analysis statistically validated the scale.

Free Research Field

看護学

Academic Significance and Societal Importance of the Research Achievements

エンドオブライフケアの中心である「終末期の話し合い」は、早すぎても遅すぎても有効ではない。また、がん疾患と非がん疾患は、病の軌跡が異なるため、その特性に応じて話し合いのタイミングを検討する必要がある。基本的に一人で訪問し、自宅でケアを提供する訪問看護師にとって、センシティブな話題となる話し合いのタイミングを適切に評価することに困難感を覚える者が少なくない。本研究により、がん療養者と非がん療養者に対する終末期の話し合いの様相を明らかにし、話し合いのタイミングを評価する尺度を作成したことは、適切なタイミングで訪問看護師が終末期の話し合いを実施する一助になると考える。