Analysis of the circumstances of death of 56 children suffering from cancer: proposal for the development of terminal medicine in Japan.
In Japan terminal medicine for children dying from cancer has not yet been developed nor has a support system for home terminal care and bereaved families been established. We have analyzed our own experiences in these areas and researched the possibilities of establishing support systems. In the 16 years from 1978 to 1993, 56 children with cancer have been treated and have died at Hamamatsu University Hospital. We analyzed the circumstances of their deaths. We interviewed 25 sets of parents about their acceptance of their child's death. Three children (5%) died unexpectedly during treatment, 27 children (48%) died from the side-effects of intensive treatment, and 26 children (47%) died during terminal care. More children with leukemia and lymphoma died from side-effects than children with solid tumors (P < 0.05). Six out of the 25 families had not yet accepted the loss of their child due to regrets associated with the missed opportunity for terminal care. From our experiences with the five children who received terminal care at home, we recognize the need for a support system run by the hospital and conclude the time is ripe for initiating home-based terminal care in Japan.
Hongo
T
T
Department of Pediatrics, Hamamatsu University School of Medicine, Japan.
Fujii
Y
Y
Yajima
S
S
Matsushita
T
T
Ogawa
N
N
Kinjo
Y
Y
D002648:Child; D002675:Child, Preschool; D005260:Female; D006699:Home Care Services; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D009369:Neoplasms / Q000401:mortality*; D013727:Terminal Care