title: Good death in elderly adults with cancer in Japan based on perspectives of the general population.
abstract: OBJECTIVE
  To investigate concepts relevant to a good death in elderly adults with cancer.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Japan.
  
  
  METHODS
  A national sample of 2,595 adults, including 466 aged 70 to 79.
  
  
  METHODS
  An anonymous questionnaire covering 18 domains (physical and psychological comfort, dying in a favorite place, good relationship with medical staff, maintaining hope and pleasure, not being a burden to others, good relationship with family, physical and cognitive control, environmental comfort, being respected as an individual, life completion, natural death, preparation for death, role accomplishment and contribution to others, unawareness of death, fighting against cancer, pride and beauty, control over the future, and religious and spiritual comfort) and two additional concepts (pokkuri (sudden death) and omakase (leaving the decisions to a medical expert) was completed. The difference in importance of the concept between two age groups (40-69 and 70-79) was investigated using effect sizes (ESs).
  
  
  RESULTS
  Clinically significant differences in the concept of good death were observed for two domains and one component: not being a burden to others (ES = -0.24), role accomplishment and contribution to others (ES = 0.29), and omakase (leaving the decisions to a medical expert; ES = 0.60).
  
  
  CONCLUSIONS
  Only a few differences in the concept of good death existed between elderly and younger adults. When caring for terminally ill elderly Japanese adults, medical staff should acknowledge that some elderly adults value the traditional paternalistic attitude of physicians and that not all people want to be actively involved in decision-making.
authors.affiliation: Department of Psychiatry and Cognitive-Behavioral Medicine, Graduate School of Medical Sciences, Nagoya City University Hospital, Nagoya, Japan. takechi@med.nagoya-cu.ac.jp
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Akechi
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Miyashita
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Morita
authors.forename: Toru
authors.initials: T
authors.lastname: Okuyama
authors.forename: Masaki
authors.initials: M
authors.lastname: Sakamoto
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Sagawa
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Uchitomi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001293:Attitude to Death; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009369:Neoplasms; D011639:Public Opinion; D012297:Right to Die; D011795:Surveys and Questionnaires