title: Why people accept opioids: role of general attitudes toward drugs, experience as a bereaved family, information from medical professionals, and personal beliefs regarding a good death.
abstract: BACKGROUND
  Many surveys have evaluated patient-related barriers to pain management.
  
  
  OBJECTIVE
  To explore associations between a preference for opioids and general attitudes toward drugs, the experience and information received as a bereaved family, and beliefs regarding a good death.
  
  
  METHODS
  A cross-sectional survey, performed in 2010, of bereaved families of patients with cancer in palliative care units across Japan. Questionnaires were sent to 997 families.
  
  
  RESULTS
  A total of 66% of families responded. Of these, 224 responses were excluded because the family declined to participate in the study (n = 38), the patient was not receiving any opioid analgesics, and there were missing data (n = 164), or data were missing for the primary end points (n = 22). Thus, 432 responses were finally analyzed (43%). In total, 26%, 41%, and 31% of family members stated that they strongly want to receive, want to receive, or slightly want to receive opioids if needed in the future, respectively. Determinants associated with a preference for receiving opioid treatment were the following: a general appreciation of the drugs (P = 0.005), witnessing an improvement in the patient's quality of life as a result of pain relief (P = 0.003), information provided by medical professionals that the opioid could be discontinued if side effects developed (P = 0.042), and the belief that a good death was one that was free from pain and physical distress (P < 0.001).
  
  
  CONCLUSIONS
  More than 90% of bereaved families whose relatives were treated with opioid analgesics reported a preference to receive opioid analgesics for the treatment of cancer pain, if necessary, in the future.
authors.affiliation: Shinjo Clinic, Kobe, Japan. Electronic address: shinjo@doctor.email.ne.jp.
authors.forename: Takuya
authors.initials: T
authors.lastname: Shinjo
authors.affiliation: Department of Palliative and Supportive Care, Palliative Care Team and Seirei Hospice, Seirei Mikatahara Hospital, Hamamatsu, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Morita
authors.affiliation: Department of Complementary and Alternative Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Hirai
authors.affiliation: Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Miyashita
authors.affiliation: Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Megumi
authors.initials: M
authors.lastname: Shimizu
authors.affiliation: Department of Multidisciplinary Cancer Treatment Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Tsuneto
authors.affiliation: Department of Palliative Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Shima
mesh_terms: D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D001293:Attitude to Death; D001601:Bereavement; D003430:Cross-Sectional Studies; D005190:Family / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000628:therapy; D010166:Palliative Care / Q000523:psychology*; D011795:Surveys and Questionnaires
chemical_list: D000701:Analgesics, Opioid
keywords: Opioid; attitudes; bereaved family; cancer; pain