title: The importance of good death components among cancer patients, the general population, oncologists, and oncology nurses in Japan: patients prefer "fighting against cancer".
abstract: BACKGROUND
  The objectives of this study were to compare the importance of components of a good death among cancer patients, the general population, oncologists, and oncology nurses, and explore which patients preferred "fighting against cancer."
  
  
  METHODS
  We conducted a cross-sectional anonymous self-reported survey of cancer patients who visited a radiation oncology outpatient clinic, oncologists, and oncology nurses at the Tokyo University Hospital and a random sample of the general population in the Tokyo metropolitan area. The outcomes were 18 previously developed components of a good death in Japanese cancer care consisting of 57 attributes.
  
  
  RESULTS
  Three hundred ten patients, 353 subjects from the general population, 109 oncologists, and 366 oncology nurses participated. The desire to "fight against cancer" was highly significantly different between patients and oncologists (effect size [ES] = -1.40; P = 0.001) and patients and oncology nurses (ES = -1.12; P = 0.001). "Physical and cognitive control" was, similarly, highly significantly different between patients and oncologists (ES = -1.30; P = 0.001) and patients and oncology nurses (ES = -1.06; P = 0.001). Patients who emphasized "maintaining hope and pleasure" (P = 0.0001), "unawareness of death" (P = 0.0001), and "good relationship with family" (P = 0.004) favored "fighting against cancer." The patients, however, who emphasized "physical and psychological comfort" did not significantly favor "fighting against cancer" (P = 0.004).
  
  
  CONCLUSIONS
  The importance of good death components differed between groups. Medical professionals should be aware of the diversity of values surrounding death and assess the patient's values and discuss them to support his or her quality of life. In addition, the development of care and a medical/social system to maintain hope and pleasure after failure of anticancer treatment is necessary.
authors.affiliation: Department of Adult Nursing/Palliative Care Nursing, School of Health Sciences and Nursing Sciences, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan, miyasita-tky@umin.net.
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Miyashita
authors.forename: Sachiko
authors.initials: S
authors.lastname: Kawakami
authors.forename: Daiki
authors.initials: D
authors.lastname: Kato
authors.forename: Hideomi
authors.initials: H
authors.lastname: Yamashita
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Igaki
authors.forename: Kimiko
authors.initials: K
authors.lastname: Nakano
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Kuroda
authors.forename: Keiichi
authors.initials: K
authors.lastname: Nakagawa
mesh_terms: D000328:Adult; D000368:Aged; D001293:Attitude to Death; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality* / Q000523:psychology* / Q000532:radiotherapy; D009726:Nurses; D010166:Palliative Care / Q000379:methods / Q000523:psychology*; D010820:Physicians / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D012945:Social Values; D011795:Surveys and Questionnaires; D014041:Tokyo