title: A Nationwide Survey of Quality of End-of-Life Cancer Care in Designated Cancer Centers, Inpatient Palliative Care Units, and Home Hospices in Japan: The J-HOPE Study.
abstract: BACKGROUND
  End-of-life (EOL) cancer care in general hospitals and home care has not previously been evaluated in Japan.
  
  
  OBJECTIVE
  This study aimed to evaluate EOL cancer care from the perspective of bereaved family members in nationwide designated cancer centers, inpatient palliative care units (PCUs), and home hospices in Japan.
  
  
  METHODS
  We conducted a cross-sectional, anonymous, self-report questionnaire survey for bereaved family members of cancer patients in March 2008 for 56 designated cancer centers and in June 2007 for 100 PCUs and 14 home hospices. Outcomes were overall care satisfaction, structure and process of care (Care Evaluation Scale), and achievement of a good death (Good Death Inventory).
  
  
  RESULTS
  In designated cancer centers, PCUs, and home hospices, 2794 (response rate 59%), 5312 (response rate 69%), and 292 (response rate 67%) bereaved family members participated, respectively. Mean scores for overall care satisfaction were high for all places of death, at 4.3 ± 1.2 for designated cancer centers, 5.0 ± 1.2 for PCUs, and 5.0 ± 1.0 for home hospices. Designated cancer centers showed significantly lower ratings than PCUs and home hospices for structure and process of care and achievement of a good death (P = 0.0001 each). Home hospices were rated significantly higher than PCUs for achievement of a good death (P = 0.0001).
  
  
  CONCLUSIONS
  The main findings of this study were: (1) overall, bereaved family members were satisfied with end-of-life care in all three places of death; (2) designated cancer centers were inferior to PCUs and home hospices and had more room for improvement; and 3) home hospices were rated higher than PCUs for achieving a good death, although home hospices remain uncommon in Japan.
authors: Department of Adult Nursing/Palliative Care Nursing, School of Health Sciences and Nursing Sciences, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan; Division of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan. Electronic address: miyasita-tky@umin.net.
authors: Mitsunori
authors: M
authors: Miyashita
authors: Department of Palliative and Supportive Care, Palliative Care Team and Seirei Hospice, Seirei Mikatahara Hospital, Hamamatsu, Japan.
authors: Tatsuya
authors: T
authors: Morita
authors: Department of Adult Nursing/Palliative Care Nursing, School of Health Sciences and Nursing Sciences, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan; Division of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors: Kazuki
authors: K
authors: Sato
authors: Department of Palliative Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
authors: Satoru
authors: S
authors: Tsuneto
authors: Department of Palliative Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan.
authors: Yasuo
authors: Y
authors: Shima
mesh_terms: D000368:Aged; D001601:Bereavement; D003258:Consumer Behavior; D003430:Cross-Sectional Studies; D003643:Death; D005190:Family / Q000523:psychology; D005260:Female; D017051:Hospice Care; D006738:Hospices / Q000191:economics / Q000379:methods; D006801:Humans; D007297:Inpatients; D007564:Japan; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000191:economics / Q000523:psychology / Q000628:therapy*; D010166:Palliative Care / Q000191:economics / Q000379:methods; D011785:Quality Assurance, Health Care; D011787:Quality of Health Care; D057566:Self Report; D013727:Terminal Care / Q000191:economics / Q000379:methods
keywords: Palliative care; bereaved family members; good death; neoplasms; quality of care; satisfaction