title: [Talking about home hospices with terminally ill cancer patients -- a multicenter survey of bereaved families].
abstract: BACKGROUND
  Communicating with patients is clearly an integral part of physicians' practice, and introducing home hospice care is sometimes a difficult task for oncologists. The primary aims of this study were to clarify family-reported degree of emotional distress and the necessity for improvement in communication when introducing home hospice care, and to identify factors contributing to distress levels.
  
  
  METHODS
  A multicenter questionnaire survey was conducted involving 1,052 family members of cancer patients who died at home at 15 home-based hospice services throughout Japan.
  
  
  RESULTS
  A total of 616 responses were analyzed(effective response rate of 60%). Fifty-nine percent of the bereaved family members reported that they were distressed or very distressed in receiving information about home hospice care, and 30% reported considerable or much improvement was necessary. There were 6 determinants of family-reported degree of emotional distress and the necessity for improvement: 1 ) Family distress was experienced when the physician stated that the disease progression defeated medicine and nothing could be done for the patient. 2 ) The physicians' explanation did not match with the state of family preparation. 3 ) There was no intimacy between hospital physician and home physician. 4 ) Physicians did not make the atmosphere relaxing enough to allow families to ask questions. 5 ) Nurses did not follow up to generate additional ideas to supplement the physician's statement. 6 ) Family members experienced pressure to make a rash decision.
  
  
  CONCLUSIONS
  In receiving information about transition of home care, a considerable number of families experienced high levels of emotional distress and felt a need for improvement in the communication style. This study proposes 6 strategies to alleviate family distress.
authors: Dept. of Community Health Care, Hamamatsu University School of Medicine.
authors: Akemi
authors: A
authors: Yamagishi
authors: Tatsuya
authors: T
authors: Morita
authors: Shohei
authors: S
authors: Kawagoe
authors: Megumi
authors: M
authors: Shimizu
authors: Taketoshi
authors: T
authors: Ozawa
authors: Emi
authors: E
authors: An
authors: Makoto
authors: M
authors: Kobayakawa
authors: Satoru
authors: S
authors: Tsuneto
authors: Yasuo
authors: Y
authors: Shima
authors: Mitsunori
authors: M
authors: Miyashita
mesh_terms: D000368:Aged; D001601:Bereavement; D005190:Family / Q000523:psychology*; D005260:Female; D006699:Home Care Services; D006738:Hospices; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000628:therapy*; D011795:Surveys and Questionnaires; D019452:Terminally Ill