Predictors of dying at home for patients receiving nursing services in Japan: A retrospective study comparing cancer and non-cancer deaths

<p>Abstract</p> <p>Background</p> <p>The combined effects of the patient's and the family's preferences for death at home have in determining the actual site of death has not been fully investigated. We explored this issue on patients who had been receiving end-of-life care from Visiting Nurse Stations (VNS). In Japan, it has been the government's policy to promote end-of-life care at home by expanding the use of VNS services.</p> <p>Methods</p> <p>A retrospective national survey of a random sample of 2,000 out of the 5,224 VNS was made in January 2005. Questionnaires were mailed to VNS asking the respondents to fill in the questionnaire for each patient who had died either at home or at the hospital from July to December of 2004. Logistic regression analysis was respectively carried out to examine the factors related to dying at home for cancer and non-cancer patients.</p> <p>Results</p> <p>We obtained valid responses from 1,016 VNS (50.8%). The total number of patients who had died in the selected period was 4,175 (cancer: 1,664; non-cancer: 2,511). Compared to cancer patients, non-cancer patients were older and had more impairment in activities of daily living (ADL) and cognitive performance, and a longer duration of care. The factor having the greatest impact for dying at home was that of both the patient and the family expressing such preferences [cancer: OR (95% CI) = 57.00 (38.79-83.76); non-cancer: OR (95% CI) = 12.33 (9.51-15.99)]. The Odds ratio was greater compared with cases in which only the family had expressed such a preference and in which only the patient had expressed such a preference. ADL or cognitive impairment and the fact that their physician was based at a clinic, and not at a hospital, had modest effects on dying at home.</p> <p>Conclusions</p> <p>Dying at home was more likely when both the patient and the family had expressed such preferences, than when the patient alone or the family alone had done so, in both cancer and non-cancer patients. Health care professionals should try to elicit the patient's and family's preferences on where they would wish to die, following which they should then take appropriate measures to achieve this outcome.</p

Life sustaining treatment at end-of-life in Japan: Do the perspectives of the general public reflect those of the bereaved of patients who had died in hospitals?

Objective To compare the perspectives of the general public and of the bereaved of patients who had died in hospitals on life sustaining treatment (LST).Method Two self-administered questionnaire surveys were conducted in a city in Japan. The general public survey was mailed to a stratified sample of 1000 residents aged 20 and over, of which 419 (42%) responded. The bereaved survey was mailed to 427 family members of patients who had died in the city's 6 hospitals, of which 205 (48%) responded.Results In the general public survey, 44% had discussed LST with their family; 30% thought physicians discussed them with the patient or family; if a family member were to have cancer 57% did not want LST, if frail, 69%. In the bereaved survey, 39% had discussed LST with the patient; 80% had the respondent's preferences followed by the physician; 23% had not wanted LST for cancer, 39% for a frail condition.Conclusion The LST preferences of a family member were known by less than half of the respondents in both surveys. When compared with the general public, the bereaved evaluated the physician's attitude more positively and the proportion who did not want LST was less.Bereaved family members Living will Life sustaining treatment End-of-life care

SHA-Based Health Accounts in 13 OECD Countries - Country Studies - Japan: National Health Accounts 2000

A project aimed at presenting initial results from the implementation of the System of Health Accounts has been carried by the Health Policy Unit at the OECD and experts from thirteen member countries. The results are presented in the form of a comparative study (OECD Health Working Papers No. 16) and a set of OECD Health Technical Papers presenting individual country studies. This volume is the sixth in this series, presenting the Japanese SHA-based health accounts. L’Unité des politiques de santé de l’OCDE et des experts originaires de treize pays Membres ont mené un projet visant à rendre compte des premiers résultats de la mise en œuvre du Système de comptes de la santé (SCS). Ces résultats se présentent sous la forme d’une étude comparative (document de travail sur la santé n° 16 de l’OCDE) et d’un ensemble de rapports techniques sur la santé contenant des études par pays. Ce volume est le sixième de la série, il examine les comptes de la santé fondés sur le SCS au Japon.

Short NoteInvasive Australian crayfish Cherax quadricarinatus in the Sanyati Basin of Lake Kariba: a preliminary survey

The invasion of Cherax quadricarinatus, the Australian redclaw crayfish, in the Sanyati Basin of Lake Kariba, Zimbabwe, is reported. A total of 79 crayfish were caught at 10 out of 12 sampling sites in the Sanyati Basin in November–December 2012. The average catch per unit effort (CPUE) varied from 1.1 to 4 crayfish per trap per night, carapace length ranged from 29 to 93.5 mm, and weight ranged from 4 to 196.2 g. Most crayfish were between 50 and 59.9 mm carapace length. Males (average 82.6 g) were significantly heavier than females (37.2 g) and males were larger in carapace length, carapace width, chela length and chela width. A feral population of C. quadricarinatus is now established in the Sanyati Basin. Possible modes of dispersal within the basin are discussed.Keywords: alien species, dispersal, ecological niche, introduction, sexual dimorphismAfrican Journal of Aquatic Science 2014, 39(2): 233–23