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Existential concerns of terminally ill cancer patients receiving specialized palliative care in Japan

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Abstract

Background

Although alleviation of existential distress is important for terminally ill cancer patients, the concept of existential distress has not been fully understood. The aim of this study was to categorize existential concerns of Japanese terminally ill cancer patients and explore care strategies based on the categorizations.

Methods

A multicenter cross-sectional study in 88 terminally ill cancer patients receiving specialized inpatient palliative care was performed. The nurses explored patient existential concerns by asking several key questions, and recorded the answers that they considered typically described the patients’ concerns. All statements recorded by the nurses were analyzed using content analysis methods.

Results

A total of 89 statements were subjected to analysis. The categories and their prevalence were: relationship-related concerns (22%; isolation, concerns about family preparation, conflicts in relationship), loss of control (16%; physical control, cognitive control, control over future), burden on others (4.5%), loss of continuity (10%; loss of role, loss of enjoyable activity, loss of being oneself), uncompleted life task (6.8%), hope/hopelessness (17%), and acceptance/preparation (25%).

Conclusions

Existential concerns of Japanese terminally ill cancer patients were categorized as relationship-related concerns, loss of control, burden on others, loss of continuity, uncompleted life task, hope/hopelessness, and acceptance/preparation. These themes seemed to encompass universal human suffering beyond cultural differences, and this conceptualization may contribute to the development of effective therapeutic interventions to alleviate existential distress.

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Authors and Affiliations

  1. Seirei Hospice, Seirei Mikatabara Hospital. 3453 Mikatabara-cho, 433-8558, Hamamatsu, Shizuoka, Japan

    Tatsuya Morita

  2. Department of Adult Nursing/Terminal and Long-term Care Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Masako Kawa & Etsuko Maeyama

  3. Department of Palliative Care, National Kure Medical Center, Kure, Japan

    Yoshifumi Honke

  4. Palliative Care Unit, National Sanyo Hospital, Yamaguchi, Japan

    Hiroyuki Kohara

  5. Division of General Medicine and Palliative Care, Tsukuba Medical Center Hospital, Tsukuba, Japan

    Yoshiyuki Kizawa

  6. Psycho-Oncology Division, National Cancer Center Research Institute East, Chiba, Japan

    Tatsuo Akechi & Yosuke Uchitomi

  7. Psychiatry Division, National Cancer Center Hospital East, Chiba, Japan

    Tatsuo Akechi & Yosuke Uchitomi

Authors
  1. Tatsuya Morita
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  2. Masako Kawa
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  3. Yoshifumi Honke
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  4. Hiroyuki Kohara
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  5. Etsuko Maeyama
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  6. Yoshiyuki Kizawa
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  7. Tatsuo Akechi
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  8. Yosuke Uchitomi
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Corresponding author

Correspondence to Tatsuya Morita.

Additional information

This is work is presented on behalf of the Japan Pain, Rehabilitation, Palliative Medicine, and Psycho-Oncology (J-PRPP) Study Group.

The study was supported by Health and Labor Sciences Research Grants, Clinical Research for Evidenced Based Medicine (2002).

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Morita, T., Kawa, M., Honke, Y. et al. Existential concerns of terminally ill cancer patients receiving specialized palliative care in Japan. Support Care Cancer 12, 137–140 (2004). https://doi.org/10.1007/s00520-003-0561-6

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  • DOI: https://doi.org/10.1007/s00520-003-0561-6

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