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Drug Discov Ther. 2019;13(1):47-51. doi: 10.5582/ddt.2019.01002.

End-of-life care conferences in Japanese nursing homes.

Author information

1
Department of General Internal Medicine, Shonan Kamakura General Hospital.
2
Unit of Public Health and Preventive Medicine, Yokohama City University.
3
Department of Internal Medicine, Hayama Heart Center.
4
Department of Medical Education, Yokohama City University.

Abstract

End-of-life (EOL) care conferences have an important role in promoting EOL care in nursing homes. However, the details of the conferences remain poorly understood. A Japanese prefecture-wide survey was conducted to investigate the factors involved in such conferences that contribute to an increase in the amount of EOL care. One hundred fifty-three nursing homes performed the conferences. The outcome was the amount of EOL care provided in nursing homes after adjusting for the facility beds in 2014. We investigated the factors of staff experience with EOL care, frequency of the conferences, years the conferences were conducted, review conferences after EOL care, and professional participants in the conferences. The multivariate analysis revealed significant associations between EOL care in nursing homes and nurses' experience with EOL care (adjusted β coefficient 2.9, 95% confidence interval (CI) 0.52 ~ 5.22, p = 0.017), more than 5 years of continuous conferences (adjusted β coefficient 3.8, 95% CI 0.46 ~ 7.05, p = 0.026), and family participation (adjusted βcoefficient ‒4.0, 95% CI ‒7.5 ~ ‒0.48, p = 0.026). In conclusion, the continuation of conferences and enrollment of the nurse with experience in EOL care may promote EOL care in nursing homes, while family enrollment in conferences may decrease EOL care in nursing homes. EOL care conferences in nursing homes should be continuously performed by staff, with an experienced nurse undertaking the task of information sharing before discussing EOL care with the patients' families.

KEYWORDS:

End-of-life care conferences; Japan; end-of-life care; interdisciplinary care; interprofessional collaboration; nursing home

PMID:
30880322
DOI:
10.5582/ddt.2019.01002
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