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Supportive Care in Cancer

, Volume 26, Issue 11, pp 3861–3871 | Cite as

Japanese physicians’ attitudes toward end-of-life discussion with pediatric patients with cancer

  • Saran Yoshida
  • Chitose Ogawa
  • Ken Shimizu
  • Mariko Kobayashi
  • Hironobu Inoguchi
  • Yoshio Oshima
  • Chikako Dotani
  • Rika Nakahara
  • Masashi Kato
Original Article
  • 143 Downloads

Abstract

Purpose

We explored pediatricians’ practices and attitudes concerning end-of-life discussions (EOLds) with pediatric patients with cancer, and identified the determinants of pediatricians’ positive attitude toward having EOLds with pediatric patients.

Methods

A multicenter questionnaire survey was conducted with 127 pediatricians specializing in the treatment of pediatric cancer.

Results

Forty-two percent of participants reported that EOLds should be held with the young group of children (6–9 years old), 68% with the middle group (10–15 years old), and 93% with the old group (16–18 years old). Meanwhile, 6, 20, and 35% of participants answered that they “always” or “usually” discussed the incurability of the disease with the young, middle, and old groups, respectively; for the patient’s imminent death, the rates were 2, 11, and 24%. Pediatricians’ attitude that they “should have” EOLds with the young group was predicted by more clinical experience (odds ratio [OR] 1.077; p = 0.007), more confidence in addressing children’s anxiety after EOLd (OR 1.756; p = 0.050), weaker belief in the demand for EOLd (OR 0.456; p = 0.015), weaker belief in the necessity of the EOLd for children to enjoy their time until death (OR, 0.506; p = 0.021), and weaker belief in the importance of maintaining a good relationship with the parents (OR 0.381; p = 0.025).

Conclusions

While pediatricians nearly reached consensus on EOLds for the old group, EOLds with the young group remain a controversial subject. While pediatricians who supported EOLds believed in their effectiveness or necessity, those who were against EOLds tended to consider the benefits of not engaging in them.

Keywords

End-of-life discussion Communication Attitude Palliative care 

Notes

Funding

This study was supported by JSPS KAKENHI Grant Number 26780408.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Graduate School of EducationTohoku UniversitySendai cityJapan
  2. 2.Department of Pediatric OncologyNational Cancer Center HospitalTokyoJapan
  3. 3.Department of Psycho-oncologyNational Cancer Center HospitalTokyoJapan
  4. 4.Division of Psycho-oncologyThe Cancer Institute Hospital of the Japanese Foundation for Cancer ResearchTokyoJapan
  5. 5.Department of PediatricsThe University of Tokyo HospitalTokyoJapan
  6. 6.Center for Cancer Control and Information ServicesNational Cancer CenterTokyoJapan

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