Decision-making Support and Patients’ Care Progress in a Palliative Care Outpatient Clinic at a Community Hospital

Gakuji Osawa; Junji Haruta; Miyuki Matsuura; Akika Ueno; Naoko Den

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Decision-making Support and Patients’ Care Progress in a Palliative Care Outpatient Clinic at a Community Hospital

VernacularTitle:地域の一般病院の緩和ケア外来における療養支援と患者の療養経過
Author: Gakuji OSAWA ¹ ; Junji HARUTA ² ; Miyuki MATSUURA ³ ; Akika UENO ¹ ; Naoko DEN ¹
Author Information

1. Department of Palliative Care, Oji-Seikyo Hospital
2. Medical Education Center, School of Medicine, Keio University
3. Department of Nursing, Oji-Seikyo Hospital
Keywords: decision-making; outpatient palliative care; community hospital
From:Palliative Care Research 2024;19(1):7-12
CountryJapan
Language:Japanese
Abstract: Purpose: This study aimed to investigate the decision-making support and patients’ care progress in a palliative care outpatient clinic at a community hospital. Methods: We conducted a retrospective examination of patients who visited our palliative care outpatient clinic and subsequently died between January 2020 and December 2021. The clinic, staffed by two palliative care physicians, operated twice weekly and accepted patients irrespective of their treatment status. Result: 93 patients were included in the analysis. At the onset of the outpatient clinic, 72 patients were asked about their preferred location for end-of-life care should their condition deteriorate. Of these, 25 patients preferred to receive end-of-life care in a palliative care unit (“PCU” group). Another 25 patients initially sought medical treatment at home through home-visits but later expressed a preference for care in a palliative care unit as their condition worsened (“home-visit→PCU” group). Additionally, 17 patients preferred home care from the end-of-life until death (“home-visit” group). Among the “PCU” patients, 96% received care in a palliative care unit, and 84% passed away in the same unit. In the “home-visit→PCU” group, 76% received care through home visit, and 80% passed away in a palliative care unit. In the “home-visit” group, 76% of patients received care at home, and 47% passed away in their own homes. Conclusion: These findings suggest that delivering end-of-life care in patients’ preferred locations is feasible with continuous decision-making support provided in the palliative care outpatient clinic.