The primary aim of this study was to investigate the reliability and validity of a measurement tool to quantify the quality of communication and cooperation among health care providers in a region. A total of 476 health care professionals were enrolled. For the 25-item scale, the internal consistency was excellent. Factor analyses identified 7 underlying factors, such as easy communication with health care providers in other institutions, understanding the role of other disciplines in the region, and knowing the face, name, and the way of thinking. The total score had weak negative but significant correlations with the cooperation subscale of the Palliative care Difficulties Scale. The total score was also significantly associated with the general evaluation of communication and cooperation in the region, the number of participations in whole-region multidisciplinary conferences, the number of persons to whom the respondent could ask about palliative care in the region, and clinical experience in the region. In conclusion, this scale can measure the quality of communication and cooperation among health care providers in a region with acceptable reliability and validity.

To explore the concept of “kao-no-mieru kankei (face-to-face relationships)” and effects on community care networks, questionnaire and interview surveys were conducted involving 207 and 5 health care professionals, respectively. The item “face-to-face relationships” were significantly correlated with “I know his/her name, face, and way of thinking” “I understand the principles and current status of the facility” “I know his/her characteristics and how to deal with them”, and “I know what each person does” (p>0.7). An interview survey showed that “face-to-face relationships” consisted of “know the name and face” “know what s/he is like” and “trust in each other”. As effects of “face-to-face relationships” on community care networks, the following items were extracted: “It facilitates easy communication” “It provides me with information on who is responsible for which problem” “It facilitates smooth communication by changing my approach” “It makes me effective at work” “It gives me a sense of intimacy”, and “it gives me the responsibility”. Thus, preliminary findings of the concept and effects of “face-to-face relationships” were obtained.

Purpose: Improving knowledge of palliative care among cancer patients and the general public may be useful for achieving a better quality of life for cancer patients. The aim of this study was to identify the actual situation after the dissemination of leaflets, booklets, and posters as a part of a regional palliative care program. Methods: We distributed leaflets, booklets, and posters on palliative care to 257 administrative and health institutions across the region. We also visited 216 institutions (84%) to observe the actual situation and performed interviews in 133 of the institutions (62%). Results: Overall, 58% of the institutions used the leaflets, booklets or posters. Public halls, libraries and hospitals used them at a rate of 65% or higher. Interviews identified 7 themes, including "explaining the aim of the project before dissemination is important", "few cancer patients or even the general public visit", "staff made various efforts to display the items after dissemination", and "staff learned from the leaflets and booklets, even if cancer patients seldom visited". Conclusion: The dissemination of leaflets, booklets or posters throughout the region might be useful for conveying accurate knowledge about palliative care not only for cancer patients and the general public, but also for health care professionals. Target institutions should include public halls, libraries, and hospitals, and pre-dissemination discussions about the aim of the project and what kinds of people visit the institutions in addition to post-dissemination follow-up may be useful. Palliat Care Res 2010;5(2): 171-174

This study was conducted to identify the needs of patients and their families based on surveys involving patients and bereaved families, and describe the process of producing a survey-based leaflet for health care professionals.Questionnaire surveys were conducted on 550 advanced cancer patients and 632 bereaved families in Hamamatsu, and 337 and 432 responses were collected. Opinions and requests regarding cancer treatment and palliative care were analyzed, and 378 meaning units were collapsed into six categories of requests to health professionals: “Share patient and family feelings and support decisions”; “Allow the patient to stay where he/she wants”; “Relieve physical discomfort as much as possible”; “Support to complete what family members want for the patient not to regret”; “Help patient and family have hope”, and; “Reduce concerns about opioids”. A leaflet for health care professionals about what they should take into the considerations was created based on patient and family surveys.

The aim of this study is to collect the suggestions and recommendations of health care professionals involved in the regional palliative care program (OPTIM-study). A total of 101 multidisciplinary health care professionals who participated in the intervention program were interviewed, and 107 meaningful units were obtained from 89 valid interviews. The responses were categorized into “suggestions regardless of profession” (n=59), including “Participate in a multi-disciplinary conference to expand the network of people”, “Try to understand the situation of others”, “Seek support from others when you cannot solve the problem by yourself”, “Pursue all possibilities before giving up”, and “Do not try too hard”. As suggestions to those engaged in each profession, “Suggestions to community pharmacies” and “Suggestions to care managers” are frequently described. An examination of suggestions by the participants in the regional palliative care program could provide some insights to improve community palliative care.

The aim of the present study was to examine the current use of a palliative care manual, brochures for patients, and assessment tools designed for the regional intervention study. A questionnaire survey (706 physicians and 2,236 nurses) and interviews (80 health care professionals) were conducted. The tools health care professionals most frequently used were the manual and brochures for families of imminently dying patients. Health care professionals experienced [shared understanding as a region level despite the clinical experience and specialty] and [increased confidence in palliative care they had practiced without clear evidence]. The manual were positively evaluated because they “cover all necessary information”, “come in an easy-to-carry-around size”, and “provide specific and practical advice”. Health care professionals valued the brochures for families of imminently dying patients, because illustrations were very helpful as oral explanation was difficult. This study suggests that the manual and brochures for families of imminently dying patients could serve to improve region-based palliative care.

The primary aim of this study was to describe how patient-held-records was used in the regional palliative care program (OPTIM-study). The number of patient-held-records disseminated was 1,131 per region per year. A total of 15% and 16% of 706 physicians and 2,236 nurses in the region reported that they used patient-held-records disseminated during the study periods, respectively. In-depth interview identified themes [difficulty in dissemination], potential benefits of patient-held-records ([improved sense-of-control of patients], [improved information sharing among health care professionals]), and barriers ([lack of patient-perceived benefits and patient burden], [necessity that all health care professionals involved should be aware the value of patient-held-records and understand how to use it]). Of 11 hospitals who introduced patient-held-records, only 2 hospitals continued to use it during 3-year study periods. In conclusion, region-wide dissemination of patient-held-records seems to be unfeasible in many regions in Japan.

The purpose of this study was to identify the greatest impact of the regional palliative care program on community health care professionals. Interviews were conducted involving 101 people who became involved in the intervention program implemented in 4 areas across Japan, and 96 valid responses were collected. The following were cited as the greatest impact: [I developed a network of people, and realized the importance of collaboration] (n＝61; “I was able to develop an interpersonal relationship” and “Now I understand the significance of collaboration”), [My knowledge and skills regarding palliative care were improved] (n＝18; “Knowledge and support helped me respond to patients with confidence” and “I have come to think that there is more to palliative care than terminal care”), [I rediscovered my role through a wide variety of experiences] (n＝10), [Both collaboration and palliative knowledge/skills meant a lot to me] (n＝4), [What I experienced in this program will help me play my role] (n＝2), and [Patients and their families became satisfied] (n＝1). The community palliative care program was most effective in facilitating collaboration, and helped participants develop knowledge and skills concerning palliative care.