Objective: To determine the factors influencing the necessity of holding death conferences. Methods: Data of 416 cancer patients who died in the palliative care unit of the National Cancer Center Hospital East between August 2013 and February 2015 were reviewed. Patients’ medical charts and data sheets of conferences held after their deaths were analyzed. Results: A total of 25.7% of participants saw the necessity of holding death conferences. Multiple logistical regression analyses revealed four independent factors that influenced the holding of death conferences: age <50 years; length of stay in the palliative care unit ≥20 days; epidural analgesia; aphonia; and abdominal distention. Conclusion: These factors might explain nurses’ difficulty in providing end-of-life care for cancer patients.

The effects of a fan to reduce dyspnea have been evaluated in several trials worldwide, however, there has been no clinical report in terminal cancer patients in Japan. We conducted a retrospective chart review to examine whether a fan is useful for dyspnea in terminally ill cancer patients. We reviewed medical and nursing records and selected all patients（n＝9）who received a fan from July 2013 and January 2014. The primary outcome measure was a decrease dyspnea measured by a visual analogue scale（VAS；0＝no shortness of breath, 100＝worst shortness of breath）. There was a significant difference in the VAS score after treatment with the fan（40.2±11.8 versus 15.6±14.9, P＝0.004）. Our results suggest that a fan may help in reduces the sensation of dyspnea in patients with terminal cancer. Future prospective study is needed.

Background: The palliative care unit (PCU) at the National Cancer Center Hospital East changed the administrative policy to strengthen the transition to palliative home care. This study aimed to identify the factors tended to transfer to palliative home care in Japan. Methods: We reviewed the medical records of consecutive cancer patients admitted to our PCU during period from October 2010 until September 2011. Patients with performance status 4 and duplication were excluded in this study. We identified variables associated with the discharged group and the others group, using the univariate and multivariate analyses. Results: There were 223 patients (Pts) during periods, 63 Pts (28.3%) discharged to palliative home care and 160 Pts (71.7%) deceased in our PCU. Univariate and multivariate analysis identified: admission from their own home, a good PS of ≤ 2, good oxygen saturation, a good amount of oral intake, maintain of PS at day 15, no dyspnea and no abdominal distention as predictions of a transition to home from our PCU. Conclusion: Our study indicated the factors tended to transfer to palliative home care from PCU in Japan, however this study had some limitations. A prospective study is required to validate these factors.

Objectives: To clarify the content of death conferences. Methods: 60 death conferences held in the palliative care unit of the National Cancer Center Hospital East between May 2012 and November 2014 were analyzed in a retrospective study. Medical records and notes from the time of the meeting were used. Results: 170 units of data were abstracted from the death conferences held during the studied period. These data were categorized into five groups: 1. supporting family members as subjects of care, 2. understanding and cherishing patient’s thoughts, 3. reducing symptoms and relieving pain, 4. realizing the importance of communication between medical personnel, and 5. becoming anxious due to interaction with patients. Conclusion: The results suggest that the death conference is a useful opportunity to look back on support from various perspectives and directions.