Objective: The aims of this study were to (i) clarify whether there are differences between bereaved families and medical staffs in their preferences for life-prolonging treatments, and (ii) investigate the factors associated with preferences for life-prolonging treatments. Methods: Cross-sectional internet survey was conducted in October 2019. Participants are bereaved families(n=618), physicians(n=206), nurses(n=206), and care workers(n=206) who registered with the internet survey company. We asked the subjects about the relative importance of 36 components of a good death in dementia and their preferences for 7 treatment items that they might need at the end of life. Results: Statistically significant differences in end-of-life medical preference between bereaved families and medical professionals included “Nutrition from gastrostomy when oral intake is difficult” (p<0.01), “Surgery for life-threatening disease” (p<0.01). As a result of logistic regression analysis, a surrogate decision-maker among bereaved family members tended to wish intravenous infusion (OR: 1.62, p=0.02) and continuation of oral medicine (OR: 1.74, p<0.01). The medical professionals who regarded good relationships with people as a requirement of good end-of-life care tended to wish surgery (OR: 2.15, p<0.01) and life-prolonging treatment (OR: 2.00, p=0.01). Conclusions: This result suggest that since the medical preferences between medical staff and the family members don’t necessarily correspond, medical professionals need to take it into consideration when they discuss the treatment options.

Purpose: Our purpose is to report an actual performance of our farewell prayer gathering held by the chaplain in our inpatient hospice at the Japan Baptist Hospital, and to describe what impressions and thoughts the bereaved families had about our farewell prayer gathering. Method: The questionnaires were sent to 84 patients’ families asking about our farewell prayer gathering. We analyzed the content of their comments. Results: Among the 40 families that responded, 15 families experienced our farewell prayer gathering. The words such as “prayer” and “participation of the staff” were mentioned as the favored experiences. The bereaved families felt “an emotional closure”, “peace of mind”, and “healing of mind and body”. They also found the gathering as “an opportunity to look back” and “special memorable moment”. Discussion: Our farewell prayer gathering is likely to be helpful for the bereaved to give peace to their mind and to reduce feelings of loss. By sharing the voices of bereaved families, it will be helpful for the betterment of grief care to future bereaved families in hospice care. We would like to see further research in the future.

A secondary analysis of data from national bereavement surveys conducted in 2014, 2016, and 2018 was conducted with the aim of identifying the contribution of various patient and bereavement backgrounds to the outcomes of the Bereavement Survey. The data were evaluated in terms of structure and process of care (CES), achievement of a desirable death (GDI), complexity grief (BGQ), and depression (PHQ-9). The large data set and comprehensive analysis of bereavement survey outcomes clarified the need for adjustment of confounding variables and which variables should be adjusted for in future analyses. Overall, the contribution of the background factors examined in this study to the CES (Adj-R2=0.014) and overall satisfaction (Adj-R2=0.055) was low. The contribution of the GDI (Adj-R2=0.105) was relatively high, and that of the PHQ-9 (Max-rescaled R2=0.200) and BGQ (Max-rescaled R2=0.207) was non-negligible.