Purpose: This study intended to clarify the lesson topics, lesson content and emotions that painfully saddened nursing students with experience of bereavement taking lectures on palliative care, as well as the emotional changes of these students and the support they expect from teachers. Methods: We conducted semi-structured interviews. Their emotions were analyzed following Krippendorff’s method. Results: Thirty-six nursing students participated in the study. Lesson topics and content included “the state and signs of loved ones near death,” and “general lessons.” Feelings and thoughts presented were “regret,” “remembering,” “emotional upset,” “feeling anxiety,” “feeling dissatisfied,” “experiencing a sense of discomfort”, and “empathizing with the people shown in the teaching material as well as their situations.” With the exception of one subject, all subjects experienced a positive change in their emotions. Regarding to the support, 20 people did not require additional support because of “nothing wrong” or “enough”. Conclusions: Teachers need to specifically explain support content and methods many times, and to face lessons with the strong desire to always support their students.

Purpose: This study was to examine both the reliability and validity of the Japanese version of the Caregiver Quality of Life Index-Cancer (CQOLC), which was developed to measure the quality of life of family caregivers of cancer patients. Methods & Results: Study subjects comprised 400 family caregivers who were registered at an Internet research company. The explanatory factor analysis yielded the following 4 domains: psychological burden (8 items); positive emotions (5 items); and financial burden (3 items); disruption of daily living (5 items). The Cronbach's alpha coefficients of the total score and each domain were 0.85 and 0.75 to 0.88, respectively. The total score and each domain were moderately correlated with mental health, vitality, social functioning, general health, role emotinal scores from the SF-36. The intraclass correlation coefficients of the total score and each domain were 0.78 and 0.67 to 0.74, respectively. Conclusion: These results suggest that the Japanese version of the CQOLC has sufficient reliability and validity.

This ecological study revealed the relationship between the percentage of death at home and medical and socioeconomic characteristics. This study was a secondary analysis of national data from the Population Survey Report in 2010 and government statistics in Japan. This data was analyzed by exploratory factor analysis and multiple linear regression analysis. As a result of exploratory factor analysis, medical and social characteristics are classified in three domains, “depopulation and aging”, “hospital and medical facility resources” and “access for home medical care”. By multiple linear regression analysis using results of exploratory factor analysis, cancer death was associated with “access for home medical care” and death from all causes was associated with “hospital and medical facility resources” and “access for home medical care”. In conclusion, death at home in cancer patients was strongly affected by “access for home medical care”. Death at home from all causes was due to poor hospital and medical facility resources and good access to home medical.

East Japan earthquake after cancer is not little survey about patients with palliative care and home health care. In this study, the cancer during an earthquake which aims to make recommendations for future large－scale disasters, and investigation of actual conditions of palliative care and home health care system or manual for basic data. Healthcare in the stricken coastal region 53 conducted semi－structured interviews. Results than cancer healthcare for patients with palliative care and home health care experience is 【cancer providing healthcare to patients with disabilities】【patient lost during the tsunami damage and evacuation oral medication continued failure】【failure of the medical provision of in－home patients by disruption of lifeline】【regional health providers and backward medical assistance and emergency medical group with disabilities】【mental care to medical staff】【disorder of the nuclear power plant accident community health providers】 of 6 organized by category. Be prepared for major disasters, disasters when cancer patients with palliative care and home care issues and how to respond it became evident.

Objectives: Primary aim of this study was to clarify the family evaluation about caring the body of the deceased patient by nurses at Japanese inpatient hospices and palliative care unit. Method: A mail survey was performed on 958 bereaved family members of 103 palliative care units in July, 2010. Result: A total of 597 family members replied（62％）. As a whole, 441（74％）families reported that they were satisfied with the way caring the body of the deceased patient by nurses. A multivariate analysis revealed three factors were significantly associated with the levels of satisfaction:the patient face became peaceful and calm, and nurses treated the patient in the same way before died, and patient age was over 70 years old. Conclusion: Making patient face peaceful and calm, and treating the patient in the same way before died is important in caring the body of the deceased.

Objectives: Primary aim of this study was to clarify the experience and evaluation of families who about caring the body of the deceased patient by nurses at Japanese inpatient hospices and palliative care unit. Method: A mail survey was performed on 958 bereaved family members of 103 palliative care units. A total of 598 family members replied. This study was content analysis about free comments in the questionnaire. Result: A total of 301 comments from 162 questionnaires were identified as the subjects for content analysis. The family was experience satisfaction or dissatisfaction about the way caring the body of the deceased patient. The family felt hesitation and worries about caring the body of deceased patient. A content analysis revealed 3 underlying themes: the family evaluate as a good experience, the family evaluate as an unpleasant experience, the family evaluate as an experience of hesitation and worries. Conclusion: The family was satisfied about treating the patient in the same way before died, making patient face beautiful and calm, facilitates family’s preparation. When nurses recommend families to care the body of deceased patient, which become memorably experience, and they come to be get over sorrow after the bereavement. But they need to confirm the family’s preparation and choose what they can do.

To monitor the quality of life （QOL）of cancer patients through the Patient Behavior Survey, a large population-based survey, we developed a short QOL and quality of care （QOC）questionnaire. In order to help evaluate QOL in cancer patients, we also conducted a web–based survey designed to evaluate the content validity and interpretability of the questionnaire. In total, 630 cancer patients completed the survey. For each item, the result that more than 90% responses determined the item was of importance indicated that the item was important for living with cancer. Regarding items related to QOC, satisfaction with care, we consolidated responses; for example, the answer of “neutral” could also be interpreted as “almost satisfied” and patients who answered “other” may also mean that the item does not apply to them. We found that this questionnaire accurately evaluated the QOL of cancer patients and the responses were interpretable and presentable.

Periodic evaluation of end-of- life (EOL) palliative care is important to maintain and improve quality of EOL palliative care. We conducted a cross-sectional, anonymous, self-report questionnaire survey for bereaved family members of cancer patients in 2010. This was the second time nationwide survey. This study aimed to evaluate EOL cancer care from the perspective of bereaved family members in nationwide general hospitals, inpatient palliative care units (PCUs), and home hospices in Japan and to explore whether there is any change of quality of palliative care over the last nationwide survey conducted in 2007. Among member facilities of Hospice Palliative Care Japan, 25 general hospitals, 103 PCUs, 14 clinics participated in this study and 7797 bereaved family members answered the questionnaire. Overall, bereaved family members were satisfied with EOL care in all places of death, as in the last survey. Although results indicated that coordination of care and physical care of nurse were warranted to improve in general hospitals, drawback of PCUs were availability and the potential deficits of clinics were the environment. Through the years, there is no clinically significant change from the last survey. We should continue to make efforts to evaluate and monitor palliative care in Japan for quality control.

Understanding the symptoms of the general population has an important role in assessing and improving the quality of palliative care systems. However, there are no reliable epidemiological data on the symptoms of the general population in Japan. The aim of this study was to survey the actual status of the symptoms experienced by the general population in Japan. A large nationwide postal survey was conducted from January through February 2013 in Japan. A total of 2400 subjects were selected randomly from among members of the general population who were 20 to 79 years of age and lived in Japan. The Memorial Symptom Assessment Scale (MSAS) was used to multi-dimensionally evaluate symptoms experienced within the past week, and the Short Form 8™ (SF-8™) was used to assess the health-related quality of life (QOL). A total of 978 (41.1%) self-completed questionnaires were analyzed. The prevalences, severity rates, and distress rates of 35 physical and psychological symptoms were analyzed according to sex and age group. In addition, the relation between symptom severity and the health-related QOL score was evaluated. From the perspectives of public health and administrative policy, the results of this survey will most likely provide important basic data, with the ultimate goal of establishing a palliative care system in Japan.

To restore gait function in paraplegic patients, hip-knee-ankle-foot orthoses are available. Orthoses maintain patient stability when standing and walking by restricting the degree of freedom the lower extremity joints. The disadvantages of orthoses include difficulties in standing and sitting movements, and the large burden placed on the upper extremities in walking. Usage of orthoses in daily living was therefore restricted. We are developing a gait assist robot, which we named WPAL (Wearable Power-Assist Locomotor). WPAL has a high degree of freedom and internal power for flexion-extension direction in each hip, knee, ankle joint. We compared WPAL with the conventional Primewalk orthosis as a preliminary investigation. (1) We compared independent standing ability and walking distance of a walker in WPAL and Primewalk orthosis. All three subjects achieved an independent level in standing and walking in WPAL, despite these users requiring assistance when using the Primewalk. Walking distances with the WPAL were several times greater when compared to walking distance with the Primewalk. (2) We performed a single case study using the patient who made the most entries into WPAL exercise. We compared heart rate, physiological cost index (PCI), modified Borg scale, lateral sway of trunk in 6 minutes walking on treadmill. His heart rate, PCI, and modified Borg scale were significantly lower and lateral sway was significantly smaller in WPAL gait. WPAL which has degree of freedom and internal power in the lower extremities is considered a step toward practical powered orthoses use in gait reconstruction for spinal cord injuries.