With the increase in chronic diseases and the assertion of consumerism by patients, the “mutual participation model” has recently been advocated. This model has changed the traditional paternalistic doctor-patient relationship to a doctorpatient alliance in which doctors share information with patients to encourage their active participation in the treatment process. The gap between the doctor's and the patient's points of view could be bridged. Patient participation would be promoted by communication and information disclosure in the mutual participation model. We should clarify the effects of communication on both doctors and patients through empirical studies, which would also contribute to the improvement of medical education for communication skills.

Purpose: To elucidate the factors associated with self-evaluations of end-of-life care (EOLC) practices for non-cancer patients experienced by nurses in general hospitals. Methods: A questionnaire survey was conducted involving 1161 nurses from general hospitals. Results: Comparing the realities of 648 cancer cases with those of 306 non-cancer cases in terms of end-of-life care practices, it was found that significantly lower EOLC self-evaluation scores (on a 10-point scale), fewer instances of eliciting patients’ intentions or wishes, and fewer team discussions related to EOLC practices were observed in the non-cancer cases. (p<0.001). For each disease, pneumonia and heart disease tended to be lower. Self-evaluation of EOLC practices was consistently associated with eliciting patients’ intentions and wishes (β=0.21 for cancer, β=0.16 for non-cancer), and team discussions (β=0.25 for cancer, β=0.35 for non-cancer) for both cancer and non-cancer cases. Conclusion: General hospital nurses’ self-evaluations of EOLC practices for non-cancer patients were lower compared to those for cancer patients. It is necessary to enhance their skills in eliciting patients’ intentions and wishes and to implement a system of care for team discussion.