Purpose: This study aimed to investigate the current status and related factors of End of Life discussions between heart failure patients and medical professionals. Method: We conducted a survey of medical records of patients who died between April 2015 and March 2020 in the Department of Cardiology, Kyoto University Hospital. We examined the presence or absence of discussions about prognosis and end-of-life care and their associated factors. Result: Of the 109 patients, prognosis was explained to 40 (36.7%) and discussion of end-of-life care was provided to 25 (22.9%). Age (younger), number of hospitalizations, palliative care team intervention, and end-of-life care discussions were associated with the prognostic explanations. Gender (male), number of hospitalizations, history of heart failure hospitalization, palliative care team intervention, and prognosis explanation were associated with the end-of-life care discussions. Conclusion: The study suggested that End of Life discussions in heart failure patients are currently focused on patients with severe and end-stage heart failure.

Objective: Basic communication skills are essential in all health personnel, including pharmacists. All junior pharmacists at Kurashiki Central Hospital undergo communication training, which is given by a clinical psychologist. In order to evaluate the outcomes of this training, we analyzed self-evaluation data for changes in professional communication skills, awareness and behavior before and after training.Methods: Training consisted of a lecture on communication skills with patients by a clinical psychologist and consequent role-play activities using a script. We conducted a self-evaluation questionnaire of pharmacist-patient interactions before and after training,from which we analyzed changes in self-evaluation. Each participant rated their own communication skills from 1 to 10 and both professional awareness and behavior from 1 to 5.Results: There was a statistically significant improvement in the mean rating for communication skills 3 months (6.47±1.23) and 9 months (6.68±1.08) after training compared to the same ratings before (4.85±1.49) and 1 month (5.45±1.60) after training (p＜0.01). Participants reported that lecture topics on silence, blank facial expressions, and lack of empathy to patients were particularily useful in improving their professional awareness skillset.Conclusion: Our study showed that the training enabled participants to extend their empathy and better estimate the personal feelings of patients. Communication skills training by a clinical psychologist seems especially useful for improving the basic communication skills in the pharmacist.