Few studies have been performed to examine the effects of educational intervention for oncologists in Japan, to update their knowledge and skills regarding palliative care. This study is aimed to evaluate not only the improvement in trainees’ knowledge and self-complacency, but also to focus on the factors associated with the actual clinical practices of trainees. In one year, 323 trainees from the Hiroshima prefecture joined palliative care workshop using the Palliative Emphasis program on symptom management and Assessment for Continuous medical Education (PEACE), and they were included as subjects in the present study. Referring to the contents of the program, a questionnaire was developed to estimate the extent of change in the trainees’ attitude towards clinical practice. Each of the 26 items included a five point Likert scale ranging from “mostly take responsibility for symptom management” to “depends mostly on the experts for direct intervention”. The questionnaire survey was conducted before and after the implementation of the PEACE program. From the 206 valid responses, most of the data items showed a significant and positive shift in the trainees’ attitude toward palliative care in a clinical setting. Items that did not show this change pertained to adjustment of antidepressants and tranquilizers for delirium and depression. These results suggest that the PEACE program may be effective in improving physicians’ attitudes regarding palliative care.

Palliative care is sometimes difficult for medical staff to say to patients with cancer and their families. The late of using the term “palliative care” decrease the opportunity to know about palliative care for the patients and their families. The primary aims of this study were to reveal physicians’ and nurses’ usage of the term “palliative care”, time to use the term for the first time, and a synonym. We conducted a questionnaire survey to 387 physicians and 518 floor nurses at Hiroshima University Hospital in February, 2010. We analyzed the results of physicians and nurses separately. Two hundred and seventy-two physicians (response rate 70.3%) and 284 nurses (54.8%) answered the questionnaire. Many physicians (77.2%) and the majority of nurses (56.0%) explain with the term “palliative care”. the majority of physicians use the term when cancer cause any symptoms and at early stage. Some nurses (31.4%) couldn’t use the term “palliative care” before physicians explained the term. Nurses having longer experience tend to use the term regardless of physicians’ use. Many physicians use the term “palliative care” at early stage of cancer. Many nurses also use the term at early stage of cancer, but some nurses couldn’t use before physicians’ use.

Introduction: The diagnosis of cancer-related neuropathic pain is often difficult for non-pain medicine specialists. We examined whether a Japanese version of a neuropathic pain screening questionnaire (Japan-Q), which was developed for chronic pain, is appropriate for screening cancer-related neuropathic pain. Methods: Our palliative care team screened 104 patients from May 2014 to December 2015 and compared total points of the Japan-Q with diagnosis of the type of cancer pain by specialized pain clinicians. Validity was evaluated using a receiver operating characteristic (ROC) curve. Results: The area under the ROC curve in terms of the total score, sensitivity, and specificity for the Japan Q was 0.82, which indicated a moderate level of diagnostic accuracy. A cut-off value of 3 points was shown to be best (sensitivity: 79%, specificity: 82%). When a cut-off value of 9 points was used as the diagnostic criterion for neuropathic pain, there was greatly reduced sensitivity (sensitivity: 40%, specificity: 97%). Conclusion: Although the Japan-Q shows moderate diagnostic accuracy related to cancer pain, the cut-off value for this tool is lower than that for chronic pain. Cancer-related neuropathic pain should be suspected with a total score of 3 or more in the Japan-Q.