Living with pleasure in daily life at the end of life: Recommended care strategy for cancer patients from the perspective of physicians and nurses

Abstract

One of the most important goals of palliative care is achieving a good death. Most Japanese believe that “having some pleasure in daily life” is necessary at the end of life. The aim of this study was to identify, from the perspective of physicians and nurses, a care strategy that ensures that cancer patients have pleasure in daily life at the end of life. We conducted semistructured interviews with experts in palliative care units. A total of 45 participants included 22 palliative care physicians and 23 nurses. Transcripts of the interviews were analyzed using a content analysis method. Care for end-of-life cancer patients that ensures they have some pleasure in daily life was classified into five categories: “Pain assessment and pain easing” aimed to offer physical and psychological pain assessment and relief. “Maintenance of recuperative environment” aimed to offer care that arranged for assistive devices and equipment in the patient's room. “Support of daily life” aimed to offer care that eased accomplishment of daily activities. “Care that respects individuality” aimed to offer care that assessed sources of pleasure for the patient. “Events and complementary and alternative therapies” aimed to offer such care as aromatherapy and massage. The elements of care identified in this study are useful for all end-of-life cancer patients, even those who do not enter palliative care units. The next step of research is to test the efficacy of interventions that reflect the five identified categories of care for end-of life cancer patients.