• Yusuke Hiratsuka, Sang-Yeon Suh, Sun-Hyun Kim, Shao-Yi Cheng, Seok-Joon Yoon, Su-Jin Koh, Shin Ae Park, Ji-Yeon Seo, Jung Hye Kwon, Jeanno Park, Youngmin Park, Sun Wook Hwang, Eon Sook Lee, Hong-Yup Ahn, David Hui, Ping-Jen Chen, Takashi Yamaguchi, Tatsuya Morita, Satoru Tsuneto, Masanori Mori, Akira Inoue, and the EASED Investigators.
• Department of Palliative Medicine, Tohoku University School of Medicine, Sendai, Miyagi Prefecture, Japan.
• Palliat Med. 2021 Sep 1; 35 (8): 1564-1577.

BackgroundSome factors associated with spiritual well-being in dying patients have previously been reported. However, there has been no cross-cultural study comparing factors related to spiritual well-being. The current investigation may shed light on this under-investigated area through a comparison of diverse factors.AimWe aimed to (1) examine factors associated with spiritual well-being in the last days and (2) compare those factors across three East Asian countries.DesignThis is an international multicenter prospective cohort study.Setting/ParticipantsNewly admitted inpatients with far advanced cancer in palliative care units in Japan, Korea and Taiwan were enrolled. Each patient was classified into one of two groups based on spiritual well-being score in the last days of life. Univariate and multivariate analyses were performed to identify the factors related to better spiritual well-being score in each country.ResultsA total of 1761 patients treated at 37 palliative care units from January 2017 to September 2018 were analyzed. Seven variables were significant in Japan, three in Korea, and five in Taiwan. "Good death scale [acceptance]," "fatigue" and "expressed wish for hastened death" were unique in Japan. "Visit from a pastoral care worker within 48 h of death" was unique in Korea. "Patient's preferences for place of death," "dyspnea" and "continuous deep sedation" were unique in Taiwan.ConclusionsThis study found novel factors related to spiritual well-being in the last days of life, several of which differed according to country. Recognition of factors associated with spiritual well-being can improve the quality of palliative care.

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