• Kayo Hirooka, Mitsunori Miyashita, Tatsuya Morita, Takeyuki Ichikawa, Saran Yoshida, Nobuya Akizuki, Miki Akiyama, Yutaka Shirahige, and Kenji Eguchi.
• *Department of System Management in Nursing, Graduate School of Heath Care Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-0034, Japan. hirkanr@tmd.ac.jp.
• Jpn. J. Clin. Oncol. 2014 Mar 1;44(3):249-56.

BackgroundAlthough confidence in providing palliative care services is an essential component of providing such care, factors relating to this have not been investigated in Japan.ObjectiveThis study aimed to explore confidence in the ability to provide palliative care and associated difficulties and to explore correlations between these variables. Design A cross-sectional mail survey of medical doctors and registered nurses in Japan was performed as part of a regional intervention trial: the Outreach Palliative Care Trial of Integrated Regional Model study. Subjects Questionnaires were sent to 7905 medical professionals, and 409 hospital doctors, 235 general practitioners, 2160 hospital nurses and 115 home visiting nurses completed them.ResultsConfidence in providing palliative care was low and difficulties frequent for all types of medical professionals assessed. In particular, only 8-24% of them, depending on category, agreed to 'having adequate knowledge and skills regarding cancer pain management'. In particular, 55-80% of medical professionals acknowledged difficulty with 'alleviation of cancer pain'. Multiple regression analysis revealed that confidence was positively correlated with the amount of relevant experience and, for medical doctors, with 'prescriptions of opioids (per year)'. Moreover, difficulties were negatively correlated with the amount of relevant clinical experience.ConclusionsEffective strategies for developing regional palliative care programs include basic education of medical professionals on management of cancer-related pain (especially regarding opioids) and other symptoms.

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