• Ji Eun Choi, Mitsunori Miyashita, Kei Hirai, Kazuki Sato, Tatsuya Morita, Satoru Tsuneto, Yasuo Shima, and Boon Han Kim.
• Office of Health Service Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Republic of Korea.
• Jpn. J. Clin. Oncol. 2012 Jun 1;42(6):498-505.

ObjectiveThe aim of the study was to evaluate whether family members believed that the decision for home hospice had been the acceptable choice and to identify factors related to families accepting that the decision was good.MethodsIn June 2007, a cross-sectional anonymous questionnaire was distributed to bereaved family members of terminal cancer patients in Japan who died at home in the previous 6 months. The questionnaire included questions about whether the family member believed that the decision for home hospice had been the acceptable choice and the decision-making process.ResultsA total of 286 responses from 14 home hospices were analyzed. A total of 92% of the participants indicated that the decision for home hospice had been the acceptable choice. Multivariate logistic regression analysis indicated that the following subjects were more likely to believe that the decision for home hospice had been the acceptable choice: those who (i) considered the patient's desire ahead of the family situation (P < 0.001); (ii) decided based on knowledge of all options (P < 0.001); (iii) decided based on agreement with patient, family and medical staff (P = 0.007); (iv) decided based on the patient and family only (P = 0.026); and (v) had patients who were enrolled in home hospice for <60 days (P = 0.032).ConclusionsIt is important to encourage discussion about end-of-life care and to assist the patient and family in the decision-making process by providing information on all available options through open communication.

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