• Am J Hosp Palliat Care · Nov 2013

    Advance directives and do-not-resuscitate orders among patients with terminal cancer in palliative care units in Japan: a nationwide survey.

    • Yoshiyuki Kizawa, Satoru Tsuneto, Jun Hamano, Hiroka Nagaoka, Takami Maeno, and Yasuo Shima.
    • 1Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
    • Am J Hosp Palliat Care. 2013 Nov 1; 30 (7): 664-9.

    ObjectiveTo examine the current status of advance directives (ADs) and do-not-resuscitate (DNR) orders among patients with terminal cancer in palliative care units (PCUs) in Japan.MethodsWe conducted a retrospective chart review of the last 3 consecutive patients who died in 203 PCUs before November 30, 2010.ResultsThe percentages of patients who had ADs during the final hospitalization for cardiopulmonary resuscitation, mechanical ventilation, intravenous fluid administration, tube feeding, antibiotic administration, and who had appointed a health care proxy were 47%, 46%, 42%, 19%, 18%, and 48%, respectively. Seventy-six percent of the patients had a DNR order. Of the patients with decision-making capacity, 68% were involved in the DNR decision.ConclusionsThese findings may reflect positive changes in patients' attitudes toward ADs, in Japan.

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