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Identification of Quality Indicators of End-of-Life Cancer Care From Medical Chart Review Using a Modified Delphi Method in Japan

Department of Adult Nursing/Palliative Care Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan, miyasita-tky{at}umin.net

Asumi Nakamura, MD

Department of Planning and Control for Medical Education, School of Medicine, University of Tsukuba, Ibaraki, Japan

Tatsuya Morita, MD

Department of Palliative and Supportive Care, Palliative Care Team and Seirei Hospice, Seirei Mikatahara Hospital, Shizuoka, Japan

Seiji Bito, MD

Division of Clinical Epidemiology, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan

End-of life care is one of the principle components of cancer care. Measurement of the quality of care provided for end-of-life cancer patients is an important issue. The aim of this study was to identify the quality indicators (QIs) for end-of-life cancer care for Japanese patients using a medical chart review. A modified Delphi method for the development of QIs was adopted. Seventeen multi-professional specialists participated by rating the appropriateness and feasibility of potential QIs. Thirty QIs for end-of-life cancer care were ultimately identified within 4 domains: (1) symptom control, (2) decision-making and preference of care, (3) family care, and (4) psychosocial and spiritual concerns. These QIs will be useful for monitoring and evaluating end-of-life care for Japanese cancer patients. The QIs are feasible for use in any clinical setting and cover a comprehensive area in accordance with the World Health Organization's (WHO) definition of palliative care including physical, psychosocial, and spiritual concerns.

Key Words: palliative care • neoplasms • quality indicators • Delphi technique • terminal care • quality of life

This version was published on March 1, 2008

American Journal of Hospice and Palliative Medicine®, Vol. 25, No. 1, 33-38 (2008)
DOI: 10.1177/1049909107307376


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