Experience of death conference at general hospital setting in Japan    — ASN Events
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Experience of death conference at general hospital setting in Japan    (#500)

Koji Sugano 1 2 3 , Nasako Adachi 1 , Kazumi Koizumi 1 , Chiharu Hirose 1 , Yoshinori Ito 3 , Yosuke Kubota 3 , Tomohiro Nakaguchi 3 , Megumi Uchida 3 , Toru Okuyama 3 , Tatsuo Akechi 3
  1. Palliative supporting team, Koshigaya Municipal Hospital, Koshigaya, Saitama, Japan
  2. Division of Respiratory Medicine, Juntendo University Faculty of Medicine & Graduate School of Medicine, Tokyo, Japan
  3. Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan

Background: Medical staffs often experience grief, helplessness after their patients’ death. To cope with the problem, we often have conferences, called “death conference” in Japan, with attending physicians, nurses, palliative care team (PCT) members and other medical staffs.

Aim: To clarify the structure of death conferences and topics discussed in the conferences, and obtain implications for more useful death conferences, we reviewed our experiences.

Method: Koshigaya Municipal Hospital is a regional core hospital. No mental health practitioners such as psychiatrists or clinical psychologists are working in the hospital. Death conferences are hold by requests mainly from ward nurses. Records of death conferences from April in 2011 to March 2012 were retrospectively reviewed. Information regarding patients characteristics (e.g., cancer lesion), structures (e.g., days between patients’ death and having the conference) and topics discussed were investigated from the conference records. Comments and feedbacks from participants were obtained using self-administered questionnaires.

Result: Thirteen death conferences were held. About half of subjected patients (46.1%) had colon cancers. All death conferences were held within a month after patients’ death and between 30 minutes and 2 hours in time. The topic discussed in the conferences were care strategies of patients in delirium and their families (53.8%), issues with negative insufficient control of pain and other physical symptoms (38.4%), and burnout of unit nurses (7.6%). The participants reported that the conferences were met their need, and also were helpful to relief their distress. The most common feedback from participants to improve conferences more useful was requests of participations of mental health practitioners.

Conclusion: Reviewing the care for dying patients after their death by multidisciplinary members seems to be helpful to manage distress among the medical staffs, especially nurses. Mental health practitioners’ participations are highly recommended.