Strategies for caring for the peaceful death of cancer patients at home in Japan – A meta-synthesis of the literature

Abstract

This study aimed to identify strategies that enable the provision of high quality home care for dying patients with cancer. We searched the NPO Japan Medical Abstracts Society database through Ichushi-Web and selected literature that focused on home care for dying patients with cancer of Japanese origin. In particular, we chose research papers published between 2005 and 2015 that used the qualitative research methodology. The research subjects comprised patients (excluding children), family members of patients, and medical staff who were primary caregivers. We identified the following four research questions by reviewing 13 articles: “A. What enables patients to live at home until they die?”, “B. What difficulties does a dying patient encounter while living at home until death?”, “C. What represents effective support for patients living at home until they die?”, and “D. What represents ineffective support for patients who live at home until they die?”. All results were grouped depending on their relevance to these research questions. We identified 4 categories each pertaining to Research Question A (RQ-A) and RQ-D, and 3 each pertaining to RQ-B and RQ-C. We identified the following five factors that can promote the peaceful death of patients with cancer at home: 1) strong family bonds; 2) caring for the dying patient by the family, according to a framework provided by the medical staff; 3) a guaranteed unconstrained daily life; 4) support for the family’s range of emotions; and 5) systematic support from visiting medical staff and the hospital.