看護と患者ケアのジャーナル

Review on the Elements Related to the Development of End of Life Care Quality Evaluation Index that Enriches the Final Years of the Elderly

Matsumoto K, Masaki H, Kawai N, Kuwata M, Yoshioka S, Nishiyama M, Sakai S, Endo K, Uchino R, Hayashi Y, Teshima M and Nagae H

Purpose: A detailed literature review was conducted with the goal of extracting quality indicators that could function as the underlying data for developing a quality index for end-of-life care that would create more enriched final years for the elderly in Japan.

Method: Literature review

Results: Literature searched elderly people, terminal care, relief, the measure, the nature index, and the guideline in the keyword. We decided to make 34 pieces of literature which met all the adoption standards in 507 extracted pieces applicable to analysis. The index factors extracted used the categorization by subject (disease) conditions as their criterions and included 24 factors in cancerous disease, 12 in dementia disorder, 17 in disease-unspecific end-of-life care, 9 in spiritual or psychological pain, 15 for bereaved families, and 17 for caregivers. The research subjects extracted from the literature were mostly patients in the end-of-life period with cancerous or disease-unspecific illness, and the literature that stood out incorporated various theories.

Conclusion: As the indexes for the quality indicators related to enriching end-of-life care for the elderly, a total of 94 index factors were extracted, including constitutional symptom, ADL, cognition, emotion, relationships with others, consideration for family and the bereaved, medical technology, psychological care, and others. These index factors demonstrated their validity in evaluating the multi-sided aspects of the quality of care and suggested the possibility of their application as a quality index evaluating factors for end-of-life care.