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Abstract
The objectives of this study were to compare the importance of components of a good death among cancer patients, the general population, oncologists, and oncology nurses, and explore which patients preferred "fighting against cancer." We conducted a cross-sectional anonymous self-reported survey of cancer patients who visited a radiation oncology outpatient clinic, oncologists, and oncology nurses at the Tokyo University Hospital and a random sample of the general population in the Tokyo metropolitan area. The outcomes were 18 previously developed components of a good death in Japanese cancer care consisting of 57 attributes. Three hundred ten patients, 353 subjects from the general population, 109 oncologists, and 366 oncology nurses participated. The desire to "fight against cancer" was highly significantly different between patients and oncologists (effect size [ES]=-1.40; P=0.001) and patients and oncology nurses (ES=-1.12; P=0.001). "Physical and cognitive control" was, similarly, highly significantly different between patients and oncologists (ES=-1.30; P=0.001) and patients and oncology nurses (ES=-1.06; P=0.001). Patients who emphasized "maintaining hope and pleasure" (P=0.0001), "unawareness of death" (P=0.0001), and "good relationship with family" (P=0.004) favored "fighting against cancer." The patients, however, who emphasized "physical and psychological comfort" did not significantly favor "fighting against cancer" (P=0.004). The importance of good death components differed between groups. Medical professionals should be aware of the diversity of values surrounding death and assess the patient's values and discuss them to support his or her quality of life. In addition, the development of care and a medical/social system to maintain hope and pleasure after failure of anticancer treatment is necessary.[PUBLICATION ABSTRACT]