Attitudes towards end-of-life care in a geriatric hospital in Japan.

Nursing and medical staff attitudes toward end-of-life care at a private, not-for-profit geriatric hospital in Japan were measured as part of a larger intervention study to develop a palliative care programme. The intervention consisted of focus groups, education with pre- and post-testing, and attitude/belief surveys. All the medical staff (n = 8) and 99% (n = 97) of the nursing staff participated. Nursing staff overwhelmingly agreed that a palliative care programme would improve end-of-life care (94.6%) and that nurses should be more involved in discussing treatment options with families (85.7%). Of the nursing staff, 88.7% did not agree that doctors currently spend enough time discussing care plans with patients/families. The main barriers to improving end-of-life care perceived by the nursing staff were the treatment-oriented attitude of the doctors and their limited communication skills. The main barriers perceived by doctors were the lack of alternatives to their medical approach and legal concerns. The findings suggest that improving doctor/nurse communication would facilitate the development of a palliative care programme at this hospital.