{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:24:17Z","timestamp":1777929857532,"version":"3.51.4"},"reference-count":14,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T00:00:00Z","timestamp":1612137600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T00:00:00Z","timestamp":1612137600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Palliative Medicine Reports"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>There are some restrictions in Japan regarding end-of-life care. For example, only physicians can legally issue death certificates. By law, ambulance staff members perform cardiopulmonary resuscitation (CPR) for all patients with cardiopulmonary arrest (CPA). Therefore, it is difficult to transport patients to hospitals without CPR, even in cases of terminal patients with do-not-attempt-resuscitation (DNAR) order. Furthermore, there is no 24-hour home care nursing system in our area. Therefore, terminal patients are unable to spend their last moments at their home in the Kuji area.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To design a system in which terminal patients who wish to spend their final moments at their home can be transported to the hospital without CPR after at-home CPA and a system to avoid confusion between ambulance staff and family members using instructions provided by the physician.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/Subjects:<\/jats:title>\n                    <jats:p>The subjects were terminal patients with DNAR order who wanted to stay at home. The instruction to not perform CPR after CPA was created as a document by physicians. Patient information was shared with the fire department; patients were transported to our hospital without CPR after at-home CPA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In total, 26 patients died during the study period; eight received emergency transport to the hospital without CPR after CPA. CPR was not performed for any patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>A system transporting terminal patients without CPR after CPA was necessary in our area. This instruction allows terminal patients to spend their last moments where they wish and avoids unwanted CPR and troubles after CPA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/pmr.2020.0113","type":"journal-article","created":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T11:04:16Z","timestamp":1614596656000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Realizing the Wishes of Terminal Patients: Caregiving Transport Efforts for End of Life in the Kuji Area of Japan"],"prefix":"10.1177","volume":"2","author":[{"given":"Mizunori","family":"Yaegashi","sequence":"first","affiliation":[{"name":"Department of Surgery, School of Medicine, Iwate Medical University, Shiwa, Iwate, Japan."},{"name":"Department of Surgery, Iwate Prefectural Kuji Hospital, Kuji, Iwate, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koki","family":"Otsuka","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine, Iwate Medical University, Shiwa, Iwate, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kasumi","family":"Nitta","sequence":"additional","affiliation":[{"name":"Department of Nursing, Iwate Prefectural Kuji Hospital, Kuji, Iwate, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chihiro","family":"Tono","sequence":"additional","affiliation":[{"name":"Department of Surgery, Iwate Prefectural Kuji Hospital, Kuji, Iwate, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukihiro","family":"Minagawa","sequence":"additional","affiliation":[{"name":"Department of Surgery, Iwate Prefectural Kuji Hospital, Kuji, Iwate, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toru","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Surgery, Iwate Prefectural Miyako Hospital, Miyako, Iwate, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidenobu","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Department of Surgery, Iwate Prefectural Kuji Hospital, Kuji, Iwate, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,3]]},"reference":[{"key":"e_1_3_5_2_2","unstructured":"Monitoring of Cancer Incidence in Japan MCIJ2017: Center for Cancer Control and Information Services Japan National Cancer Center. https:\/\/ganjoho.jp\/reg_stat\/statistics\/stat\/summary.html [in Japanese]. (Last accessed March31 2020)."},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.300.14.1665"},{"key":"e_1_3_5_4_2","first-page":"629","article-title":"In-advance end-of-life discussions and the quality of inpatient end-of-life care: A pilot study in bereaved primary caregivers of advanced cancer patients","volume":"21","author":"Mori M","year":"2013","unstructured":"Mori M, , Ellison D, , Ashikaga T, et al.: In-advance end-of-life discussions and the quality of inpatient end-of-life care: A pilot study in bereaved primary caregivers of advanced cancer patients. Support Care Cancer, 2013; 21:629\u2013636.","journal-title":"Support Care Cancer"},{"key":"e_1_3_5_5_2","doi-asserted-by":"crossref","unstructured":"Sudore RL Lum HD You JJ et al.: Defining advance care planning for adults: A consensus definition from a multidisciplinary Delphi panel. J Pain Symptom Manage 2017;53:821.e821\u2013832.e821.","DOI":"10.1016\/j.jpainsymman.2016.12.331"},{"key":"e_1_3_5_6_2","unstructured":"Japanese Ministry of Health Labour and Welfare: The Practice Guidelines for Process of Decision-Making regarding Treatment in the End-of-Life Care. https:\/\/www.mhlw.go.jp\/file\/04-Houdouhappyou-10802000-Iseikyoku-Shidouka\/0000197701.pdf [in Japanese]. (Last accessed March14 2018)."},{"key":"e_1_3_5_7_2","unstructured":"Japanese Ministry of Health Labor and Welfare: Index of Physician Distribution. https:\/\/www.mhlw.go.jp\/content\/10801000\/000480270.pdf (Last accessed February12 2021)."},{"key":"e_1_3_5_8_2","unstructured":"Japanese Society for Emergency Medcine (JSEM): Recommendations for CPR in Workplace According to Opinions of Patients in Their Final Stage. https:\/\/jsem.me\/wp-content\/uploads\/2017\/04\/0e7f884c59f52e065b274fcb5be129f36d8d572f.pdf [in Japanese]. (Last accessed March23 2020)."},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/oso\/9780195103724.001.0001"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.30.7173"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.330.7498.1007"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdm068"},{"key":"e_1_3_5_13_2","unstructured":"Fire and Disaster Management Agency: Standard for Emergency Treatment by Paramedics (Notification from Fire and Disaster Management Agency 2 on July 1 1978) Article 3. https:\/\/www.fdma.go.jp\/laws\/kokuji\/post95\/ [in Japanese] (Last accessed February12 2021)."},{"key":"e_1_3_5_14_2","doi-asserted-by":"crossref","first-page":"67","DOI":"10.2512\/jspm.14.67","article-title":"The true intention of rescue squads in terms of the CPA transportation of cancer patients in the terminal phase of the disease who make a DNAR order","volume":"14","author":"Miyabashi M","year":"2019","unstructured":"Miyabashi M, , Nakamura C: The true intention of rescue squads in terms of the CPA transportation of cancer patients in the terminal phase of the disease who make a DNAR order. Paliat Care Res, 2019; 14:67\u201372.","journal-title":"Paliat Care Res"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/ams2.271"}],"container-title":["Palliative Medicine Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/pmr.2020.0113","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/pmr.2020.0113","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/pmr.2020.0113","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:55:44Z","timestamp":1777679744000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.1089\/pmr.2020.0113"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1089\/pmr.2020.0113"],"URL":"https:\/\/doi.org\/10.1089\/pmr.2020.0113","relation":{},"ISSN":["2689-2820","2689-2820"],"issn-type":[{"value":"2689-2820","type":"print"},{"value":"2689-2820","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2]]},"article-number":"pmr.2020.0113"}}