{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T19:59:45Z","timestamp":1768593585315,"version":"3.49.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T00:00:00Z","timestamp":1695772800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100020685","name":"Japan Hospice Palliative Care Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020685","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Symptom burdens tend to increase for patients with cancer and their families over the disease trajectory. There is still a lack of evidence on the associations between symptom changes and the quality of dying and death. In this context, this research investigated how symptom changes influence the quality of dying and death.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This international prospective cohort study (the East Asian Collaborative Cross-Cultural Study to Elucidate the Dying Process (EASED), 2017-2019) included 22, 11, and 4 palliative care units across Japan, South Korea, and Taiwan. Eligible participants were adults (Japan and Korea, \u226518 years; Taiwan, \u226520 years) with locally advanced or metastatic cancer. Physical and psychological symptoms were assessed by physicians upon admission and within 3 days before death. Death quality was assessed using the Good Death Scale (GDS), developed in Taiwan. Univariate and multivariate regression analyses were used to identify correlations between symptom severity changes and GDS scores.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 998 patients (542 [54.3%] men and 456 [45.7%] women; mean [SD] age\u2005=\u200570.1 [\u00b1 12.5] years), persistent dyspnea was associated with lower GDS scores when compared to stable dyspnea (\u03b2\u2005=\u2005\u22120.427, 95% CI\u2005=\u2005\u22120.783 to \u22120.071). Worsened (\u22121.381, \u22121.932 to \u22120.831) and persistent (\u22121.680, \u22122.701 to \u22120.659) delirium were also significantly associated with lower GDS scores.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Better quality of dying and death was associated with improved symptom control, especially for dyspnea and delirium. Integrating an outcome measurement for the quality of dying and death is important in the management of symptoms across the disease trajectory in a goal-concordant manner.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/oncolo\/oyad269","type":"journal-article","created":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T23:29:50Z","timestamp":1695857390000},"page":"e553-e560","source":"Crossref","is-referenced-by-count":5,"title":["Improved Symptom Change Enhances Quality of Dying in Patients With Advanced Cancer: An East Asian Cross-Cultural Study"],"prefix":"10.1093","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2163-5596","authenticated-orcid":false,"given":"Hsien-Liang","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Family Medicine, College of Medicine and Hospital, National Taiwan University , Taipei , Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ping-Jen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Division of Geriatrics and Gerontology, Kaohsiung Medical University Hospital, Kaohsiung Medical University , Kaohsiung , Republic of China"},{"name":"Department of Family Medicine, School of Medicine, Kaohsiung Medical University , Kaohsiung , Republic of China"},{"name":"Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London , London , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masanori","family":"Mori","sequence":"additional","affiliation":[{"name":"Division of Palliative and Supportive Care, Seirei Mikatahara General Hospital , Hamamatsu , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang-Yeon","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Dongguk University Ilsan Hospital , Goyang , South Korea"},{"name":"Department of Medicine, School of Medicine, Dongguk University , Seoul , South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chien-Yi","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Division of Geriatrics and Gerontology, Kaohsiung Medical University Hospital, Kaohsiung Medical University , Kaohsiung , Republic of China"},{"name":"Department of Public Health, College of Health Sciences, Kaohsiung Medical University , Kaohsiung , Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jen-Kuei","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, College of Medicine and Hospital, National Taiwan University , Taipei , Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chih-Yuan","family":"Shih","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, College of Medicine and Hospital, National Taiwan University , Taipei , Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chien-An","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, College of Medicine and Hospital, National Taiwan University , Taipei , Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaw-Shiun","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, College of Medicine and Hospital, National Taiwan University , Taipei , Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tai-Yuan","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, College of Medicine and Hospital, National Taiwan University , Taipei , Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2334-3893","authenticated-orcid":false,"given":"Yusuke","family":"Hiratsuka","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, Tohoku University School of Medicine , Sendai, Miyagi Prefecture , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sun-Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, School of Medicine, Catholic Kwandong University, International St. Mary\u2019s Hospital , Incheon , South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuya","family":"Morita","sequence":"additional","affiliation":[{"name":"Division of Palliative and Supportive Care, Seirei Mikatahara General Hospital , Hamamatsu , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3060-0245","authenticated-orcid":false,"given":"Takashi","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, Kobe University Graduate School of Medicine , Kobe , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoru","family":"Tsuneto","sequence":"additional","affiliation":[{"name":"Department of Human Health Sciences, Graduate School of Medicine, Kyoto University , Kyoto, Kyoto Prefecture , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2733-6607","authenticated-orcid":false,"given":"David","family":"Hui","sequence":"additional","affiliation":[{"name":"Department of Palliative Care, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2224-4140","authenticated-orcid":false,"given":"Shao-Yi","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, College of Medicine and Hospital, National Taiwan University , Taipei , Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,9,27]]},"reference":[{"key":"2024041017275508800_CIT0001","first-page":"717","article-title":"Evaluating the quality of dying and death","volume-title":"J Pain Symptom Manage","author":"Patrick","year":"2001"},{"key":"2024041017275508800_CIT0002","first-page":"933","article-title":"A good death from the perspective of palliative cancer patients","volume-title":"Support Care Cancer","author":"Kastbom","year":"2017"},{"key":"2024041017275508800_CIT0003","first-page":"691","article-title":"What do laypersons consider as a good death","volume-title":"Support Care Cancer","author":"Leung","year":"2009"},{"key":"2024041017275508800_CIT0004","first-page":"486","article-title":"Good death inventory: a measure for evaluating good death from the bereaved family member\u2019s perspective","volume-title":"J Pain Symptom Manage","author":"Miyashita","year":"2008"},{"key":"2024041017275508800_CIT0005","first-page":"2164","article-title":"Decision making in older adults with cancer","volume-title":"J Clin Oncol","author":"DuMontier","year":"2021"},{"key":"2024041017275508800_CIT0006","first-page":"626","article-title":"Good death study of elderly patients with terminal cancer in Taiwan","volume-title":"Palliat Med","author":"Cheng","year":"2008"},{"key":"2024041017275508800_CIT0007","first-page":"50","article-title":"A combination of routine laboratory findings and vital signs can predict survival of advanced cancer patients without physician evaluation: a fractional polynomial model","volume-title":"Eur J Cancer","author":"Hamano","year":"2018"},{"key":"2024041017275508800_CIT0008","first-page":"1973","article-title":"Prognostication in advanced cancer: update and directions for future research","volume-title":"Support Care Cancer","author":"Hui","year":"2019"},{"key":"2024041017275508800_CIT0009","first-page":"1167","article-title":"Dyspnea review for the palliative care professional: assessment, burdens, and etiologies","volume-title":"J Palliat Med","author":"Kamal","year":"2011"},{"key":"2024041017275508800_CIT0010","first-page":"697","article-title":"Fatigue in advanced disease associated with palliative care: a systematic review of non-pharmacological treatments","volume-title":"Palliat Med","author":"Cuhls","year":"2021"},{"key":"2024041017275508800_CIT0011","first-page":"2004","article-title":"Impact of delirium and recall on the level of distress in patients with advanced cancer and their family caregivers","volume-title":"Cancer","author":"Bruera","year":"2009"},{"key":"2024041017275508800_CIT0012","first-page":"i3085","article-title":"Delirium and agitation at the end of life","volume-title":"BMJ","author":"Hosker","year":"2016"},{"key":"2024041017275508800_CIT0013","first-page":"555","article-title":"Religiousness and spiritual support among advanced cancer patients and associations with end-of-life treatment preferences and quality of life","volume-title":"J Clin Oncol","author":"Balboni","year":"2007"},{"key":"2024041017275508800_CIT0014","first-page":"995","article-title":"Dissemination and implementation of palliative care in oncology","volume-title":"J Clin Oncol","author":"Ferrell","year":"2020"},{"key":"2024041017275508800_CIT0015","first-page":"4694","article-title":"Personalized sedation goal for agitated delirium in patients with cancer: balancing comfort and communication","volume-title":"Cancer","author":"Hui","year":"2021"},{"key":"2024041017275508800_CIT0016","first-page":"257","article-title":"Validation of the Integrated Palliative care Outcome Scale (IPOS)\u2014Japanese version","volume-title":"Jpn J Clin Oncol","author":"Sakurai","year":"2019"},{"key":"2024041017275508800_CIT0017","first-page":"128","article-title":"The memorial delirium assessment scale","volume-title":"J Pain Symptom Manage","author":"Breitbart","year":"1997"},{"key":"2024041017275508800_CIT0018","first-page":"229","article-title":"Validation of the delirium rating scale-revised-98","volume-title":"J Neuropsychiatry Clin Neurosci","author":"Trzepacz","year":"2001"},{"key":"2024041017275508800_CIT0019","first-page":"e000603","article-title":"Unanswered questions and future direction in the management of terminal breathlessness in patients with cancer","volume-title":"ESMO Open","author":"Mori","year":"2020"},{"key":"2024041017275508800_CIT0020","first-page":"e1573","article-title":"A cross-cultural study on behaviors when death is approaching in East Asian countries: what are the physician-perceived common beliefs and practices","volume-title":"Medicine (Baltim)","author":"Cheng","year":"2015"},{"key":"2024041017275508800_CIT0021","first-page":"336","article-title":"How successful is parenteral oxycodone for relieving terminal cancer dyspnea compared with morphine? A multicenter prospective observational study","volume-title":"J Pain Symptom Manage","author":"Mori","year":"2021"},{"key":"2024041017275508800_CIT0022","first-page":"413","article-title":"Predictive factors for the development of dyspnea within 7 days after admission among terminally ill cancer patients","volume-title":"Am J Hosp Palliat Care","author":"Matsunuma","year":"2022"},{"key":"2024041017275508800_CIT0023","first-page":"106","article-title":"Dyspnea review for the palliative care professional: treatment goals and therapeutic options","volume-title":"J Palliat Med","author":"Kamal","year":"2012"},{"key":"2024041017275508800_CIT0024","first-page":"1047","article-title":"Effect of Lorazepam with haloperidol vs haloperidol alone on agitated delirium in patients with advanced cancer receiving palliative care: a randomized clinical trial","volume-title":"JAMA","author":"Hui","year":"2017"},{"key":"2024041017275508800_CIT0025","first-page":"284","article-title":"A conscious choice: Is it ethical to aim for unconsciousness at the end of life","volume-title":"Bioethics","author":"Takla","year":"2021"},{"key":"2024041017275508800_CIT0026","first-page":"65","article-title":"Appropriate death and the hospice program","volume-title":"Hosp J","author":"Weisman","year":"1988"},{"key":"2024041017275508800_CIT0027","first-page":"269216319896932","article-title":"End-of-life decision-making in Asia: a need for in-depth cultural consideration","volume-title":"Palliat Med","author":"Mori","year":"2020"},{"key":"2024041017275508800_CIT0028","first-page":"1564","article-title":"Factors related to spiritual well-being in the last days of life in three East Asian countries: an international multicenter prospective cohort study","volume-title":"Palliat Med","author":"Hiratsuka","year":"2021"},{"key":"2024041017275508800_CIT0029","first-page":"204","article-title":"The \u201cFrench exception\u201d: the right to continuous deep sedation at the end of life","volume-title":"J Med Ethics","author":"Horn","year":"2018"}],"container-title":["The Oncologist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/oncolo\/article-pdf\/29\/4\/e553\/57210411\/oyad269.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/oncolo\/article-pdf\/29\/4\/e553\/57210411\/oyad269.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T18:15:32Z","timestamp":1712772932000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/oncolo\/article\/29\/4\/e553\/7284047"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,27]]},"references-count":29,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,9,27]]},"published-print":{"date-parts":[[2024,4,4]]}},"URL":"https:\/\/doi.org\/10.1093\/oncolo\/oyad269","relation":{},"ISSN":["1083-7159","1549-490X"],"issn-type":[{"value":"1083-7159","type":"print"},{"value":"1549-490X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,4,1]]},"published":{"date-parts":[[2023,9,27]]}}}