{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T14:02:34Z","timestamp":1777384954386,"version":"3.51.4"},"reference-count":29,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science (JSPS) KAKENHI","doi-asserted-by":"publisher","award":["21H02829"],"award-info":[{"award-number":["21H02829"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Hosp Palliat Care"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients in intensive care units (ICU) frequently face severe distress and complex ethical dilemmas, underscoring the critical role of palliative care. Despite growing international attention on ICU-based palliative care, the attitude of palliative care specialists remains unclear. In Japan, although ICU physicians express willingness to collaborate, actual engagement with palliative care teams is limited. To support palliative care integration in the ICU, understanding specialists\u2019 perspectives on its provision to ICU patients is critical.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We examined the attitudes, confidence, motivation, and perceived barriers among Japanese palliative care specialists regarding their provision of care in the ICU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We conducted a nationwide cross-sectional survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/Subjects<\/jats:title>\n                    <jats:p>Conducted in Japan in June 2023, targeting 335 board-certified palliative care physicians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Attitudes, confidence, motivation, and perceived barriers were assessed using a self-administered questionnaire with five-point Likert scales. Descriptive statistics with 95% confidence intervals were generated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Responses from 218 physicians were received (65.0% valid response rate). Among these, although 65.5% agreed that palliative care is important even when curative goals are present, &lt;30% reported confidence in prognostication, symptom management, or understanding ICU culture. Motivation to engage in ICU care was also limited. Primary barriers identified were lack of reimbursement (77.2%) and insufficient ICU-specific education (72.5%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite acknowledging its importance, Japanese palliative care specialists demonstrate limited preparedness for ICU-based palliative care. Our findings highlight an urgent need for specialized education, improved interdisciplinary collaboration, and removal of financial disincentives, including the absence of reimbursement for ICU palliative care consultations under Japan\u2019s health insurance system.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10499091261424906","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T14:52:04Z","timestamp":1770821524000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Nationwide Survey of Physician\u2019s Attitudes Toward Palliative Care for Patients in the ICU in Japan"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9343-1832","authenticated-orcid":false,"given":"Haruka","family":"Harano","sequence":"first","affiliation":[{"name":"Kobe University Graduate School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0099-3765","authenticated-orcid":false,"given":"Yusuke","family":"Miyoshi","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, Kobe City Medical Center General Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuko","family":"Igarashi","sequence":"additional","affiliation":[{"name":"Kobe University Graduate School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoko","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, Saiseikai Yokohamashi Nanbu Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Hagimoto","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, Tosei General Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5092-9377","authenticated-orcid":false,"given":"Yoshinobu","family":"Matsuda","sequence":"additional","affiliation":[{"name":"NHO Kinki Chuo Chest Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3060-0245","authenticated-orcid":false,"given":"Takashi","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Kobe University Graduate School of Medicine"},{"name":"Department of Palliative Medicine, Konan Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,2,11]]},"reference":[{"key":"e_1_3_9_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-018-0574-9"},{"key":"e_1_3_9_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181f267ee"},{"key":"e_1_3_9_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181cf6d94"},{"key":"e_1_3_9_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-024-07565-7"},{"key":"e_1_3_9_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-015-4098-1"},{"key":"e_1_3_9_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/0885066616664329"},{"key":"e_1_3_9_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003969"},{"key":"e_1_3_9_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-022-06729-7"},{"key":"e_1_3_9_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000001018"},{"key":"e_1_3_9_11_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201805-0996OC"},{"key":"e_1_3_9_12_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.128.1.280"},{"key":"e_1_3_9_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000005701"},{"key":"e_1_3_9_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2021.09.015"},{"key":"e_1_3_9_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40560-022-00605-8"},{"key":"e_1_3_9_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2021.06.015"},{"key":"e_1_3_9_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000239233.63425.1D"},{"key":"e_1_3_9_18_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2011.0261"},{"key":"e_1_3_9_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.aucc.2022.03.011"},{"key":"e_1_3_9_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2014.09.015"},{"key":"e_1_3_9_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e318205df9b"},{"key":"e_1_3_9_22_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-4-200902170-00004"},{"key":"e_1_3_9_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3182387d43"},{"key":"e_1_3_9_24_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2318-11-35"},{"key":"e_1_3_9_25_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269216314534514"},{"key":"e_1_3_9_26_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2015.0450"},{"key":"e_1_3_9_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002099"},{"key":"e_1_3_9_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-019-00838-w"},{"key":"e_1_3_9_29_2","unstructured":"Japanese Society of Palliative Medicine. Palliative care team registry analysis: report for FY2022. 2023. https:\/\/jspm.ne.jp\/files\/palliativeCareTeam\/report_jspmpct2023.pdf. Published 2023. Accessed May 26 2025."},{"key":"e_1_3_9_30_2","unstructured":"Japanese Circulation Society; Japanese Heart Failure Society. JCS\/JHFS 2021 guideline on diagnosis and treatment of acute and chronic heart failure. 2021. https:\/\/www.j-circ.or.jp\/cms\/wp-content\/uploads\/2021\/03\/JCS2021_Anzai.pdf. Published 2021. Accessed May 26 2025."}],"container-title":["American Journal of Hospice and Palliative Medicine\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10499091261424906","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10499091261424906","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10499091261424906","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T09:31:44Z","timestamp":1777368704000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10499091261424906"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,11]]},"references-count":29,"alternative-id":["10.1177\/10499091261424906"],"URL":"https:\/\/doi.org\/10.1177\/10499091261424906","relation":{},"ISSN":["1049-9091","1938-2715"],"issn-type":[{"value":"1049-9091","type":"print"},{"value":"1938-2715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,11]]},"article-number":"10499091261424906"}}