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Just over half of patients with end-stage renal disease engaged in end-of-life discussions with physicians in Japan. Such discussions were found to result in better quality of care and patient-centred outcomes and are an opportunity to support families and align treatment with patients’ values. Background: Patients with end-stage renal disease face complex decision-making regarding dialysis. Aims: This study examined the characteristics of end-of-life discussions and their association with family-reported quality of care. Methods: A cross-sectional postal survey was recorded in 2022 of bereaved family members of end-stage renal disease patients who died between January 2018 and March 2020 at a university hospital in Japan.This survey assessed the presence of end-of-life discussions and measured care quality with the Care Evaluation Scale and Good Death Inventory. Findings: Among 45 respondents, 23 (51.1%) reported that end-of-life discussions had occurred. Among 31 dialysis patients, only 13.8% had discussed its withdrawal. End-of-life discussions were significantly associated with higher family-rated quality of care (CES scores 83.3±11.8 vs 68.3±28.1, P =0.043; GDI scores 81.2±17.4 vs 69.6±17.4, P =0.042). Conclusion: End-of-life discussions are associated with higher family evaluations of care quality.
Kawashima et al. (Sat,) studied this question.