29 31 38 2008 31 1) 2) 2) 3) 2) 1) 2008 302008 12 Activities of Daily Living ADL ADL 42 ADL ADL 1990 QOL Quality of Life QOL 1 QOL // 2 Activity of Daily Living ADL Performance Status PS ADL 3 1) 2) 3)
32 ADL ADL 4 5 6 ADL ADL ADL ADL 7 ADL 15 56 42 ADL ADL 2006 5 2006 12 ADL 8 42 67.6SD=9.7 30.9 21.4 19.080.0 ADL
33 ADL 10 ADL 9.8 16.6 4.6 8.9 11.9 16.6 9.2 16.6 16.6
34 ADL 8.4 9.0 35.7 9.2 9.0 33.3 2.6 2.3 59.5 1.8 64.2 ADL 9 10 ADL ADL 11 ADL ADL 12 13
35 14 ADL QOL n 206 2005 P3
36 2003 1998 15 16 QOL QOL ADL 17 18 ADL ADL 2003 60 80 19 Shirley S 2006 9-27 QOLWHO/QOL
37. QOL 1995 36-42 159-72 4 2005 1-6 Kimura R Hashiguchi S, Miyashita M,et al. Pain management and related factors in advanced cancer patients who initiated opioid therapy in an outpatient setting. Palliat Support Care (2005);3(4) 301-309 200618 52-54. ADL 199218(14) 2024-2029 7 2007 27(12) 18-26 10 PT2006 40(11) 917-923 11 4 12 Redinbaugh E Baum A, Tarbell S, et al. End-of-life caregiving: what helps family caregivers cope? J Palliat Med(2003); 6(6):901-909. 13 4 14 2007 93-117 15 4 178-184. 16 De Conno F, Ripamonti C, Sbanotto A, et al. Oral complications in patients with advanced cancer. J Palliat Care(1989); 5(1) 7-15. 17 Mariah S, Nojima Y. 28 2006 119-127 18 2006 178-184. 19 18
38 Ruka SEYAMA 1), Kazuko ISHIDA 2), Yoko NAKAJIMA 2) Kumiko YOSHIDA 3), Akemi TUNODA 2), Kiyoko KANDA 1) Activities of Daily Living (ADL) of a cancer patient deteriorates with aggravation of condition, and it becomes difficult to maintain the life that became independent of then in the end period. But it is necessary to perform the support that does not decrease pride of the patients because their most want to work as oneself by oneself as much as possible. Therefore a purpose of this study is to clarify duration of survival after the cancer patient who spent the end period in a general ward in the university hospital causes an obstacle for ADL from the record of the medical record and to cosider the support that is necessary to live life that the hope of a patient and the family is kept until last time. The subjects were 42 patients who died by cancer in a general ward of the university hospital. The data collection went from the records such as a doctor, the nurse mentioned in a medical record. The investigation item assumed it the time when ability of ADL of the patient was affected. As a result, all ADL deteriorated as the death day approached, but the numbers of the patient to hold an obstacle from before death 5 days increased conspicuously. It was movement, evacuation, urination that a period to suffer a handicap was long. In addition obstacles of the ingestion increased before death 5 days. Also conversation and response of the ingestion increased before death 1 day. It was suggested that grasp the hope of a patient and the family surely and relation that respected autonomy of patient oneself were necessary because terminal patients maintains the function of conversation and response comparatively till the last. Cancer patient, terminal, Activities of Daily Living 1) Department of Nursing, School of Health Science Faculty of Medicine, Gunma University 2) Division of Nursing, Gunma University Hospital