Overview of Cancer Rehabilitation Provided in Palliative Care Units in Japan: A Nationwide Survey.

Abstract

Objectives: We aimed to clarify the current state of cancer rehabilitation in palliative care units (PCUs) in Japan, thus helping to improve cancer rehabilitation and effectively address patients' complex needs.

Methods: A nationwide questionnaire survey was conducted, targeting 462 hospitals in Japan that met the eligibility criteria for reimbursement of inpatient fees for PCUs and had submitted notifications to local health authorities. The survey focused on cancer types, intervention types, duration and frequency of interventions, and other characteristics of cancer rehabilitation in PCUs.

Results: Responses were received from 265 facilities (response rate, 57.4%), of which 242 (91.3%) provided cancer rehabilitation in their PCU. Cancer rehabilitation in Japanese PCUs primarily targeted patients with lung, hepatobiliary and pancreatic, colorectal, gastric, and breast cancers. Interventions included relaxation therapy, walking, basic mobility training, resistance exercises, and range-of-motion exercises. Support for quality of life, ikigai (a Japanese concept for a sense of meaning and purpose in life), and temporary discharge from the PCU were identified as distinctive elements of rehabilitation in palliative care. In many facilities, sessions lasted 20-40 min, with interventions provided 3-4 times per week.

Conclusions: The findings highlight the need for further evaluation of the effectiveness of interventions tailored to unmet medical needs, as well as the development of evidence stratified by cancer type and disease stage. Such evidence may inform future policies to strengthen rehabilitation within PCUs.