Evidence map›Paper›PMID 41943934›Full record

ArticlePalliative & supportive care2026

Exploring the underlying structural mechanisms and whole-person perspectives on the desire for hastened death in patients with terminal cancer: A qualitative study.

Yuko Matsumura, Hiroki Kato, Eiko Maetaki, Kengo Imai, Yusuke Hiratsuka, Hideyuki Kashiwagi, Koji Amano, Yutaka Hatano, Masanori Mori, Tatsuya Morita and 3 more

Abstract read
In one paragraph

Article in Palliative & supportive care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Yuko MatsumuraDepartment of Advanced Nursing Sciences, School of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.ORCID https://orcid.org/0000-0001-9465-1207
Hiroki KatoDepartment of Nursing, Aino University, Osaka, Japan.
Eiko MaetakiFaculty of Nursing, Graduate School of Nursing, Kansai Medical University, Osaka, Japan.
Kengo ImaiDepartment of Seirei Hospice, Seirei Mikatahara General Hospital, Shizuoka, Japan.
Yusuke HiratsukaDepartment of Palliative Medicine, Takeda General Hospital, Aizuwakamatu, Japan.
Hideyuki KashiwagiDepartment of Transitional and Palliative Care, Iizuka Hospital, Fukuoka, Japan.
Koji AmanoDepartment of Supportive and Palliative Care, Osaka International Cancer Institute, Osaka, Japan.
Yutaka HatanoDepartment of Palliative Care, Yoshida Hospital, Nara, Japan.
Masanori MoriDivision of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Shizuoka, Japan.
Tatsuya MoritaDivision of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Shizuoka, Japan.
Yuki ShiraiDepartment of Advanced Nursing Sciences, School of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Keiko TamuraDepartment of Advanced Nursing Sciences, School of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Keiko SatoDepartment of Health Informatics, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesIn this study, we aimed to elucidate the underlying structural mechanisms that generate a desire for hastened death (DHD) in patients with terminal cancer from a whole-person perspective based on insights from palliative-care professionals (PCPs).

methodsWe conducted semi-structured interviews with 36 PCPs experienced in caring for patients with terminal cancer and DHD, followed by a thematic analysis based on Boyatzis' hybrid approach.

resultsWe identified 6 themes that characterize the underlying structural mechanisms of DHD. DHD arises from feelings such as loss of self-control, inability to escape adverse circumstances, confronting death and letting go of life, pain of loneliness, being unable to accept living life as it is, and feeling unable to live with the thought of being an inconvenience to others, in addition to physical and psychological pain. In contrast, certain patients who had built good relationships with family members and/or PCPs found new meaning and value in their current lives, expressing a desire to live in the moment and choosing to continue living until the end. SIGNIFICANCE OF

resultsThis study provides the first comprehensive analysis of the underlying structural mechanisms of DHD in patients with terminal cancer from a whole-person perspective. DHD with spiritual pain is linked to the loss of future orientation, autonomy, and meaningful relationships through interconnected structural pathways, leading to feelings of worthlessness and existential meaninglessness. The identified framework demonstrates that these underlying mechanisms operate through an interplay of existential, relational, and autonomy-related factors extending beyond physical and psychological symptoms, reflecting an interconnected human experience across physical, psychological, social, and spiritual dimensions. This study established an evidence-based framework enabling healthcare professionals to implement whole-person approaches to recognize the multidimensional nature of DHD and address existential distress across all dimensions of human experience in end-of-life care.

Indexed as

Attitude to DeathNeoplasmsTerminal CareAdultAgedFemaleHumansInterviews as TopicMaleMiddle AgedPalliative CareQualitative Researchdesire for hastened deathspiritual painsufferingTerminal cancerwhole-person approach

Identifiers

PMID41943934
PMCPMC13166461

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.