An exploration of the views of staff on cultural aspects of end-of-life care in Japanese long-term care facilities: a qualitative study

Kieko Iida, Assumpta Ryan, Felicity Hasson, Sheila Payne, Sonja McIlfatrick

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Long-term care facilities are increasingly important places for palliative and end-of-life care provision in Japan. While the importance of culture has been noted for palliative and end-of-life care, an exploration of its influence on care provision in long-term care settings has received little direct attention in Japan. Exploring staff views and beliefs in palliative and end-of-life care in these settings can potentially enhance our understanding of culturally oriented care and facilitate the development of tailored and more effective support practices. This study aimed to explore the cultural views and beliefs regarding palliative and end-of-life care among the staff in Japanese long-term care facilities. A qualitative exploratory study was conducted using focus groups with facility staff (n=71) and semi-structured interviews with facility managers (n=10) in the Kanto region of Japan. Thematic analysis was conducted according to Braun and Clarke’s approach. The findings are presented in five key themes: ‘Changes in society’s and family’s end-of-life perspectives’, ‘Values and beliefs regarding death and dying’, ‘Anxiety and regret’, ‘Tensions in doing the right thing’, and ‘Ways of alleviating pressure’. The findings indicate that the provision of palliative and end-of-life care is underpinned by cultural nuances that influence care providers’ approach and delivery. Recognising and understanding the cultural beliefs of staff around death, dying, and end-of-life care are important in meeting the needs of residents. Palliative care education for staff in these settings should include cultural considerations that reflect changing societal views on death and dying.
Original languageEnglish
Pages (from-to)1-23
Number of pages23
JournalAgeing and Society
Early online date26 Apr 2022
Publication statusPublished online - 26 Apr 2022

Bibliographical note

This study was funded by a research grant awarded to Kieko Iida by the Sasakawa Health Foundation, Japan (Grant no. 2019A-010).


  • Palliative care
  • residential facilities
  • long-term care
  • culture
  • Japan
  • qualitative research
  • palliative care


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