Monique Daniels is conducting research in Japan as part of her PhD trajectory at ESPHM, in collaboration with RadboudMC. After over 20 years in hospital management, of which the last decade at Erasmus MC, she got the unique opportunity to live in Japan for 4 years. Her research focuses on End-of-Life care, a growing public health priority globally, and an important aspect of people-centered policies.
Japan presents a unique scenario for patients requiring mechanical ventilation as a life-sustaining treatment. Unlike in most other countries, mechanical ventilation is often continued even when recovery is not possible, and terminal weaning is rarely implemented. As a result, thousands of patients are hospitalized long-term and remain on mechanical ventilation until they pass away. Research on this patient group is sparse, and there is limited information available.
The projects encompass a case study involving interviews with family members of patients to understand their perspectives on the situation. A Q study is being conducted to gain insights into what doctors consider important when deciding to initiate ventilation. Also, a quantitative study using nationwide administrative data is being done to describe these patients and identify risk factors.
Monique hopes the results will contribute to restarting the dialogue on prolonged mechanical ventilation and to improving quality of care and life for patients and their families.
Collaboration with Japanese researchers is essential for practical reasons as getting EC approval or access to data, but also, and more importantly to understand the Japanese health system, clinical practice, specific legislation and cultural norms. Currently, researchers from Kyoto University, Kansai University and the University of Tokyo are involved.