Arai Asuna, Arai Yumiko
Department of Gerontological Policy, National Institute for Longevity Sciences (NILS), National Center for Geriatrics and Gerontology (NCGG).
Nihon Ronen Igakkai Zasshi. 2008 Nov;45(6):640-6. doi: 10.3143/geriatrics.45.640.
To explore attitudes towards advance care planning among the general public in Japan and to examine the association between the advance care planning and awareness about dementia.
We conducted a postal self-administered questionnaire survey in a sample of the general population aged 40 and over and 86% (n=2,161) of the sample were eligible for analysis. The question items included sociodemographic characteristics, awareness about dementia (anxiety about dementia and knowledge about dementia), and advance care planning (decision making on own care preference if extra assistance were required and disclosure of their care preferences to family members).
More than a half of the participants had yet to consider what kind of care they preferred to receive if extra assistance were required, especially in men and younger people. Although some people had made a decision regarding care preferences, only 39% of those had disclosed their wishes for care to family members. People who had higher awareness (anxiety and knowledge) about dementia were more likely to consider or make a decision about care preferences, irrespective of age and gender. On the other hand, the disclosure of care preferences to family members was associated with the age groups but not with the extent of awareness about dementia.
The general public in Japan are not used to determining and disclosing their own preferences on advance care planning. There is clearly a need for greater public awareness and further study about an effective method for enhancement of advance care planning.
探讨日本普通公众对预先医疗计划的态度，并研究预先医疗计划与痴呆症认知之间的关联。
我们对40岁及以上的普通人群样本进行了邮寄自填问卷调查，86%（n = 2161）的样本符合分析条件。问题项目包括社会人口学特征、痴呆症认知（对痴呆症的焦虑和对痴呆症的了解）以及预先医疗计划（如果需要额外帮助，对自己护理偏好的决策以及向家庭成员披露护理偏好）。
超过一半的参与者尚未考虑如果需要额外帮助，他们更喜欢接受哪种护理，尤其是男性和年轻人。尽管一些人已经就护理偏好做出了决定，但其中只有39%的人向家庭成员披露了他们的护理意愿。对痴呆症有更高认知（焦虑和了解）的人更有可能考虑或做出护理偏好的决定，无论年龄和性别如何。另一方面，向家庭成员披露护理偏好与年龄组有关，而与痴呆症认知程度无关。
日本普通公众不习惯在预先医疗计划中确定和披露自己的偏好。显然需要提高公众意识，并进一步研究增强预先医疗计划的有效方法。
