Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan.
J Pain Symptom Manage. 2013 Jan;45(1):63-70.e7. doi: 10.1016/j.jpainsymman.2011.12.287. Epub 2012 Aug 25.
Advance directives are poorly understood in Japanese nursing homes. In April 2006, additional funding for end-of-life care became available as the first support for terminal care at Japanese nursing homes.
The objectives of this study were to investigate the adoption of advance directives by Japanese nursing homes, the effect of additional funding for end-of-life care in nursing homes from long-term care insurance on the use of advance directives, and the types of directives used.
A nationwide questionnaire survey of nursing homes was performed in Japan. The participants were 913 nursing homes. We investigated the prevalence of advance directives, details of the directives, and demographic data of the responders.
Advance directives were used in 58.4% of nursing homes. The timing of introduction of the directives and the results of multivariate analysis at the facility level suggested a relation between the availability of additional funding for end-of-life care and the adoption of advance directives. Most nursing homes used instructional directives, especially directives providing an explanation and informed consent for end-of-life care in the nursing home.
More than half of Japanese nursing homes have introduced advance directives, and additional funding for end-of-life care is related to their introduction. Most nursing homes have adopted instructional directives, especially those providing an explanation and informed consent regarding end-of-life care at the nursing home.
在日本养老院中，预先指示的理解程度很低。2006 年 4 月，随着长期护理保险为日本养老院提供临终关怀的第一项支持，额外的临终关怀资金开始到位。
本研究的目的是调查日本养老院采用预先指示的情况、养老院额外的临终关怀资金对预先指示使用的影响，以及所使用的指示类型。
在日本对养老院进行了一项全国范围的问卷调查。参与者为 913 家养老院。我们调查了预先指示的流行程度、指示的详细信息以及应答者的人口统计数据。
58.4%的养老院使用了预先指示。在设施层面上，指示的引入时间和多变量分析的结果表明，额外的临终关怀资金的可用性与预先指示的采用之间存在关系。大多数养老院使用了指导指令，特别是在养老院中提供临终关怀解释和知情同意的指令。
超过一半的日本养老院已经引入了预先指示，额外的临终关怀资金与他们的引入有关。大多数养老院都采用了指导指令，特别是那些在养老院提供临终关怀解释和知情同意的指令。
