Hirakawa Yoshihisa, Chiang Chifa, Yasuda Uemura Mayu, Aoyama Atsuko
a Department of Public Health and Health Systems , Nagoya University Graduate School of Medicine , Aichi , Japan.
J Soc Work End Life Palliat Care. 2018 Oct-Dec;14(4):315-327. doi: 10.1080/15524256.2018.1533912. Epub 2019 Jan 17.
Successful advance care planning relies heavily on effective communication between the elderly and their families, care managers, and social workers. However, care managers and social workers are often not adequately prepared to conduct such discussion. The aim of the present study was to identify the specific challenges facing Japanese care managers and social workers when involvement in advance care planning. Two focus group discussions were held between August and November 2017, involving eleven care managers and three social workers employed at two long-term care facilities actively pursuing advance care planning initiatives. Four main themes were identified, through content analysis, as barriers and facilitators: client readiness, communication, variation-rich client individuality, and difficult-to-explain end-of-life options. This study revealed the importance of building rapport with the residents and their families in order to assess their readiness to discuss care options and preferences. Obstacles included lack of medical knowledge of care managers and social workers. Study findings suggested that a multi-disciplinary team, facilitated by care managers and social workers, was fundamental to achieving the goals of advance care planning.
成功的预先护理计划在很大程度上依赖于老年人与其家人、护理经理和社会工作者之间的有效沟通。然而，护理经理和社会工作者往往没有充分准备好进行此类讨论。本研究的目的是确定日本护理经理和社会工作者在参与预先护理计划时面临的具体挑战。2017年8月至11月期间举行了两次焦点小组讨论，参与者包括在两家积极推行预先护理计划举措的长期护理机构工作的11名护理经理和3名社会工作者。通过内容分析确定了四个主要主题，作为障碍和促进因素：客户准备情况、沟通、丰富多样的客户个性以及难以解释的临终选择。本研究揭示了与居民及其家人建立融洽关系以评估他们讨论护理选择和偏好的准备情况的重要性。障碍包括护理经理和社会工作者缺乏医学知识。研究结果表明，由护理经理和社会工作者推动的多学科团队对于实现预先护理计划的目标至关重要。
