Department of Innovation in Fundamental and Scientific Nursing Care, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
Geriatr Gerontol Int. 2020 Jan;20(1):72-77. doi: 10.1111/ggi.13812. Epub 2019 Nov 19.
The purpose of the present study was to clarify the current state of awareness-raising activities to educate residents about decision-making regarding end-of-life care using a nationwide survey of municipalities in Japan.
A cross-sectional questionnaire-based survey of all municipalities in Japan (n = 1741) was carried out. We asked one representative from each municipality whether or not there were ongoing municipality-led activities to raise awareness and educate the community about end-of-life care decisions. A logistic regression analysis was carried out to examine the regional characteristics associated with running municipality-led awareness-raising activities. Additionally, we investigated the creation and contents of awareness-raising materials targeting residents.
The questionnaire was completed by 1145 municipalities (valid response rate 65.8%). We found that 39.4% of the municipalities surveyed were currently running or planning activities about end-of-life care. Municipalities with active public awareness campaigns had a significantly higher financial capability index than inactive municipalities. Awareness-raising materials targeting residents were created in 134 of the municipalities. The most frequently mentioned components of the materials were the importance of articulating one's intentions with regard to end-of-life care services in advance, sharing those feelings with the family and revisiting them repeatedly (73.9%), and the explanation of home healthcare and long-term care services (47.7%).
The present findings suggest that cities with tight budgets are unable to carry out activities to raise awareness and educate residents about end-of-life care. Thus, it is important to pursue the implementation of further national-level initiatives and funding support for municipalities. Geriatr Gerontol Int 2020; 20: 72-77.
本研究旨在通过对日本所有市町村的全国性调查，阐明当前旨在提高居民对终末期医疗决策意识的宣传活动的现状。
对日本所有市町村（n=1741）进行了横断面问卷调查。我们询问每个市町村的一名代表，是否正在开展市町村主导的提高社区对终末期护理决策意识和教育的活动。采用逻辑回归分析，考察与开展市町村主导的提高认识活动相关的地区特征。此外，我们还调查了针对居民的提高认识材料的编制和内容。
1145 个市町村完成了问卷（有效应答率为 65.8%）。我们发现，39.4%的被调查市町村正在开展或计划开展终末期护理活动。积极开展公共宣传活动的市町村的财务能力指数明显高于不活跃的市町村。有 134 个市町村针对居民制作了提高认识的材料。材料中最常提到的内容是提前表达对终末期护理服务的意愿、与家人分享这些感受并反复重温（73.9%），以及解释家庭医疗和长期护理服务（47.7%）。
目前的调查结果表明，预算紧张的城市无法开展提高居民对终末期护理意识的活动。因此，必须进一步开展国家一级的倡议，并为市町村提供资金支持。老年医学杂志 2020；20：72-77。
