J Hosp Palliat Nurs. 2020 Apr;22(2):159-165. doi: 10.1097/NJH.0000000000000633.
Advance care planning is spreading globally, but it is still a difficult task for healthy, community-dwelling Japanese residents. In Japan, it is called "life discussion," and the first step is a discussion on goals, values, and preferences of medical care among family or other close persons, as knowledge on this topic is limited. This study aimed to explore the factors associated with the degree of engagement in life discussions among friends and family in depopulated areas. In 2 areas of Japan, 2466 individuals (aged 40-79 years) participated in this survey. Health/life habits, such as collecting health information and participating in some community activities, were significantly associated with the discussions more than attitude to medical/long-term care and community. Additionally, it was discussed how local governments could intervene to encourage advance care planning in depopulated areas. In conclusion, health habits or attitudes for care such as preference and desire for care among community-dwelling adults were associated with engaging in the discussions. It was proposed that local governments should motivate individuals to consider end-of-life experiences from a first-person perspective for creating advance care planning directives, and nurses could facilitate the discussion when death is imminent.
预先医疗照护计划在全球范围内得到推广，但对于健康的、居住在社区的日本居民来说，这仍然是一项艰巨的任务。在日本，它被称为“生活讨论”，第一步是与家人或其他亲近的人讨论医疗保健的目标、价值观和偏好，因为这方面的知识有限。本研究旨在探讨与人口减少地区朋友和家人参与生活讨论程度相关的因素。在日本的 2 个地区，2466 名（年龄在 40-79 岁）参与了这项调查。健康/生活习惯，如收集健康信息和参与一些社区活动，与讨论的相关性明显高于对医疗/长期护理和社区的态度。此外，还讨论了地方政府如何进行干预，以鼓励人口减少地区的预先医疗照护计划。总之，社区居住的成年人对护理的偏好和愿望等护理态度或习惯与参与讨论有关。有人提出，地方政府应激励个人从第一人称的角度考虑临终体验，制定预先医疗照护计划指令，而护士可以在临近死亡时促进讨论。
