Fukushima Medical University, Japan.
Kyoto University, Japan.
J Appl Gerontol. 2021 Oct;40(10):1180-1188. doi: 10.1177/0733464820911537. Epub 2020 Mar 31.
This study aimed to reveal the features of older adults' advance care planning (ACP) discussions by identifying psychosocial factors related to their discussions in Japan, where people value family-centered decision making. A qualitative study using in-depth interviews was conducted with 39 participants (aged ≥65 years) recruited from the outpatient department of a community hospital in Fukushima, Japan. Data were analyzed using the grounded theory approach. Through experiences of family caregiving, participants became aware of their own feelings about the end of life. Equal relationship with family members was important for lowering the threshold for having discussions. Some participants and their families in the same generation reached agreements on ACP; however, they were willing to yield to children's decision making despite these discussions. These findings provide insights into the psychosocial factors in relation to ACP discussions and support for the role of ACP discussions in the family-centered decision-making culture.
本研究旨在揭示日本老年人预先医疗照护计划（ACP）讨论的特点，通过确定与他们讨论相关的社会心理因素。本研究采用定性研究方法，通过深入访谈，对来自日本福岛县一家社区医院的 39 名参与者（年龄≥65 岁）进行了研究。数据采用扎根理论方法进行分析。通过家庭护理的经验，参与者意识到自己对生命终末期的感受。与家庭成员建立平等的关系对于降低讨论的门槛很重要。一些参与者和他们同代的家庭成员就 ACP 达成了一致；然而，尽管进行了这些讨论，他们还是愿意听从子女的决策。这些发现提供了关于 ACP 讨论相关的社会心理因素的见解，并支持 ACP 讨论在以家庭为中心的决策文化中的作用。
