Department of General Medicine, Shirakawa Satellite for Teaching and Research (STAR), Fukushima Medical University, Fukushima, Japan.
You Home Clinic Heiwadai, Tokyo, Japan.
Geriatr Gerontol Int. 2021 Feb;21(2):197-202. doi: 10.1111/ggi.14114. Epub 2020 Dec 14.
There is growing recognition of the need to hold advance care planning discussions. Older adults who have direct interpersonal involvement with dying family members might begin to consider their own end-of-life care. This study examined the associations between experiences of being with a dying family member and advance care planning discussions among Japanese older adults.
This study examined data from a previous self-administered questionnaire survey carried out among outpatients aged ≥65 years. All participants were visitors of a community hospital in Japan, with data being collected over a 1-week period in July 2016. The main exposure was experiences of being with dying family members, while the outcome was advance care planning discussions with the family members and/or their physician. We analyzed the associations between experiences of being with dying family members and advance care planning discussions through log-binomial regression models adjusted for possible sociodemographic confounders.
Of the 302 respondents included for analysis, 96 (32%) had experiences of being with dying family members, while 179 (59%) held advance care planning discussions. Respondents with said experiences were more likely to have discussions than those without experiences (fully adjusted prevalence ratio 1.31, 95% confidence interval 1.04-1.65). Subgroup analyses showed no significant interaction effects between experiences of being with dying family members and the covariates.
Direct interpersonal involvement with dying family members might facilitate advance care planning discussions among Japanese older adults. Our results should help healthcare providers recognize individuals who are unlikely to have discussions. Geriatr Gerontol Int 2021; 21: 197-202.
人们越来越认识到需要进行预先护理计划的讨论。与临终家庭成员有直接人际接触的老年人可能开始考虑自己的临终护理。本研究探讨了日本老年人与临终家庭成员相处的经历与预先护理计划讨论之间的关联。
本研究分析了之前在日本一家社区医院进行的自我管理问卷调查的数据。所有参与者都是日本一家社区医院的来访者，数据收集时间为 2016 年 7 月的一周内。主要暴露因素是与临终家庭成员相处的经历，而结果是与家庭成员和/或他们的医生进行预先护理计划讨论。我们通过对数二项式回归模型分析了与临终家庭成员相处的经历与预先护理计划讨论之间的关联，并对可能的社会人口统计学混杂因素进行了调整。
在纳入分析的 302 名受访者中，96 名（32%）有与临终家庭成员相处的经历，而 179 名（59%）进行了预先护理计划讨论。有这种经历的受访者比没有这种经历的受访者更有可能进行讨论（完全调整后的患病率比 1.31，95%置信区间 1.04-1.65）。亚组分析显示，与临终家庭成员相处的经历与协变量之间没有显著的交互作用。
与临终家庭成员的直接人际接触可能会促进日本老年人进行预先护理计划的讨论。我们的研究结果应该有助于医疗保健提供者识别那些不太可能进行讨论的个体。老年医学与老年病学杂志 2021；21：197-202。
