Chikada Ai, Takenouchi Sayaka, Nin Kazuko, Mori Masanori
Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Hamamatsu, Japan.
Asia Pac J Oncol Nurs. 2021 Sep 15;8(6):628-638. doi: 10.4103/apjon.apjon-2137. eCollection 2021 Nov-Dec.
Although Delphi studies in Western countries have provided a consensus for practices pertaining to advance care planning (ACP), their findings may not be applicable to Asian countries with distinct, family-oriented cultures. This systematic review aimed to synthesize the definitions of and evidence for ACP and analyze recommended practices in Japan. We conducted a systematic review using narrative synthesis in December 2018. Key words were searched from Ichushi-Web by NPO Japan Medical Abstracts Society, Citation Information by the National Institute of Informatics, and Japanese Institutional Repositories Online databases. In addition, in August 2019, we conducted hand searching using Google Scholar and Google. We included original Japanese articles that addressed factors regarding ACP (e.g. definitions, elements, roles and tasks, and timing of ACP). Data were synthesized using thematic analysis. The study protocol was registered prospectively (PROSPERO: CRD42020152391). Of the 3,512 studies screened, 27 were included: 22 quantitative and 5 qualitative. Five-position statements/guidelines were added by hand searching. Definitions and several distinct practice patterns of ACP and the importance of families' roles were identified. Unique recommendations addressed the importance of properly eliciting patients' preferences that are the best for both patients and families, engaging the public to raise awareness of ACP, and developing policies and guidelines for ACP. We identified the definition of and unique recommendations for ACP based on Japanese cultural values and norms. Further research is needed to evaluate the recommendations provided in this systematic review.
尽管西方国家的德尔菲研究已就预立医疗照护计划（ACP）的相关实践达成了共识，但其研究结果可能不适用于有着独特家庭文化的亚洲国家。本系统评价旨在综合ACP的定义和证据，并分析日本的推荐实践。我们于2018年12月采用叙述性综合法进行了系统评价。通过日本非营利性医学文摘协会的Ichushi-Web、国立情报学研究所的文献信息以及日本机构在线知识库数据库检索关键词。此外，在2019年8月，我们利用谷歌学术和谷歌进行了手工检索。我们纳入了探讨ACP相关因素（如定义、要素、角色与任务以及ACP时机）的日文原创文章。采用主题分析法对数据进行综合。该研究方案已预先注册（PROSPERO：CRD42020152391）。在筛选的3512项研究中，纳入了27项：22项定量研究和5项定性研究。通过手工检索补充了五项立场声明/指南。确定了ACP的定义、几种不同的实践模式以及家庭角色的重要性。独特的建议涉及正确引出对患者和家庭都最有利的患者偏好、让公众参与以提高对ACP的认识以及制定ACP的政策和指南的重要性。我们基于日本的文化价值观和规范确定了ACP的定义和独特建议。需要进一步的研究来评估本系统评价中提供的建议。
