Department of General Medicine, Shirakawa Satellite for Teaching And Research (STAR), Fukushima Medical University, 2-1, Toyochikamiyajiro, Shirakawa, Fukushima, 961-0005, Japan.
Center for University-Wide Education, School of Health and Social Services, Saitama Prefectural University, Saitama, Japan.
Sci Rep. 2023 Jan 25;13(1):1371. doi: 10.1038/s41598-023-28663-4.
Advance care planning (ACP) is essential for end-of-life care, especially during the novel coronavirus disease 2019 (COVID-19) pandemic, and resilience is critical to deal with pandemic-related stressors. Therefore, we investigated the association between resilience ability and ACP discussions during the COVID-19 pandemic. A nationwide web-based survey was conducted in July 2021 in Japan. We analyzed the respondents' ability to bounce back from stress (bouncing-back ability), positive stress coping (e.g., "seeking social support", "planning"), and negative stress coping (e.g., "avoidance", "alcohol and drug use") in relation to ACP discussions using multivariable logistic regression models. In total, 2000 responses (86% participation rate) were received (mean age: 51.8 ± 16.7). Normal and high bouncing-back ability (adjusted odds ratio [AOR]: 1.69, 95% CI: 1.03-2.79; AOR: 2.07, 95% CI: 1.18-3.65, respectively) were significantly associated with the occurrence of ACP discussions. Seeking social support and planning were significantly associated with ACP discussions, whereas avoidance and alcohol and drug use were not. Both bouncing-back ability and positive stress coping were significantly associated with the occurrence of ACP discussions during the COVID-19 pandemic in Japan. These findings could be useful for aiding health-care providers involved in ACP discussions during the COVID-19 pandemic.
在生命末期关怀中，预先医疗照护计划（ACP）至关重要，尤其是在 2019 年新型冠状病毒病（COVID-19）大流行期间，而韧性对于应对与大流行相关的压力源至关重要。因此，我们调查了在 COVID-19 大流行期间韧性能力与 ACP 讨论之间的关联。2021 年 7 月在日本进行了一项全国性的网络调查。我们使用多变量逻辑回归模型分析了受访者从压力中恢复的能力（反弹能力）、积极的压力应对方式（例如，“寻求社会支持”、“规划”）和消极的压力应对方式（例如，“回避”、“饮酒和吸毒”）与 ACP 讨论之间的关系。共收到 2000 份回复（86%的参与率）（平均年龄：51.8±16.7）。正常和高反弹能力（调整后的优势比[OR]：1.69，95%置信区间[CI]：1.03-2.79；OR：2.07，95%CI：1.18-3.65）与 ACP 讨论的发生显著相关。寻求社会支持和规划与 ACP 讨论显著相关，而回避和饮酒和吸毒则没有。反弹能力和积极的压力应对方式均与 COVID-19 大流行期间日本 ACP 讨论的发生显著相关。这些发现可能有助于在 COVID-19 大流行期间为参与 ACP 讨论的医疗保健提供者提供帮助。
