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- Title
Practice and Perceived Importance of Advance Care Planning and Difficulties in Providing Palliative Care in Geriatric Health Service Facilities in Japan: A Nationwide Survey.
- Authors
Yokoya, Shoji; Kizawa, Yoshiyuki; Maeno, Takami
- Abstract
Background: The provision of end-of-life (EOL) care by geriatric health service facilities (GHSFs) in Japan is increasing. Advance care planning (ACP) is one of the most important issues to provide quality EOL care. This study aimed to clarify the practice and perceived importance of ACP and the difficulties in providing palliative care in GHSFs. Methods: A self-report questionnaire was mailed to head nurses at 3437 GHSFs nationwide. We asked participants about their practices regarding ACP, their recognition of its importance, and their difficulties in providing palliative care. We also analyzed the relationship between these factors and EOL care education. Results: Among 844 respondents (24.5% response rate), approximately 69% to 81% of head nurses confirmed that GHSF residents and their families understood disease conditions and goals of care. There was a large discrepancy between the actual practice of ACP components and the recognition of their importance (eg, asking residents about existing advance directive [AD; 27.5% practiced it, while 79.6% considered it important]; recommending completion of an AD [18.1% vs 68.4%], and asking for designation of a health-care proxy [30.4% vs 76.8%]). The EOL care education was provided at 517 facilities (61.3%). Head nurses working at EOL care education–providing GHSFs practiced ACP significantly more frequently and had significantly fewer difficulties in providing palliative care. Conclusion: A large discrepancy was found between GHSF nurses’ practice of ACP and their recognition of its importance. Providing EOL care education in GHSFs may increase ACP practices and enhance respect for resident’s preferences concerning EOL care.
- Subjects
JAPAN; CHI-squared test; CONFIDENCE intervals; MULTIVARIATE analysis; NURSING practice; NURSING care facilities; PALLIATIVE treatment; QUESTIONNAIRES; RESEARCH funding; SELF-evaluation; SURVEYS; T-test (Statistics); ADVANCE directives (Medical care); LOGISTIC regression analysis; MULTIPLE regression analysis; CROSS-sectional method; DATA analysis software; DESCRIPTIVE statistics; ODDS ratio; MANN Whitney U Test
- Publication
American Journal of Hospice & Palliative Medicine, 2018, Vol 35, Issue 3, p464
- ISSN
1049-9091
- Publication type
Article
- DOI
10.1177/1049909117723859