Culturally Adapted Consensus Definition and Action Guideline: Japan's Advance Care Planning
Culturally Adapted Consensus Definition and Action Guideline: Japan's Advance Care Planning
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DOI：
10.1016/j.jpainsymman.2022.09.005
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发表时间：
2022-12-01
影响因子：
4.7
通讯作者：
Yamamoto, Yosuke
中科院分区：
文献类型：
--
作者：
Miyashita, Jun;Shimizu, Sayaka;Yamamoto, Yosuke
上下文。像日本这样重视以家庭为中心的决策的社会，缺乏预先护理计划的概念框架。预先护理计划的共识定义与行动指南，以适应日本社会。我们进行了2020-2022年多学科修正德尔菲研究。30名医生、10名医疗保健和生物伦理学研究人员、6名护士、3名患者护理管理人员、3名医务社会工作者、3名法律专家和1名牧师，在7轮（包括两项基于网络的调查，其中共识水平被定义为>= 70%的小组成员在9分李克特量表上打分）中，用简短的句子描述了日本提前护理计划的定义、范围、主题和行动指南。最终的29个项目集达到了目标共识水平，72%-96%的项目评分为7-9。预先护理计划被定义为“个人在与他们建立了信任关系的医疗保健提供者的必要支持下，考虑并与他们的家人和其他亲近的人讨论，为未来做准备，包括他们希望在未来拥有的生活方式和医疗和护理。”这个定义/行动指南特别包括了对那些不愿表达意见的个人的支持，以发展和表达对未来的准备。通过有意识地加强和支持个人自主决策，使预先护理计划适应日本文化，可以促进其在日本和其他以家庭为中心的决策文化社会的传播和建立。[J] journal of practical nursing; 2009; 34(4): 591 - 591。(c) 2022年美国临终关怀和姑息医学学会。Elsevier Inc.出版。版权所有。
Context. A conceptual framework for advance care planning is lacking in societies like Japan's valuing family-centered decision-making.Objectives. A consensus definition of advance care planning with action guideline adapted to Japanese society.Methods. We conducted a multidisciplinary modified Delphi study 2020-2022. Thirty physicians, 10 healthcare and bioethics researchers, six nurses, three patient care managers, three medical social workers, three law experts, and a chaplain evaluated, in 7 rounds (including two web-based surveys where the consensus level was defined as ratings by >= 70% of panelists of 7-9 on a nine-point Likert scale), brief sentences delineating the definition, scope, subjects, and action guideline for advance care planning in Japan.Results. The resulting 29-item set attained the target consensus level, with 72%-96% of item ratings 7-9. Advance care planning was defined as "an individual's thinking about and discussing with their family and other people close to them, with the support as necessary of healthcare providers who have established a trusting relationship with them, preparations for the future, including the way of life and medical treatment and care that they wish to have in the future." This definition/action guideline specifically included support for individuals hesitant to express opinions to develop and express preparations for the future.Conclusion. Adaptation of advance care planning to Japanese culture by consciously enhancing and supporting individuals' autonomous decision-making may facilitate its spread and establishment in Japan and other societies with family-centered decision-making cultures.J Pain Symptom Manage 2022;64:602-613. (c) 2022 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.