Preferences in end of life care substantially differ between the Netherlands and Japan: Results from a cross-sectional survey study.
Preferences in end of life care substantially differ between the Netherlands and Japan: Results from a cross-sectional survey study.
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DOI：
10.1097/md.0000000000022743
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发表时间：
2020-10-30
期刊：
影响因子：
1.6
通讯作者：
Imanaka Y
中科院分区：
文献类型：
--
作者：
Groenewoud AS;Sasaki N;Westert GP;Imanaka Y
提高EoL护理适当性的策略，例如共享决策（SDM）和提前护理计划（ACP），已在国际上受到欢迎，尤其是自COVID-19大流行以来。然而，个人对EoL护理的偏好可能在国际上有所不同。目前的文献缺乏对EoL护理偏好如何在国家和大洲之间存在差异的见解。本研究的目的是比较荷兰和日本的一般公众的态度和偏好EoL照顾，和EoL的决定。方法：采用横断面调查设计。这项调查是在荷兰和日本公众的样本中进行的，使用了一个全国性的社会研究小组，在荷兰有220，000名注册者，在日本有1，200，000名注册者。进行配额抽样（年龄、性别和居住地区）。每个国家的N =1.040。 与荷兰公民相比，更多的日本公民倾向于避免提前考虑未来的依赖情况（26.0% vs 9.4%; P =.000）;如果他们在生命的最后阶段成为依赖者，他们会觉得自己是亲戚的负担（79.3% vs 47.8%; P =.000）;并选择医院作为他们的首选死亡地点（19.4% vs 3.6% P =.000）。 更多的荷兰人比日本人表示，他们会对医生在EoL问题上的积极态度感到满意（78.0% vs 65.1% JPN; P =.000）。 荷兰和日本在EoL护理方面的偏好有很大差异。a）在解释EoL护理的地理差异时，以及B）如果考虑SDM或ACP等策略，则应考虑这些差异。如果采取国际上“一刀切”的做法，这种战略将失败。
Strategies to increase appropriateness of EoL care, such as shared decision making (SDM), and advance care planning (ACP) are internationally embraced, especially since the COVID-19 pandemic. However, individuals preferences regarding EoL care may differ internationally. Current literature lacks insight in how preferences in EoL care differ between countries and continents. This study's aim is to compare Dutch and Japanese general publics attitudes and preferences toward EoL care, and EoL decisions. Methods: a cross-sectional survey design was chosen. The survey was held among samples of the Dutch and Japanese general public, using a Nationwide social research panel of 220.000 registrants in the Netherlands and 1.200.000 in Japan. A quota sampling was done (age, gender, and living area). N = 1.040 in each country. More Japanese than Dutch citizens tend to avoid thinking in advance about future situations of dependence (26.0% vs 9.4%; P = .000); say they would feel themselves a burden for relatives if they would become dependent in their last phase of life (79.3% vs 47.8%; P = .000); and choose the hospital as their preferred place of death (19.4% vs 3.6% P = .000). More Dutch than Japanese people say they would be happy with a proactive approach of their doctor regarding EoL issues (78.0% vs 65.1% JPN; P = .000). Preferences in EoL care substantially differ between the Netherlands and Japan. These differences should be taken into account a) when interpreting geographical variation in EoL care, and b) if strategies such as SDM or ACP – are considered. Such strategies will fail if an international “one size fits all” approach would be followed.