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. 2024 Oct;72(10):3171-3178.
doi: 10.1111/jgs.19040. Epub 2024 Jun 19.

Pre-post-evaluation of a dementia-specific advance care planning toolkit for Japanese primary care clinicians

Christine E Kistler  1   2   3   4   5 , Machiko Inoue  5 , Tomoko Matsui  5 , Michiko Abe  5 , Monique Le Donne  6 , Ayano Kiyota  7 , Feng-Chang Lin  8 , Yumei Yang  8 , Laura C Hanson  1   2
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Pre-post-evaluation of a dementia-specific advance care planning toolkit for Japanese primary care clinicians

Christine E Kistler et al. J Am Geriatr Soc. 2024 Oct.

Abstract

Background: The population of people living with dementia (PLwD) continues to grow in Japan where advance care planning (ACP) for PLwD is relatively new. Our aim was to evaluate the feasibility and cultural acceptability of a dementia-specific ACP communication skills toolkit for Japanese primary care clinicians.

Methods: We delivered 13 training sessions in primary care clinics across central Japan and conducted a post-training survey to assess whether the toolkit increased confidence in dementia-specific ACP communication skills and the acceptability of the toolkit with the following four statements: (1) The language in the sessions was clear, (2) The sessions took an appropriate amount of time to complete, (3) The design of the sessions was an effective educational method, and (4) The sessions were culturally appropriate for communication with Japanese patients with dementia and their family members. We asked participants to respond using a 5-point Likert scale from strongly agree to strongly disagree.

Results: All participants were Japanese and included 80 physicians (mean age 39.8 years), 33 nurses (mean age 45.7 years), and 58 other participants (mean age 42.9 years), who were 30.0%, 87.9%, and 55.2% female, respectively. Most participants practiced in rural settings. In pre- post-comparisons, participant confidence increased in determining capacity, understanding dementia prognosis, goals of care, eliciting surrogates, recommending self-care practices to families, and leading family meetings (all p < 0.001). Most participants strongly agreed or agreed that the toolkit was an effective method (96.9%), took an appropriate amount of time (94.5%), contained clear language (89.8%), and was culturally appropriate (73.6%).

Conclusions: Dementia-specific ACP communication skills toolkit can be delivered in Japan. Japanese primary care clinicians generally felt the dementia-specific ACP toolkit increased their confidence in ACP communication skills and was acceptable. The language, time, and design were well received, though further work is needed to improve the cultural appropriateness of the toolkit.

Keywords: Japan; advance care planning; advanced directives; communication skills; dementia; primary care.

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Conflict of interest statement

Conflicts of Interest: None of the authors have any conflict of interest, either personal or financial, to report.

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References

    1. Prince M, Ali GC, Guerchet M, Prina AM, Albanese E, Wu YT. Recent global trends in the prevalence and incidence of dementia, and survival with dementia. Alzheimers Res Ther. 2016;8(1):23. - PMC - PubMed
    1. Nakahori N, Sekine M, Yamada M, Tatsuse T, Kido H, Suzuki M. Future projections of the prevalence of dementia in Japan: results from the Toyama Dementia Survey. BMC Geriatr. 2021;21(1):602. - PMC - PubMed
    1. Inoue M, Hanari K, Hamano J, Gallagher J, Tamiya N. Current Engagement in Advance Care Planning in Japan and Its Associated Factors. Gerontol Geriatr Med. 2019;5:2333721419892694. - PMC - PubMed
    1. Lum HD, Sudore RL, Bekelman DB. Advance care planning in the elderly. Med Clin North Am. 2015;99(2):391–403. - PubMed
    1. Survey on Attitudes toward Medical Care and Care in the Final Stage of Life Report. In: Ministry of Health L, and Welfare, ed: NTT DATA Management Research Institute, Inc; 2023.

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