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An experimental study of biases affecting end-of-life medical decisions based on behavioral economics

Research Project

Project/Area Number 16K15302
Research Category

Grant-in-Aid for Challenging Exploratory Research

Allocation TypeMulti-year Fund
Research Field Medical sociology
Research InstitutionKobe University

Principal Investigator

Kizawa Yoshiyuki  神戸大学, 医学部附属病院, 特命教授 (80289181)

Co-Investigator(Kenkyū-buntansha) 森田 達也  聖隷クリストファー大学, 看護学研究科, 臨床教授 (70513000)
吉田 沙蘭  東北大学, 教育学研究科, 准教授 (70636331)
Project Period (FY) 2016-04-01 – 2020-03-31
Project Status Completed (Fiscal Year 2019)
Budget Amount *help
¥3,510,000 (Direct Cost: ¥2,700,000、Indirect Cost: ¥810,000)
Fiscal Year 2018: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2017: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
Fiscal Year 2016: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Keywordsアドバンス・ケア・プランニング / 行動経済学 / 緩和医療学 / 意思決定 / バイアス / フレーミング / アドバンスケアプランイング / 医療・福祉 / 行動学 / 経済学 / 社会学 / 倫理学
Outline of Final Research Achievements

We investigated how readiness for advanced care planning (ACP) varied depending on the way in which prognostic communication was given and how the ACP was framed. For prognostic communication, it was considered to be undesirable to say, I don't know the prognosis. Other 3 groups were all similar.For framing, it was suggested that doing a loss-framing would promote ACP and reduce uncertainty rather than a gain-framing. However, there was no significant difference in the method of prognostication and framing for the primary endpoint of this study, readiness for ACP, between the groups.

Academic Significance and Societal Importance of the Research Achievements

予後の伝え方としては、「予後はわかりません」と伝えることは好ましくない。「平均値および範囲を伝える」、「予後曲線のグラフを用いて伝える」、「PSの変化を示すグラフを用いて伝える」はいずれも同等だった。フレーミングとしては損失フレーム(ACPをしておかないとこんな困ったことが起こるかもしれません)をしたほうが、利得フレーム(ACPをするとこんないいことがあります)よりも、ACPが促進されて不確実性が減る可能性が示唆された。今後はこの行動経済学の知見を取り入れたACPのプログラムを開発し、その患者/家族に対する効果を検証する必要がある。

Report

(5 results)
  • 2019 Annual Research Report   Final Research Report ( PDF )
  • 2018 Research-status Report
  • 2017 Research-status Report
  • 2016 Research-status Report
  • Research Products

    (13 results)

All 2020 2018 2017

All Journal Article (8 results) (of which Int'l Joint Research: 1 results,  Peer Reviewed: 7 results,  Open Access: 3 results) Presentation (5 results) (of which Int'l Joint Research: 1 results,  Invited: 5 results)

  • [Journal Article] 特集 人を生かし自分を活かす 意思決定支援とACP 話し合いの手引き 「意思決定支援とACP」の基本的知識とエビデンス 「人生の最終段階における医療・ケアの決定プロセスに関するガイドライン」と意思決定支援のプロセス2020

    • Author(s)
      木澤 義之
    • Journal Title

      看護管理

      Volume: 30 Pages: 108-112

    • Related Report
      2019 Annual Research Report
  • [Journal Article] Effects of Brief Nurse Advance Care Planning Intervention with Visual Materials on Goal-of-Care Preference of Japanese Elderly Patients with Chronic Disease: A Pilot Randomized-Controlled Trial2020

    • Author(s)
      Kizawa Yoshiyuki、Okada Hiroko、Kawahara Takuya、Morita Tatsuya
    • Journal Title

      Journal of Palliative Medicine

      Volume: 23 Issue: 8 Pages: 1076-1083

    • DOI

      10.1089/jpm.2019.0512

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Frequency of discussing and documenting advance care planning in primary care: secondary analysis of a multicenter cross-sectional observational study2020

    • Author(s)
      Hamano Jun、Oishi Ai、Morita Tatsuya、Kizawa Yoshiyuki
    • Journal Title

      BMC Palliative Care

      Volume: 19 Issue: 1 Pages: 32-32

    • DOI

      10.1186/s12904-020-00543-y

    • NAID

      120006826793

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Effects of End-of-Life Discussions on the Mental Health of Bereaved Family Members and Quality of Patient Death and Care.2017

    • Author(s)
      Yamaguchi T, Kizawa Y, et.al.
    • Journal Title

      J Pain Symptom Manage.

      Volume: 54 Pages: 17-26

    • Related Report
      2017 Research-status Report
    • Peer Reviewed
  • [Journal Article] Advance care planning for adolescent patients with life-threatening neurological conditions: a survey of Japanese paediatric neurologists.2017

    • Author(s)
      Yotani N, Kizawa Y, Shintaku H.
    • Journal Title

      BMJ Paediatr Open.

      Volume: 28 Issue: 1 Pages: e000102-e000102

    • DOI

      10.1136/bmjpo-2017-000102

    • NAID

      120006619815

    • Related Report
      2017 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] End-of-life care and discussions in Japanese geriatric health service facilities: A nationwide survey of managing directors’ viewpoints.2017

    • Author(s)
      Kanoh A, Kizawa Y, Tsuneto S, Yokoya S.
    • Journal Title

      Am J Hosp Palliat Care

      Volume: ー Issue: 1 Pages: 83-91

    • DOI

      10.1177/1049909117696203

    • Related Report
      2017 Research-status Report
    • Peer Reviewed
  • [Journal Article] Differences between Pediatricians and Internists in Advance Care Planning for Adolescents with Cancer2017

    • Author(s)
      Yotani N, Kizawa Y, Shintaku H.
    • Journal Title

      J Pediatr

      Volume: ー Pages: 356-362

    • DOI

      10.1016/j.jpeds.2016.11.079

    • Related Report
      2017 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Benefits of the Japanese version of the advance care planning facilitators education program.2017

    • Author(s)
      Miura H, Kizawa Y, Bito S, Onozawa S, Shimizu T, Higuchi N, Takanashi S, Kubokawa N, Nishikawa M, Harada A, Toba K.
    • Journal Title

      Geriatr Gerontol Int.

      Volume: 17 Issue: 2 Pages: 350-352

    • DOI

      10.1111/ggi.12814

    • Related Report
      2017 Research-status Report
    • Peer Reviewed
  • [Presentation] Advance Directive & Advance Care Planning in Japan: focusing on education for health care professionals2018

    • Author(s)
      Yoshiyuki Kizawa
    • Organizer
      アドバンス・ケア・プランニングの現状と課題
    • Related Report
      2018 Research-status Report
    • Int'l Joint Research / Invited
  • [Presentation] 意思決定支援~私たち医療者ができることの具体を討論する~2018

    • Author(s)
      木澤義之
    • Organizer
      アドバンス・ケア・プランニングの現状と課題
    • Related Report
      2018 Research-status Report
    • Invited
  • [Presentation] 意思決定支援~私たち医療者ができることの具体を討論する~2018

    • Author(s)
      木澤義之
    • Organizer
      第14回日本クリティカルケア看護学会学術集会
    • Related Report
      2018 Research-status Report
    • Invited
  • [Presentation] アドバンス・ケア・プランニングの現状と課題2018

    • Author(s)
      木澤義之
    • Organizer
      第14回日本クリティカルケア看護学会学術集会
    • Related Report
      2018 Research-status Report
    • Invited
  • [Presentation] アドバンス・ケア・プランニング(ACP)のビデオ上映会:アンケート調査の総括.2018

    • Author(s)
      森雅紀
    • Organizer
      第7回膵がん教室ワークショップ in 福岡
    • Related Report
      2017 Research-status Report
    • Invited

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Published: 2016-04-21   Modified: 2021-02-19  

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