2023 Fiscal Year Annual Research Report
Do patients make decisions about their end of life care in advance? Impact of Advance Care Planning (ACP) on end-of-life (EoL) in ICU; comparing practices between UK and Japan
| Project/Area Number |
18K17320
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| Research Institution | Kyoto University |
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Principal Investigator |
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| Project Period (FY) |
2018-04-01 – 2024-03-31
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| Keywords | Advancaed care planning / palliative care / Intensive care / end of life care / decision making |
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| Outline of Annual Research Achievements |
Participants of this study were health care professionals working in palliative care, intensive care and academics in the field. Interviews were conducted in both UK and Japan, looking at the attitudes and preferences of the use of advanced care planning in the intensive care context.
Study results: Differences in goals and actors involved in ACP practice between UK and Japan may reflect differences in cultural values. Patient autonomy(UK) vs patient dignity (Japan) and patient-centered (UK) vs family-centered (Japan) decision-making were some of the key differences with regards to ACP priorities and communication patterns. Both UK and Japan clinicians prefered to engage in withholding treatment discussions comparing to withdrawal. DNAR orders were routinely assessed in the UK, whilst performed only when 'disease worsening' in Japan. Balance between suffering and prolonging life was considered by both countries, albeit with different importance. Individual ICU culture, training in ACP and involvement of palliative care teams seem to influence variation in engagement and implementation of ACP practices in the different units.
The study results have been communicated at the international conference of ACP in Singapore in 2023. Two conference poster presentations will communicate the latest results of the study: 1. World Congress of Palliative care research of EAPC, 2. National conference of the Japanese palliative care society.
A manuscript for international publication is underway
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