Awareness-raising activities of advance care planning for community residents: a nationwide cross-sectional survey in Japan

BMC Palliat Care. 2024 Dec 31;23(1):303. doi: 10.1186/s12904-024-01635-9.

Abstract

Background: Japan is implementing awareness-raising of advance care planning for older adults; however, only 451 out of 1 741 municipalities were engaged in advance care planning awareness-raising activities among residents, according to a 2017 survey. This study examined advance care planning awareness-raising activities among community residents by local governments after the 2018 revision of the government guidelines, as well as utilization of the revised guidelines, issues in awareness-raising activities, and directions for future activities.

Methods: This cross-sectional questionnaire survey was conducted in prefectures and municipalities nationwide in 2022. Questions included the status, content, and issues of advance care planning awareness-raising activities for community residents. A multi-level logistic regression analysis was used to examine the characteristics of municipalities engaged in activities.

Results: Responses were received from 43 prefectures (response rate: 91.5%) and 912 municipalities (response rate: 53.1%). Of the municipalities, 63.6% (n = 580) reported "active" advance care planning awareness-raising. A high financial capability index and implementation of awareness-raising activities in the prefecture where the municipality was located were significantly associated with its awareness-raising activities. Municipalities engaged in awareness-raising activities reported experiencing issues related to the objectives, methods, and outcome evaluation of the activities.

Conclusions: Five-hundred eighty municipalities engaged in awareness-raising activities-a number that had increased significantly since the 2017 survey. Municipalities that could not engage in awareness-raising activities should receive financial support and other forms of support from prefectures. Furthermore, to ensure that municipalities clarify the purpose of awareness-raising and the desired outcomes, indices for quantitatively measuring results and achievements should be developed.

Keywords: Advance care planning; Awareness-raising activities; Cross-sectional survey; Financial capability index; Municipalities.

MeSH terms

  • Adult
  • Advance Care Planning* / standards
  • Advance Care Planning* / statistics & numerical data
  • Advance Care Planning* / trends
  • Aged
  • Awareness
  • Cross-Sectional Studies
  • Female
  • Humans
  • Japan
  • Male
  • Middle Aged
  • Surveys and Questionnaires