How do community registered nurses use Advance Care Planning in Japan?

Author: Yumi Naito

Naito, Yumi, 2021 How do community registered nurses use Advance Care Planning in Japan?, Flinders University, College of Nursing and Health Sciences

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This thesis explores the perceptions of Japanese community registered nurses towards the use of advance care planning (ACP). The Japanese government has introduced new guidelines for end-of-life care which now includes the concept of ACP. However, unlike Australia, Japan does not have a legal framework to support ACP. Advance Care Planning is indeed a new concept in Japan and a controversial topic among medical professionals. The researcher attended the 7th Advance Care Planning International (ACPI) conference in Rotterdam 2019 to gain knowledge of the various global perspectives on ACP. The 250 participants from 25 countries demonstrated a strong interest and enthusiasm for the benefits of ACP (ACPI, 2019). As a result of attending this conference, it became clear that there is a need for research exploring the various cultural issues involved in the understanding of ACP around the world. From both the researcher’s attendance at the conference and her own presentations at public lectures in Japan, it became apparent that ACP is urgently needed as a tool for individual decision-making, and that health professionals should take the lead in talking more openly about ACP. Health professional leadership in this area should support a change in both public opinion and culture in Japan. This study was informed by the qualitative methodology of interpretive description, which involved interviewing 11 community registered nurses. The results showed that the majority of community registered nurses interviewed ACP to be of high importance; however, they were not sure how to use ACP in their role as community registered nurses. There were also difficulties in adopting ACP arising from differing cultural contexts and backgrounds between the use of ACP in Australia and Japan. The results from this study emphasised the need for the establishment of governmental policy, clear documentation, further education, and training in assertive communication. Advance Care Planning is the key to improving the quality of the end of life for Japanese people and it will ensure more information about decision-making in the future. This research may encourage the development of a new policy, establishing both a definition of ACP and standardised documentation.

Keywords: advance care planning, end of life care, community nurses, Japanese culture, decision-making, quality of life

Subject: Nursing thesis

Thesis type: Masters
Completed: 2021
School: College of Nursing and Health Sciences
Supervisor: Yvonne Parry