Effects of an Education Program to Promote Advance Directive Completion in Local Residents

抄録

Purpose: An educational program was developed to facilitate advance directive (AD) completion, using the situation of end-of-life care for people with dementia. The aim of the study was to examine the effects on AD completion rates of an education program conducted for local community residents.
Methods: The design was a quasi-experimental study with intervention and control groups, respectively. The study population included local welfare officers from two cities in Osaka Prefecture, Japan, of whom 81 persons were allocated to an intervention group and 60 persons to a control group. A 70-minute intervention program was performed twice for the intervention group. Primary outcomes included AD completion and intention to complete an AD, as indicated by binary “Yes” or “No” responses, and secondary outcomes included knowledge of AD, attitudes towards AD, and knowledge of dementia.
Results: The intervention group exhibited a significant increase in the number of people who completed an AD from the baseline assessment compared to the four-month reassessment (odds ratio = 5.0, 95% confidence interval = 1.0–25.0, p = 0.04). The results showed that the interactions between group and time were statistically significant for scores of both the AD Attitude Survey Test (F = 4.1, p = 0.04) and the Dementia Knowledge Scale (F = 4.6, p = 0.04).
Conclusions: The results suggest that this education program to facilitate AD completion may promote 1) AD completion, 2) favorable attitudes towards AD, and 3) knowledge of dementia among local residents.