2024 Volume 73 Issue 4 Pages 145-155
【Objective】The purpose of this study was to promote Advance Care Planning（ACP） at a hospital specializing in cancer and respiratory diseases, evaluate the overall initiative through a staff awareness survey, and clarify issues that need to be addressed in the future.
【Methods】The ACP Working Group carried out initiatives to promote ACP（educational and enlightment activities for staff, patients, and their families, and prepared documents such as in-hospital manuals）, and conducted a questionnaire survey of staff（doctors, nurses, rehabilitation therapists, and medical social workers） to verify changes in awareness of ACP and attitudes toward decision‑making regarding end‑of‑life care.
【Results】The survey results showed that awareness of ACP had increased after the initiative. However, there was no change in awareness in terms of whether multiple professions were actually involved and whether the patient's wishes and values were reflected in end‑of‑life care. There was still a high percentage of stuff who thought that supporting end‑of‑life decision‑making was difficult with reasons given including "the patient's will is unclear due to a decrease in consciousness or dementia", "differences in opinion between the patient and their family（and medical professionals）" and "not knowing when to start ACP discussion", "lack of staff ability", "work‑related issues", "lack of communication with the family" and "lack of cooperation between professions".
【Conclusion】After the initiatives of the ACP Working Group, the awareness of ACP among the staff members improved. However, this is not enough to promote ACP, and efforts will require further enlightenment of patients and their families, holding multi disciplinary conferences using specific cases, developing and utilizing communication tools between staff and families, and considering efficient methods for implementing ACP.
