Advance care planning’s promotion is crucial post-COVID-19 pandemic
Submitted: 21 June 2024
Accepted: 17 July 2024
Published online: 1 October, TAPS 2024, 9(4), 90-91
https://doi.org/10.29060/TAPS.2024-9-4/LE3444
Tomoko Miyoshi1,2, Masaki Chuuda3 & Fumio Otsuka2
1Center for Medical Education and Internationalization, Kyoto University, Kyoto, Japan; 2Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan; 3Department of Clinical Laboratory, Japanese Red Cross Okayama Hospital, Okayama, Japan
Advance care planning (ACP) enables individuals to define their goals and preferences for future treatment and care, discuss them with their families and healthcare providers, and record and review their preferences if appropriate (Rietjens, et al., 2017). In Japan, guidelines for ACP were developed in 2007, and the Ministry of Health, Labour and Welfare (MHLW) promoted it. However, whether the COVID-19 pandemic, which infected many people and led to the deaths of many, affected ACP practices needs to be explored.
Before and after the pandemic, the MHLW conducted a national survey on ACP in Japan among individuals aged 20-80 years. It was found that 2.8% and 39.4% of the 2179 citizens discussed ACP in detail before the COVID-19 pandemic in 2012, whereas 3000 citizens showed a downward trend of 1.5% and 28.4% after the pandemic in 2022, respectively. The most common reason for not discussing the issue was a lack of opportunity to discuss it (62.8%), followed by lack of knowledge and not knowing what to discuss (31.0%), not feeling the need to discuss it (21.8%), and not wanting to discuss it (2.1%). The most common events that might trigger relevant discussions were family illness (54.8%), own illness (47.7%), caring for a family member (40.7%), and death of a family member (31.1%), while the spread of coronavirus infections was only 5.2%. Thus, it was found that the public may face barriers to ACP practices unless someone close to them is ill or is dying.
Cinemeducation, which uses films as a method of medical education, is one of the most effective educational strategies for medical ethics and professionalism education (Shankar, et al., 2019). In this study, we used the Cinemeducation method to conduct a public lecture on thinking about what to value in life after watching a short film on end-of-life care following the COVID-19 pandemic. Twenty people attended the lecture and 18 completed the questionnaire. Fourteen (77.8%) had previously practiced ACP, while three (16.7%) showed interest in practising it.
Hence, the COVID-19 pandemic did not motivate the public to practice ACP. This lack of ACP awareness could be mitigated by Cinemeducation for the public and encourage its practice. As the field of medical care advances and life expectancy grows, it is essential to maintain ongoing awareness and implementation of ACP to improve the quality of life.
Notes on Contributors
TM conceptualised the study, analysed the literature, and wrote the manuscript.
MC conceptualised the study and revised the manuscript.
FO conceptualised the study and revised the manuscript.
Acknowledgement
We would like to thank Dr. Sun Daisuke for his lecture on ACP.
Funding
No funding was received.
Declaration of Interest
All authors have no conflict of interest to declare.
References
Rietjens, J. A. C., Sudore, R. L., Connolly, M., van Delden, J. J., Drickamer, M. A., Droger, M., van der Heide, A., Heyland, D. K., Houttekier, D., Janssen, D. J. A., Orsi, L., Payne, S., Seymour, J., Jox, R. J., & Korfage, I. J. (2017). Definitions and recommendations for advance care planning: An international consensus supported by the European Association for Palliative Care. Lancet Oncology 18, e543-e551.
Shankar, P. R. (2019). Cinemeducation: Facilitating educational sessions for medical students using the power of movies. Archives of Medicine and Health Sciences, 7(1), 96-103.
*Tomoko Miyoshi
Yoshida Konoe-cho,
Sakyo-ku, Kyoto City,
Japan, 606-8501
+81-75-753-9454
Email: miyoshi.tomoko.7z@kyoto-u.ac.jp
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