Impact of Serious Illnesses on Advance Care Planning Practice in Japan.

This study was conducted to clarify the practical characteristics of decision-making support in the form of advance care planning provided by care managers to clients with heart disease and dementia and to examine the impact of perceptions of multidisciplinary collaboration on such practices. A survey was conducted of care managers working for home-based care support agencies in Japan. Measures included advance care planning practice scales that were specific to each condition and a scale measuring collaboration with medical professionals. Factor analysis revealed that the content of advance care planning practice varies in relation to the characteristics of the given condition. For heart disease, the elements were emotional support and the understanding of values, while for dementia, the elements were information sharing with families and respect for each individual's strengths. Furthermore, multiple regression analysis indicated that perceptions regarding overall collaboration with healthcare professionals and predictions of future changes were common factors that promoted advance care planning practice in both disease groups. These findings indicated that promoting effective advance care planning requires an approach that is tailored to the characteristics of each disease and that strengthening interprofessional collaboration is key to supporting care managers' practice.