論文

査読有り
2019年5月

Associated factors for discussing advance directives with family physicians by noncancer outpatients in Japan

Journal of General and Family Medicine
  • Hamada S
  • ,
  • Haruta J
  • ,
  • Hamano J
  • ,
  • Maeno T
  • ,
  • Maeno T

20
3
開始ページ
82
終了ページ
92
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1002/jgf2.238
出版者・発行元
Journal of General and Family Medicine

© 2019 The Authors. Journal of General and Family Medicine published by John Wiley & Sons Australia, Ltd on behalf of Japan Primary Care Association. Background: Advance directives (ADs) are seldom discussed between primary care physicians (PCPs) and their patients, especially those with noncancer diseases. The aim was to identify the factors associated with discussing AD by noncancer patients with their physicians. Methods: This cross-sectional study was conducted in a hospital or clinic from October to December 2017. Physicians chose eligible noncancer patients aged 20 years or older to respond to an anonymous self-completed questionnaire inquiring about the objective variable “I want to discuss AD with my doctor,” as well as basic characteristics, and facilitators and barriers to discussing AD identified in previous studies. The physicians responded to a survey comprising the Palliative Performance Scale (PPS) and inquiring about the disease category for each patient. Data were analyzed using binomial logistic regression analysis. Results: A total of 270 patients (valid response rate, 79.6%) were included. Multivariate analysis identified a period of visit to the study site ≥ 3 years (odds ratio [OR], 2.07; 95% confidence interval [CI], 1.05-4.10), physicians who are very good at taking care of patients’ disease (OR, 12.68; 95% CI, 1.12-143.22), and patients’ worry about their quality of life (QOL) in the future (OR, 2.69; 95% CI, 1.30-5.57) as facilitators for discussing AD with physicians, and PPS ≤ 90 (OR, 0.51; 95% CI, 0.26-0.98) as a barrier. Conclusions: Our study indicates that patients’ future QOL concerns, a long period of visit to a hospital, and the presence of physical symptoms were associated with the willingness of noncancer patients to discuss AD with PCPs.

リンク情報
DOI
https://doi.org/10.1002/jgf2.238
URL
https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85095729765&origin=inward

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