Assessing the Knowledge, Perceptions and Practices in Advance Care Planning: A Comparison between American and Japanese Physicians

The global trend of a rapidly aging population in developed countries has resulted in an unmet need for healthcare professionals trained in advance care planning (ACP). To reveal driving and restraining forces of ACP physician to patient communication and ascertain training receptivity, this study explored the differences in the approaches and perceptions of ACP between physicians in a Japanese Medical Center, Japan (n=71), and a United States Medical Center, US (n=83). Data was collected using an online survey administered in 2015 which included both qualitative and quantitative questions. Thematic coding techniques were employed to analyze the qualitative responses and independent samples t-tests and chi-squared tests were applied for quantitative analysis. Findings revealed that American physicians were significantly more likely than Japanese physicians to be satisfied with their understanding of their patient population's cultural perspectives of ACP (p<.001). While no significant association (p=.242) could be ascertained on their perceived value for additional training on ACP, the average response indicated they thought that such training would at least be moderately helpful. American physicians were also significantly more likely to have advance directives than their Japanese counterparts (p<.001). The results highlighted the continued ambivalent nature of discussions on death and dying, underscoring the need to improve physicians' preparedness for ACP in both Japan and the United States of America (USA). Future studies should investigate the efficacy of measures used for such additional training.