AWARENESS OF ADVANCE CARE PLANNING AND ADVANCE DIRECTIVE AMONG OLDER ADULTS IN JAPAN, HONG KONG, AND KOREA. (11th November 2018)

• Record Type: Journal Article
• Authors: Kawakami, A; Mikoshiba, N; Kwong, E; Lai, C; Song, M; Boo, S; Yamamoto-Mitani, N
• Is Part Of: Innovation in aging. Volume 2(2018)Supplement 1
• Page Start: 528
• Page End: 528
• Publication Date: 2018-11-11
• Subjects: Aging -- Periodicals; Gerontology -- Periodicals; 612.67
• DOI: 10.1093/geroni/igy023.1950
• Languages: English
• ISSNs: 2399-5300

Abstract

Abstract: Advance care planning (ACP) and advance directives (AD) are important to promote quality end-of life decisions. Information is limited regarding how it varies across different cultures. We examined older adults' awareness of ACP/AD (asked by the question "Have you ever heard of ACP/AD?") and its factors in Japan, Hong Kong, and Korea. A cross-cultural survey was conducted with a convenience sample of 415 community-dwelling older adults, with 184 (44.3%) from Japan, 132 (31.8%) from Hong Kong, and 99 (23.9%) from Korea. Their mean age was 74.8 years old and 54.4% were female. One hundred twenty-one participants (30.0%) have heard of ACP/AD, with 35.4% of Japanese, 36.4% of persons from Hong Kong and 12.2% of Korean. Multiple logistic regression analysis revealed that the rate of those who have heard of ACP/AD was significantly higher among Japanese than Korean (Adjusted odds ratio (AOR) 4.54, 95% confidence interval (CI) 1.89–11.1, p<0.01), even after other demographic variables were controlled. Japanese and those from Hong Kong did not show significant difference (AOR: 0.85, 95% CI: 0.49–1.51, p=0.59). Among the demographic variables collected, educational level (more than 12 years) was significantly associated with the awareness of ACP/AD (AOR: 2.29, 95% CI: 1.24–4.22, p<0.01). Efforts should be made to address the issue of ACP/AD to persons with shorter educational history. We need further examination to learn why this cultural difference exist, how this difference affects the EOL decisions and quality of death in each country, and how we could collaborate in providing quality care in each country.