{"id":2184,"date":"2021-08-13T17:42:35","date_gmt":"2021-08-13T08:42:35","guid":{"rendered":"https:\/\/www.hcfm.jp\/journal\/?p=2184"},"modified":"2021-08-13T17:42:35","modified_gmt":"2021-08-13T08:42:35","slug":"%e6%97%a5%e6%9c%ac%e3%81%ab%e3%81%8a%e3%81%91%e3%82%8bacp%e8%a9%b1%e3%81%97%e5%90%88%e3%81%84%e9%96%8b%e5%a7%8b%e3%81%ae%e3%82%bf%e3%82%a4%e3%83%9f%e3%83%b3%e3%82%b0%e3%81%ab%e9%96%a2%e3%81%99","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=2184","title":{"rendered":"\u65e5\u672c\u306b\u304a\u3051\u308bACP\u8a71\u3057\u5408\u3044\u958b\u59cb\u306e\u30bf\u30a4\u30df\u30f3\u30b0\u306b\u95a2\u3059\u308b\u533b\u7642\u63d0\u4f9b\u8005\u306e\u8a8d\u8b58"},"content":{"rendered":"

\u2015\u6587\u732e\u2015
\nMiyashita J, Kohno A, Shimizu S, Kashiwazaki M, Kamihiro N, Okawa K, Fujisaki M, Fukuhara S, Yamamoto Y. Healthcare Providers’ Perceptions on the Timing of Initial Advance Care Planning Discussions in Japan: a Mixed-Methods Study. J Gen Intern Med. 2021 Feb 5. doi: 10.1007\/s11606-020-06524-4. Epub ahead of print. PMID: 33547574.<\/p>\n

\u2015\u8981\u7d04\u2015
\n\uff1c\u80cc\u666f\uff1e<\/strong>
\n\u3000\u307b\u3068\u3093\u3069\u306e\u6210\u4eba\u60a3\u8005\u306f\u3001\u75c5\u6c17\u304c\u767a\u75c7\u3059\u308b\u524d\u306bACP\u306b\u3064\u3044\u3066\u8a71\u3057\u5408\u3044\u305f\u3044\u3068\u601d\u3063\u3066\u3044\u308b\u3002\u533b\u7642\u63d0\u4f9b\u8005\u3068\u60a3\u8005\u3068\u306e\u9593\u306b\u3001A C P\u8a71\u3057\u5408\u3044\u958b\u59cb\u306e\u30bf\u30a4\u30df\u30f3\u30b0\u306b\u3064\u3044\u3066\u597d\u307f\u306b\u9055\u3044\u304c\u3042\u308b\u304b\u3082\u3057\u308c\u306a\u3044\u3002
\n\uff08\u65e5\u672c\u4eba\u306f\u3001\u533b\u7642\u63d0\u4f9b\u8005\u304b\u3089\u7d42\u672b\u671f\u30b1\u30a2\u306b\u95a2\u3059\u308b\u60c5\u5831\u3092\u53d7\u3051\u53d6\u308b\u3053\u3068\u3092\u671b\u3093\u3067\u3044\u308b\u3002\u53f0\u6e7e\u3068\u65e5\u672c\u306e\u60a3\u8005\u306e70\uff05\u4ee5\u4e0a\u304c\u3001\u5065\u5eb7\u306a\u72b6\u614b\u3067\u8a71\u3057\u5408\u3044\u3092\u958b\u59cb\u3059\u308b\u610f\u601d\u304c\u3042\u308a\u3001\u4e21\u56fd\u306e90\uff05\u304c\u9032\u3093\u3067\u8a71\u3057\u5408\u3044\u3092\u59cb\u3081\u305f\u3044\u3068\u56de\u7b54\u3057\u305f\uff09<\/p>\n

\uff1c\u76ee\u7684\uff1e<\/strong>
\n\u3000\u65e5\u672c\u306e\u533b\u7642\u63d0\u4f9b\u8005\u304c\u3001 ACP\u8a71\u3057\u5408\u3044\u3092\u958b\u59cb\u3057\u3088\u3046\u3068\u601d\u3046\u30bf\u30a4\u30df\u30f3\u30b0\u3092\u7279\u5b9a\u3059\u308b\u3053\u3068<\/p>\n

\uff1c\u30c7\u30b6\u30a4\u30f3\uff1e<\/strong>
\n \u30003\u3064\u306e\u7570\u306a\u308billness trajectory\u306b\u57fa\u3065\u304f3\u3064\u306e\u30b1\u30fc\u30b9\u30b7\u30ca\u30ea\u30aa\u3092\u542b\u3080\u8cea\u554f\u7968\u306b\u3088\u308bmixed method\uff08\u6df7\u5408\u7814\u7a76\u6cd5\uff09<\/p>\n

\uff1c\u5bfe\u8c61\uff1e<\/strong>
\n\u3000\u65e5\u672c\u306e4\u3064\u306e\u30b3\u30df\u30e5\u30cb\u30c6\u30a3\u30db\u30b9\u30d4\u30bf\u30eb\u3067\u52e4\u52d9\u3059\u308b\u533b\u5e2b\u3068\u770b\u8b77\u5e2b<\/p>\n

\uff1c\u4e3b\u306a\u6e2c\u5b9a\uff1e<\/strong>
\n\u3000\u60a3\u8005\u306eillness trajectory\u306e4\u3064\u306e\u6bb5\u968e\u306e\u3069\u306e\u30bf\u30a4\u30df\u30f3\u30b0\u3067ACP\u8a71\u3057\u5408\u3044\u3092\u958b\u59cb\u3057\u3088\u3046\u3068\u601d\u3046\u304b\u306b\u3064\u3044\u3066\u3001\u533b\u5e2b\u3068\u770b\u8b77\u5e2b\u306e\u8003\u3048\u304c\u91cf\u7684\u306b\u6e2c\u5b9a\u3055\u308c\u305f\u3002\u307e\u305f\u3001\u597d\u307e\u3057\u3044\u30bf\u30a4\u30df\u30f3\u30b0\u306b\u95a2\u3059\u308b\u8a8d\u8b58\u304c\u8cea\u7684\u306b\u7279\u5b9a\u3055\u308c\u305f\u3002
\n\u3000ACP\u306e\u5b9a\u7fa9\uff1a\u300c\u60a3\u8005\u304c\u91cd\u7be4\u306b\u306a\u3063\u305f\u5834\u5408\u306b\u3001\u751f\u547d\u7dad\u6301\u6cbb\u7642\u3092\u542b\u3080\u533b\u7642\u3092\u53d7\u3051\u305f\u3044\u3001\u307e\u305f\u306f\u53d7\u3051\u305f\u304f\u306a\u3044\u3068\u3044\u3063\u305f\u60a3\u8005\u306e\u5e0c\u671b\u3092\u3001\u8eab\u8fd1\u306a\u4eba\u306b\u77e5\u3063\u3066\u3082\u3089\u3046\u3053\u3068\u300d<\/p>\n

\uff1c\u4e3b\u306a\u7d50\u679c\uff1e<\/strong>
\n\u3000108\u4eba\u306e\u533b\u5e2b\u3068123\u4eba\u306e\u770b\u8b77\u5e2b\u306e\u56de\u7b54\u8005\uff08\u56de\u7b54\u7387\uff1a99\uff05\uff09\u304b\u3089\u30013\u3064\u306e\u30b1\u30fc\u30b9\u30b7\u30ca\u30ea\u30aa\u306b\u3064\u3044\u3066291\u306e\u533b\u5e2b\u306e\u56de\u7b54\u3068362\u306e\u770b\u8b77\u5e2b\u306e\u56de\u7b54\u304c\u5f97\u3089\u308c\u305f\u3002\u5168\u4f53\u3068\u3057\u3066\u3001\u533b\u5e2b\u306e51.2\uff05\u3068\u770b\u8b77\u5e2b\u306e65.5\uff05\uff08p <0.001\uff09\u304c\u3001\u75c5\u6c17\u306b\u306a\u308b\u524d\u306e\u8a71\u3057\u5408\u3044\u3092\u3088\u3057\u3068\u3057\u305f\u3002\u533b\u5e2b\u306f3\u5206\u306e1\u672a\u6e80\u304cACP\u3092\u300c\u8ee2\u3070\u306c\u5148\u306e\u6756\uff08\u8ce2\u660e\u306a\u4e88\u9632\u7b56\uff09\u300d\u3068\u8003\u3048\u3066\u3044\u305f\u304c\u3001\u770b\u8b77\u5e2b\u306f\u7d043\u5206\u306e2\u304c\u305d\u3046\u8003\u3048\u3066\u3044\u305f\u3002\u3055\u3089\u306b\u3001\u533b\u5e2b\u3068\u770b\u8b77\u5e2b\u306e\u4e21\u65b9\u306e\u534a\u6570\u4ee5\u4e0a\u304c\u3001\u60a3\u8005\u306e\u5dee\u3057\u8feb\u3063\u305f\u6b7b\u307e\u3067ACP\u3092\u5ef6\u671f\u3059\u308b\u3053\u3068\u3092\u597d\u3093\u3060\u3002\n\n\uff1c\u7d50\u8ad6\uff1e<\/strong>
\n\u3000\u307b\u3068\u3093\u3069\u306e\u533b\u5e2b\u306f\u3001ACP\u306e\u8a71\u3057\u5408\u3044\u306e\u958b\u59cb\u3092\u3001\u60a3\u8005\u304c\u6b7b\u306b\u8fd1\u3065\u304f\u307e\u3067\u5f85\u3064\u3053\u3068\u3092\u597d\u3080\u3002\u60a3\u8005\u306e\u5065\u5eb7\u304c\u60aa\u5316\u3059\u308b\u524d\u306b\u3001ACP\u306e\u8a71\u3057\u5408\u3044\u3092\u958b\u59cb\u3059\u308b\u3053\u3068\u3092\u671b\u3080\u306e\u306f\u3001\u533b\u5e2b\u3088\u308a\u770b\u8b77\u5e2b\u3067\u3042\u308b\u3002\u65e5\u672c\u3067\u306eACP\u5b9f\u65bd\u7387\u3092\u5411\u4e0a\u3055\u305b\u308b\u305f\u3081\u306b\u306f\u3001ACP\u306b\u5bfe\u3059\u308b\u533b\u7642\u63d0\u4f9b\u8005\u306e\u614b\u5ea6\u306b\u53d6\u308a\u7d44\u3080\u5fc5\u8981\u304c\u3042\u308b\u3002<\/p>\n

\uff1c\u8a73\u3057\u3044\u7d50\u679c\uff1e<\/strong>
\n\u5b9a\u91cf\u7684\u7d50\u679c
\n\u3000\u5168\u4f53\u7684\u306a\u30b7\u30ca\u30ea\u30aa\u3067\u306f\u3001\u770b\u8b77\u5e2b\u306f\u533b\u5e2b\u3088\u308a\u3082\u8106\u5f31\u306a\u30b9\u30c6\u30fc\u30b80\uff0851.2\uff05\u5bfe65.5\uff05\u3001p <0.001\uff09\u3092\u9078\u629e\u3059\u308b\u53ef\u80fd\u6027\u304c\u9ad8\u304b\u3063\u305f\u3002\u8106\u5f31\u6027\u30b9\u30c6\u30fc\u30b80\u307e\u305f\u306f\u8106\u5f31\u6027\u30b9\u30c6\u30fc\u30b81\u306e\u3044\u305a\u308c\u304b\u304c\u3001\u533b\u5e2b\u306784\uff05\u3001\u770b\u8b77\u5e2b\u306793\uff05\u306b\u3088\u3063\u3066\u9078\u629e\u3055\u308c\u307e\u3057\u305f\uff08p <0.001\u3001\u56f32\uff09\u3002 3\u3064\u306e\u500b\u5225\u306e\u30b7\u30ca\u30ea\u30aa\u306e\u7d50\u679c\u306f\u3001\u533b\u5e2b\u3068\u770b\u8b77\u5e2b\u306e\u6bd4\u8f03\u3068\u3044\u3046\u70b9\u3067\u306f\u3001\u5168\u4f53\u7684\u306a\u7d50\u679c\u3068\u307b\u307c\u540c\u3058\u3067\u3059\u3002\u75c5\u6c17\u306e\u8ecc\u8de1\u306e\u671f\u9593\u304c\u9577\u3044\u30b7\u30ca\u30ea\u30aa\u3067\u306f\u3001\u533b\u7642\u63d0\u4f9b\u8005\u306f\u8106\u5f31\u306a\u30b9\u30c6\u30fc\u30b80\u3092\u9078\u629e\u3059\u308b\u53ef\u80fd\u6027\u304c\u4f4e\u304f\u306a\u308a\u307e\u3057\u305f\uff08\u56f33\uff09\u3002\n\n\u8ee2\u3070\u306c\u5148\u306e\u6756\uff08\u8ce2\u660e\u306a\u4e88\u9632\u7b56\uff09\n\u3000 ACP\u306e\u8b70\u8ad6\u304c\u5c06\u6765\u306e\u7121\u80fd\u529b\u5316\u306e\u53ef\u80fd\u6027\u306b\u5099\u3048\u308b\u305f\u3081\u306b\u91cd\u8981\u3067\u3042\u308b\u3068\u4fe1\u3058\u305f\u4eba\u3005\uff1a\u770b\u8b77\u5e2b\u306f\u533b\u5e2b\uff0827\uff05\u3001p <0.001\uff09\u3088\u308a\u3082\u3053\u306e\u4fe1\u5ff5\uff0863\uff05\uff09\u3092\u3088\u308a\u4e00\u822c\u7684\u306b\u8868\u660e\u3057\u307e\u3057\u305f\u3002\n\n\u300c\u60a3\u8005\u3055\u3093\u304c\u5065\u5eb7\u306a\u6642\u3067\u3082\u3001\u3067\u304d\u308b\u3060\u3051\u65e9\u304fACP\u306b\u53d6\u308a\u7d44\u3080\u3053\u3068\u304c\u975e\u5e38\u306b\u91cd\u8981\u3067\u3059\u3002 \u5065\u5eb7\u306a\u60a3\u8005\u3055\u3093\u306e\u4e2d\u306b\u306f\u3001\u65e9\u3059\u304e\u308b\u3068\u601d\u3063\u3066\u8a71\u3057\u5408\u3044\u3092\u62d2\u5426\u3059\u308b\u4eba\u3082\u3044\u307e\u3059\u3002 \u305d\u306e\u5834\u5408\u3001\u79c1\u305f\u3061\u306f\u5f7c\u3089\u306b\u305d\u308c\u306b\u3064\u3044\u3066\u8b70\u8ad6\u3059\u308b\u3053\u3068\u3092\u5f37\u5236\u3057\u307e\u305b\u3093\u3002 \u5f7c\u3089\u306f\u5225\u306e\u8a2d\u5b9a\u3067\u305d\u308c\u3092\u8b70\u8ad6\u3059\u308b\u3053\u3068\u304c\u3067\u304d\u307e\u3059\u3002 \u3057\u304b\u3057\u3001\u3059\u3079\u3066\u306e\u60a3\u8005\u306b\u8a71\u3057\u5408\u3044\u306e\u6a5f\u4f1a\u3092\u63d0\u4f9b\u3057\u3066\u3001[ACP\u306e\u91cd\u8981\u6027\u3092]\u8a8d\u8b58\u3055\u305b\u308b\u3053\u3068\u306f\u610f\u5473\u304c\u3042\u308a\u307e\u3059\u3002\u300d\uff08ID\uff1a15023\u300151\u6b73\u306e\u5973\u6027\u533b\u5e2b\uff09\n\n\u300c\u60a3\u8005\u3055\u3093\u304c\u7a81\u7136\u306e\u5065\u5eb7\u72b6\u614b\u306e\u5909\u5316\u306b\u5099\u3048\u3066\u7d42\u672b\u671f\u30b1\u30a2\u306b\u3064\u3044\u3066\u610f\u898b\u3092\u4f1d\u3048\u3066\u3044\u308c\u3070\u3001\u5bb6\u65cf\u306f\u5f7c\u3089\u306e\u610f\u898b\u306b\u540c\u610f\u3057\u3001\u7d42\u672b\u671f\u30b1\u30a2\u306b\u3064\u3044\u3066\u6c7a\u5b9a\u3092\u4e0b\u3059\u3053\u3068\u304c\u3067\u304d\u307e\u3059\u3002 \u3067\u3059\u304b\u3089\u3001\u75c5\u6c17\u306e\u521d\u671f\u6bb5\u968e\u3067\u8a71\u3057\u5408\u3046\u306e\u306f\u826f\u3044\u3053\u3068\u3067\u3059\u300d \uff08ID\uff1a13008\u300125\u6b73\u306e\u5973\u6027\u770b\u8b77\u5e2b\uff09\n\n\u60a3\u8005\u306e\u5dee\u3057\u8feb\u3063\u305f\u5bff\u547d\u307e\u3067\u306eACP\u306e\u5ef6\u671f\n \u533b\u5e2b\u3068\u770b\u8b77\u5e2b\u306f\u540c\u69d8\u306e\u53cd\u5fdc\u3092\u793a\u3057\u307e\u3057\u305f\uff0855\uff05\u5bfe54\uff05\u3001p = 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