Abstract：
A conceptual framework for advance care planning is lacking in societies like Japan\'s valuing family-centered decision-making.
A consensus definition of advance care planning with action guideline adapted to Japanese society.
We conducted a multidisciplinary modified Delphi study 2020-2022. Thirty physicians, 10 healthcare and bioethics researchers, six nurses, three patient care managers, three medical social workers, three law experts, and a chaplain evaluated, in 7 rounds (including two web-based surveys where the consensus level was defined as ratings by ≥70% of panelists of 7-9 on a nine-point Likert scale), brief sentences delineating the definition, scope, subjects, and action guideline for advance care planning in Japan.
The resulting 29-item set attained the target consensus level, with 72%-96% of item ratings 7-9. Advance care planning was defined as \"an individual\'s thinking about and discussing with their family and other people close to them, with the support as necessary of healthcare providers who have established a trusting relationship with them, preparations for the future, including the way of life and medical treatment and care that they wish to have in the future.\" This definition/action guideline specifically included support for individuals hesitant to express opinions to develop and express preparations for the future.
Adaptation of advance care planning to Japanese culture by consciously enhancing and supporting individuals\' autonomous decision-making may facilitate its spread and establishment in Japan and other societies with family-centered decision-making cultures.
A consensus definition of advance care planning with action guideline adapted to Japanese society.
We conducted a multidisciplinary modified Delphi study 2020-2022. Thirty physicians, 10 healthcare and bioethics researchers, six nurses, three patient care managers, three medical social workers, three law experts, and a chaplain evaluated, in 7 rounds (including two web-based surveys where the consensus level was defined as ratings by ≥70% of panelists of 7-9 on a nine-point Likert scale), brief sentences delineating the definition, scope, subjects, and action guideline for advance care planning in Japan.
The resulting 29-item set attained the target consensus level, with 72%-96% of item ratings 7-9. Advance care planning was defined as \"an individual\'s thinking about and discussing with their family and other people close to them, with the support as necessary of healthcare providers who have established a trusting relationship with them, preparations for the future, including the way of life and medical treatment and care that they wish to have in the future.\" This definition/action guideline specifically included support for individuals hesitant to express opinions to develop and express preparations for the future.
Adaptation of advance care planning to Japanese culture by consciously enhancing and supporting individuals\' autonomous decision-making may facilitate its spread and establishment in Japan and other societies with family-centered decision-making cultures.
摘要：
在像日本这样重视以家庭为中心的决策的社会中，缺乏预先护理计划的概念框架。
适应日本社会的行动指南的预先护理计划的共识定义。
我们进行了一项2020-2022年的多学科改良Delphi研究。30位医生,10名医疗保健和生物伦理学研究人员，六个护士,三位病人护理经理,三名医务社会工作者,三位法律专家,一名牧师被评估，在7轮（包括两个基于网络的调查，其中共识水平被定义为≥70％的小组成员在9分李克特量表上的评分为7-9），描述定义的简短句子，范围,主题,以及日本提前护理计划的行动指南。
由此产生的29个项目集达到了目标共识水平，72%-96%的项目评级为7-9。提前护理计划被定义为“一个人思考并与家人和其他亲近的人讨论，在与他们建立信任关系的医疗保健提供者的必要支持下，为未来做准备，包括他们未来希望拥有的生活方式、医疗和护理。“这个定义/行动指南特别包括支持那些不愿发表意见的个人，以制定和表达未来的准备工作。
通过有意识地增强和支持个人的自主决策，使预先护理计划适应日本文化，这可能会促进其在日本和其他以家庭为中心的决策文化社会的传播和建立。
适应日本社会的行动指南的预先护理计划的共识定义。
我们进行了一项2020-2022年的多学科改良Delphi研究。30位医生,10名医疗保健和生物伦理学研究人员，六个护士,三位病人护理经理,三名医务社会工作者,三位法律专家,一名牧师被评估，在7轮（包括两个基于网络的调查，其中共识水平被定义为≥70％的小组成员在9分李克特量表上的评分为7-9），描述定义的简短句子，范围,主题,以及日本提前护理计划的行动指南。
由此产生的29个项目集达到了目标共识水平，72%-96%的项目评级为7-9。提前护理计划被定义为“一个人思考并与家人和其他亲近的人讨论，在与他们建立信任关系的医疗保健提供者的必要支持下，为未来做准备，包括他们未来希望拥有的生活方式、医疗和护理。“这个定义/行动指南特别包括支持那些不愿发表意见的个人，以制定和表达未来的准备工作。
通过有意识地增强和支持个人的自主决策，使预先护理计划适应日本文化，这可能会促进其在日本和其他以家庭为中心的决策文化社会的传播和建立。
