Abstract：
OBJECTIVE: This study aimed to elucidate the barriers perceived by Advance Care Planning (ACP) facilitators in nursing and welfare professions when implementing ACP in practice.
METHODS: An online survey using Google Forms was conducted between December 2021 and January 2022. The survey targeted 220 individuals, including 82 who completed the Hiroshima Prefecture ACP Promotion Training in 2020 and 138 ACP Promotion Collaborators in Fukuyama City, Hiroshima Prefecture. In addition to the respondents\' attributes, the survey asked about the importance of 37 items related to barriers to ACP implementation, using a 7-point scale. We compared two groups: nurses and physicians (\"nurses/physicians\") and other medical and nursing care professionals (\"nursing care professionals, etc.\").
RESULTS: Responses were obtained from 67 participants (response rate: 34.4%). The barriers to ACP perceived by nursing care professionals were as follows: 1) lack of knowledge about ACP, 2) belief that other professions are more suitable for implementing ACP than themselves, and 3) difficulty in realizing intentions due to institutional and environmental factors. Nurses and physicians perceived lack of time as an important barrier. Measures such as 1) clarifying how different professions should be involved in ACP, 2) expanding educational opportunities tailored to each profession, 3) utilizing tools to support the decision-making process in ACP, and 4) establishing an information-sharing system infrastructure are considered to be effective in promoting the implementation of ACP by facilitators in the nursing and welfare professions.
CONCLUSIONS: By implementing measures to address the barriers identified in this study, it is expected that the practice of ACP by facilitators in nursing and welfare professions will be promoted, and ACP will become more widespread in the community.
METHODS: An online survey using Google Forms was conducted between December 2021 and January 2022. The survey targeted 220 individuals, including 82 who completed the Hiroshima Prefecture ACP Promotion Training in 2020 and 138 ACP Promotion Collaborators in Fukuyama City, Hiroshima Prefecture. In addition to the respondents\' attributes, the survey asked about the importance of 37 items related to barriers to ACP implementation, using a 7-point scale. We compared two groups: nurses and physicians (\"nurses/physicians\") and other medical and nursing care professionals (\"nursing care professionals, etc.\").
RESULTS: Responses were obtained from 67 participants (response rate: 34.4%). The barriers to ACP perceived by nursing care professionals were as follows: 1) lack of knowledge about ACP, 2) belief that other professions are more suitable for implementing ACP than themselves, and 3) difficulty in realizing intentions due to institutional and environmental factors. Nurses and physicians perceived lack of time as an important barrier. Measures such as 1) clarifying how different professions should be involved in ACP, 2) expanding educational opportunities tailored to each profession, 3) utilizing tools to support the decision-making process in ACP, and 4) establishing an information-sharing system infrastructure are considered to be effective in promoting the implementation of ACP by facilitators in the nursing and welfare professions.
CONCLUSIONS: By implementing measures to address the barriers identified in this study, it is expected that the practice of ACP by facilitators in nursing and welfare professions will be promoted, and ACP will become more widespread in the community.
摘要：
目的：本研究旨在阐明护理和福利专业中的高级护理计划（ACP）促进者在实践中实施ACP时所感受到的障碍。
方法：在2021年12月至2022年1月之间使用GoogleForms进行了在线调查。这项调查针对220个人，包括在2020年完成广岛县ACP推广培训的82人和福山市的138名ACP推广合作者，广岛县。除了受访者的属性之外，调查询问了与非加太实施障碍相关的37个项目的重要性，使用7点量表。我们比较了两组：护士和医师（“护士/医师”）和其他医疗和护理专业人员（“护理专业人员，等。\")。
结果：从67名参与者获得了响应（响应率：34.4％）。护理专业人员认为ACP的障碍如下：1)缺乏关于ACP的知识，2）相信其他职业比自己更适合实施ACP，3)制度和环境因素难以实现意图。护士和医生认为缺乏时间是一个重要的障碍。措施，如1)澄清不同的职业应该如何参与非加太，2）扩大适合每个专业的教育机会，3)利用工具支持ACP的决策过程，4）建立信息共享系统基础设施被认为可以有效地促进护理和福利专业的促进者实施ACP。
结论：通过实施解决本研究中发现的障碍的措施，预计将促进护理和福利专业中的促进者进行ACP的做法，ACP将在社区中变得更加普遍。
方法：在2021年12月至2022年1月之间使用GoogleForms进行了在线调查。这项调查针对220个人，包括在2020年完成广岛县ACP推广培训的82人和福山市的138名ACP推广合作者，广岛县。除了受访者的属性之外，调查询问了与非加太实施障碍相关的37个项目的重要性，使用7点量表。我们比较了两组：护士和医师（“护士/医师”）和其他医疗和护理专业人员（“护理专业人员，等。\")。
结果：从67名参与者获得了响应（响应率：34.4％）。护理专业人员认为ACP的障碍如下：1)缺乏关于ACP的知识，2）相信其他职业比自己更适合实施ACP，3)制度和环境因素难以实现意图。护士和医生认为缺乏时间是一个重要的障碍。措施，如1)澄清不同的职业应该如何参与非加太，2）扩大适合每个专业的教育机会，3)利用工具支持ACP的决策过程，4）建立信息共享系统基础设施被认为可以有效地促进护理和福利专业的促进者实施ACP。
结论：通过实施解决本研究中发现的障碍的措施，预计将促进护理和福利专业中的促进者进行ACP的做法，ACP将在社区中变得更加普遍。
