Abstract：
OBJECTIVE: This study aimed to examine self-reported code-status practice patterns among emergency clinicians from Japan and the U.S.
METHODS: A cross-sectional questionnaire was distributed to emergency clinicians from one academic medical center and four general hospitals in Japan and two academic medical centers in the U.S. The questionnaire was based on a hypothetical case involving a critically ill patient with end-stage lung cancer. The questionnaire items assessed whether respondent clinicians would be likely to pose questions to patients about their preferences for medical procedures and their values and goals.
RESULTS: A total of 176 emergency clinicians from Japan and the U.S participated. After adjusting for participants\' backgrounds, emergency clinicians in Japan were less likely to pose procedure-based questions than those in the U.S. Conversely, emergency clinicians in Japan showed a statistically higher likelihood of asking 10 out of 12 value-based questions.
CONCLUSIONS: Significant differences were found between emergency clinicians in Japan and the U.S. in their reported practices on posing procedure-based and patient value-based questions.
CONCLUSIONS: Serious illness communication training based in the U.S. must be adapted to the Japanese context, considering the cultural characteristics and practical responsibilities of Japanese emergency clinicians.
METHODS: A cross-sectional questionnaire was distributed to emergency clinicians from one academic medical center and four general hospitals in Japan and two academic medical centers in the U.S. The questionnaire was based on a hypothetical case involving a critically ill patient with end-stage lung cancer. The questionnaire items assessed whether respondent clinicians would be likely to pose questions to patients about their preferences for medical procedures and their values and goals.
RESULTS: A total of 176 emergency clinicians from Japan and the U.S participated. After adjusting for participants\' backgrounds, emergency clinicians in Japan were less likely to pose procedure-based questions than those in the U.S. Conversely, emergency clinicians in Japan showed a statistically higher likelihood of asking 10 out of 12 value-based questions.
CONCLUSIONS: Significant differences were found between emergency clinicians in Japan and the U.S. in their reported practices on posing procedure-based and patient value-based questions.
CONCLUSIONS: Serious illness communication training based in the U.S. must be adapted to the Japanese context, considering the cultural characteristics and practical responsibilities of Japanese emergency clinicians.
摘要：
目的：这项研究旨在检查日本和美国急诊临床医生的自我报告的代码状态实践模式。
方法：向来自日本的一家学术医学中心和四家综合医院以及美国的两家学术医学中心的急诊临床医生分发了一份横断面问卷。该问卷基于一个涉及患有晚期肺癌的危重患者的假设案例。问卷项目评估了受访者的临床医生是否可能向患者提出关于他们对医疗程序的偏好及其价值观和目标的问题。
结果：共有来自日本和美国的176名急诊临床医生参加。在调整参与者的背景后，与美国相比，日本的急诊临床医生不太可能提出基于程序的问题，相反，日本的急诊临床医生在12个基于价值的问题中提出10个的可能性在统计学上较高.
结论：日本和美国的急诊临床医生在提出基于程序和基于患者价值的问题的实践中发现了显著差异。
结论：基于美国的严重疾病沟通培训必须适应日本的情况，考虑到日本急诊临床医生的文化特点和实际责任。
方法：向来自日本的一家学术医学中心和四家综合医院以及美国的两家学术医学中心的急诊临床医生分发了一份横断面问卷。该问卷基于一个涉及患有晚期肺癌的危重患者的假设案例。问卷项目评估了受访者的临床医生是否可能向患者提出关于他们对医疗程序的偏好及其价值观和目标的问题。
结果：共有来自日本和美国的176名急诊临床医生参加。在调整参与者的背景后，与美国相比，日本的急诊临床医生不太可能提出基于程序的问题，相反，日本的急诊临床医生在12个基于价值的问题中提出10个的可能性在统计学上较高.
结论：日本和美国的急诊临床医生在提出基于程序和基于患者价值的问题的实践中发现了显著差异。
结论：基于美国的严重疾病沟通培训必须适应日本的情况，考虑到日本急诊临床医生的文化特点和实际责任。
