Disparity in pre-emptive end-of-life conversation experience caused by subjective economic status among general Japanese elderly people: a cross-sectional study with stratified random sampling

Objectives Pre-emptive conversations (PCs) about end-of-life (EOL) preferences are beneficial for both elderly people and their families to understand and share the preferences. However, the factors which promote/inhibit PCs have yet to be clarified. We therefore aimed to determine the factors relat...

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Main Authors: Tomoo Hidaka, Shota Endo, Hideaki Kasuga, Yusuke Masuishi, Takeyasu Kakamu, Tomohiro Kumagai, Tetsuhito Fukushima, Keiko Saito, Kouichi Abe
Format: Article
Language:English
Published: BMJ Publishing Group 2019-10-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/10/e031681.full
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author Tomoo Hidaka
Shota Endo
Hideaki Kasuga
Yusuke Masuishi
Takeyasu Kakamu
Tomohiro Kumagai
Tetsuhito Fukushima
Keiko Saito
Kouichi Abe
author_facet Tomoo Hidaka
Shota Endo
Hideaki Kasuga
Yusuke Masuishi
Takeyasu Kakamu
Tomohiro Kumagai
Tetsuhito Fukushima
Keiko Saito
Kouichi Abe
author_sort Tomoo Hidaka
collection DOAJ
description Objectives Pre-emptive conversations (PCs) about end-of-life (EOL) preferences are beneficial for both elderly people and their families to understand and share the preferences. However, the factors which promote/inhibit PCs have yet to be clarified. We therefore aimed to determine the factors related to having PCs with hypothesis that age, subjective economic status and subjective health status are associated with having PC experience.Design A cross-sectional study administering a questionnaire and using stratified random sampling by gender and region.Setting Residents aged 65 years or older who were not receiving nursing care as of 1 November 2016, were extracted from the Japanese long-term care insurance system registry in Koriyama City, Fukushima Prefecture, Japan.Participants 1575 participants (717 males and 858 females).Outcome Presence or absence of PC experience with family or friends (yes/no).Results The mean age of the participants was 74.0 years. A multivariable logistic-regression analysis revealed that having PC experience was significantly associated with gender (OR=1.907; 95% CI=1.556 to 2.337; p<0.001), subjective economic status (OR=0.832; 95% CI=0.716 to 0.966; p=0.016) and subjective happiness (OR=0.926; 95% CI=0.880 to 0.973; p=0.003).Conclusions Poor subjective economic status of elderly people may result in the absence of EOL conversation experience with their families and friends, hindering the elderly from sharing and understanding the EOL preferences. To promote PCs about EOL, gerontology and public health professionals should give special consideration to the subjective economic status of elderly people.
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spelling doaj-art-158fbc17e3d74f53ac2dc315c8d472832025-08-20T02:39:31ZengBMJ Publishing GroupBMJ Open2044-60552019-10-0191010.1136/bmjopen-2019-031681Disparity in pre-emptive end-of-life conversation experience caused by subjective economic status among general Japanese elderly people: a cross-sectional study with stratified random samplingTomoo Hidaka0Shota Endo1Hideaki Kasuga2Yusuke Masuishi3Takeyasu Kakamu4Tomohiro Kumagai5Tetsuhito Fukushima6Keiko Saito7Kouichi Abe81 Department of Hygiene and Preventive Medicine, Fukushima Medical University School of Medicine, Fukushima, JapanDepartment of Hygiene and Preventive Medicine, School of Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Hygiene and Preventive Medicine, School of Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Hygiene and Preventive Medicine, School of Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Hygiene and Preventive Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan1 Department of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Hygiene and Preventive Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan2 Division of Children, Hoshi General Hospital Foundation, Fukushima, Japan3 Director, Koriyama City Public Health Center, Fukushima, JapanObjectives Pre-emptive conversations (PCs) about end-of-life (EOL) preferences are beneficial for both elderly people and their families to understand and share the preferences. However, the factors which promote/inhibit PCs have yet to be clarified. We therefore aimed to determine the factors related to having PCs with hypothesis that age, subjective economic status and subjective health status are associated with having PC experience.Design A cross-sectional study administering a questionnaire and using stratified random sampling by gender and region.Setting Residents aged 65 years or older who were not receiving nursing care as of 1 November 2016, were extracted from the Japanese long-term care insurance system registry in Koriyama City, Fukushima Prefecture, Japan.Participants 1575 participants (717 males and 858 females).Outcome Presence or absence of PC experience with family or friends (yes/no).Results The mean age of the participants was 74.0 years. A multivariable logistic-regression analysis revealed that having PC experience was significantly associated with gender (OR=1.907; 95% CI=1.556 to 2.337; p<0.001), subjective economic status (OR=0.832; 95% CI=0.716 to 0.966; p=0.016) and subjective happiness (OR=0.926; 95% CI=0.880 to 0.973; p=0.003).Conclusions Poor subjective economic status of elderly people may result in the absence of EOL conversation experience with their families and friends, hindering the elderly from sharing and understanding the EOL preferences. To promote PCs about EOL, gerontology and public health professionals should give special consideration to the subjective economic status of elderly people.https://bmjopen.bmj.com/content/9/10/e031681.full
spellingShingle Tomoo Hidaka
Shota Endo
Hideaki Kasuga
Yusuke Masuishi
Takeyasu Kakamu
Tomohiro Kumagai
Tetsuhito Fukushima
Keiko Saito
Kouichi Abe
Disparity in pre-emptive end-of-life conversation experience caused by subjective economic status among general Japanese elderly people: a cross-sectional study with stratified random sampling
BMJ Open
title Disparity in pre-emptive end-of-life conversation experience caused by subjective economic status among general Japanese elderly people: a cross-sectional study with stratified random sampling
title_full Disparity in pre-emptive end-of-life conversation experience caused by subjective economic status among general Japanese elderly people: a cross-sectional study with stratified random sampling
title_fullStr Disparity in pre-emptive end-of-life conversation experience caused by subjective economic status among general Japanese elderly people: a cross-sectional study with stratified random sampling
title_full_unstemmed Disparity in pre-emptive end-of-life conversation experience caused by subjective economic status among general Japanese elderly people: a cross-sectional study with stratified random sampling
title_short Disparity in pre-emptive end-of-life conversation experience caused by subjective economic status among general Japanese elderly people: a cross-sectional study with stratified random sampling
title_sort disparity in pre emptive end of life conversation experience caused by subjective economic status among general japanese elderly people a cross sectional study with stratified random sampling
url https://bmjopen.bmj.com/content/9/10/e031681.full
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