Exploring palliative and end-of-life Care in Japanese long-term care facilities and assessing the transferability of 'PACE Steps to Success Programme' to Japanese context

: a mixed-methods study

Abstract

The global ageing population has increased the demand for long-term care facilities requiring high-quality palliative and end-of-life care provision. Whilst its importance is acknowledged, access to palliative and end-of-life care education in this setting is limited and evidence-based educational interventions are under-researched in Japan. Europe-originated ‘PACE Steps to Success Programme’ is a well-tested educational programme for facility staff to improve palliative care; however, the transferability into the Japanese context is not known. Therefore, this study aimed to examine palliative and end-of-life care practice and education in Japanese long-term care facilities and consider the transferability of the PACE Programme into the Japanese context.

A mixed methods approach was employed over three phases; Phase 1 integrative literature review; Phase 2 expert elicitation (n=12); and Phase 3 facility staff focus groups (n=71) and facility manager individual interviews (n=10).

Study findings suggested that there is an ongoing need to strengthen the educational, practice and policy support provided to enhance palliative and end-of-life care in Japanese facilities. Culture and context, from national, organisational and individual levels, influenced what people (e.g. practitioners, older people, and their families) believed to be a good death. These, in turn, impacted palliative and end-of-life care practices in this setting.

This study makes an original contribution to knowledge by advancing understanding of the current palliative and end-of-life care in Japanese long-term care facilities and key aspects of assessing transferability when implementing new interventions in Japanese context. The content of the PACE programme appears to be aligned with the educational needs of Japanese facility staff. However, further work is required to incorporate Japanese culture, values and beliefs into
the PACE programme prior to its implementation across long-term care settings in Japan.

Thesis is embargoed until 30th April 2024

Date of Award	Apr 2022
Original language	English
Sponsors	Vice Chancellor's Research Scholarship (VCRS)
Supervisor	Sonja McIlfatrick (Supervisor), Assumpta Ryan (Supervisor) & Felicity Hasson (Supervisor)