title: End-of-life preferences of the general public: Results from a Japanese national survey.
abstract: OBJECTIVE
  To determine under different End-of-Life (EoL) scenarios the preferences of the general public for EoL care setting and Life-sustaining-Treatments (LST), and to develop a new framework to assess these preferences.
  
  
  METHODS
  Using a 2-stage, geographical cluster sampling method, we conducted a postal survey across Japan of 2000 adults, aged 20+. Four EoL scenarios were used: cancer, cardiac failure, dementia and persistent vegetative state (PVS).
  
  
  RESULTS
  We received 969 valid responses (response rate 48.5%). Preference for EoL care setting varied by illness with those wishing to spend EoL at home only 39% for cancer, 22% for cardiac failure, and 10-11% for dementia and PVS. Preference for LST differed by scenario and treatment type. In cancer, cardiac failure and dementia, about half to two thirds expressed a preference for antibiotics and fluid drip infusion but few for nasogastric (NG) tube feeding, percutaneous endoscopic gastrostomy (PEG), ventilation or cardiopulmonary resuscitation (CPR). Although our models accounted for only 3-9% of the variance, preferences to receive LST were associated with preference to spend EoL in hospital for cancer and cardiac failure but not dementia.
  
  
  CONCLUSIONS
  Few people preferred to die at home, while a preference for hospital was largely determined by factors other than preference for LST.
authors.affiliation: Department of Health Policy and Management, Keio University Medical School, Shinanomachi, Shinjuku-ku, Tokyo, Japan. Electronic address: lak10016@gmail.com.
authors.forename: Lee Andrew
authors.initials: LA
authors.lastname: Kissane
authors.affiliation: Department of Health Policy and Management, Keio University Medical School, Shinanomachi, Shinjuku-ku, Tokyo, Japan.
authors.forename: Baku
authors.initials: B
authors.lastname: Ikeda
authors.affiliation: Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka Prefecture 411-8777 Japan.
authors.forename: Reiko
authors.initials: R
authors.lastname: Akizuki
authors.affiliation: Tokyo Musashino Hospital, 4-11-11, Komone, Itabashi-ku, Tokyo 173-0037, Japan.
authors.forename: Shoko
authors.initials: S
authors.lastname: Nozaki
authors.affiliation: Department of Health Policy and Management, Keio University Medical School, Shinanomachi, Shinjuku-ku, Tokyo, Japan.
authors.forename: Kimio
authors.initials: K
authors.lastname: Yoshimura
authors.affiliation: Department of Health Policy and Management, Keio University Medical School, Shinanomachi, Shinjuku-ku, Tokyo, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Ikegami
mesh_terms: D000328:Adult; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D057240:Patient Preference; D011639:Public Opinion; D011795:Surveys and Questionnaires; D013727:Terminal Care; D055815:Young Adult
keywords: Dementia, primary senile degenerative; Japan; Life support care; Palliative care; Public opinion; Terminal care