{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:12:44Z","timestamp":1785420764722,"version":"3.56.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"the Japanese Foundation for Hospice and Palliative Care Research"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Advance care planning (ACP) improves end-of-life care and communication; however, its long-term effects on bereaved family members remain underexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This study aimed to (1) examine how bereaved family members\u2019 participation in a deceased cancer patient\u2019s ACP influenced their own ACP behavior and (2) explore its impact on their interpersonal relationships and values regarding life and death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A nationwide, cross-sectional, anonymous questionnaire survey was conducted as part of the Japan Hospice and Palliative Evaluation Study 4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/Subjects:<\/jats:title>\n                    <jats:p>Participants were bereaved family members of cancer patients who had received care at designated palliative care units in Japan and had died before January 31, 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements:<\/jats:title>\n                    <jats:p>The survey assessed bereaved individuals\u2019 ACP behavior (thinking about, discussing, or documenting preferences), discussion partners, and psychological outcomes. Logistic regression analyses identified factors associated with ACP engagement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of the 639 questionnaires returned (response rate: 63.5%), 544 valid responses were analyzed. Among respondents, 75% had thought about their own ACP, 42.1% had discussed it, and 7.9% had documented it. Participation in a loved one\u2019s ACP was significantly associated with thinking about (odds ratio [OR] = 5.07) and discussing (OR = 2.46) one\u2019s own ACP. Conversations were linked to increased trust, emotional understanding, and reduced anxiety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Participation in a loved one\u2019s ACP was associated with greater engagement in bereaved individuals\u2019 own ACP, along with enhanced interpersonal trust and reflection on life and death. These findings support viewing ACP as a relational and life-oriented process.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10966218261444992","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T01:31:26Z","timestamp":1776994286000},"page":"1048-1055","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The Impact of Advance Care Planning on Bereaved Cancer Families, Their Relationships, and Their Views on Life and Death in Japan: Findings from the J-HOPE4 Study"],"prefix":"10.1177","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4305-2693","authenticated-orcid":false,"given":"Yuka","family":"Urushibara-Miyachi","sequence":"first","affiliation":[{"name":"Medical Education Development Center, Gifu University School of Medicine, Gifu, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariko","family":"Shiozaki","sequence":"additional","affiliation":[{"name":"Department of Applied Sociology, Kindai University, Osaka, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoru","family":"Tsuneto","sequence":"additional","affiliation":[{"name":"Japan Hospice Palliative Care Foundation, Osaka, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Morita","sequence":"additional","affiliation":[{"name":"Department of Palliative and Supportive Care, Palliative Care Team and Seirei Hospice, Seirei Mikatahara Hospital, Hamamatsu, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiyuki","family":"Kizawa","sequence":"additional","affiliation":[{"name":"Institute of Medicine, University of Tsukuba, Tsukuba, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5993-0822","authenticated-orcid":false,"given":"Kento","family":"Masukawa","sequence":"additional","affiliation":[{"name":"Division of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuo","family":"Shima","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsunori","family":"Miyashita","sequence":"additional","affiliation":[{"name":"Division of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.5271"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gns051"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.5402\/2013\/483673"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16801"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-060201"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2009.02396.x"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.14497"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2016.12.331"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-020-00543-y"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2022.09.005"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-018-0319-z"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cms063"},{"key":"e_1_3_3_14_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2008.0126"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2003.10.014"},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2007.07.009"},{"key":"e_1_3_3_17_1","first-page":"59","article-title":"An introduction to the statistical free software HAD: Suggestions to improve teaching, learning and practice data analysis","volume":"1","author":"Shimizu H","year":"2016","unstructured":"16.Shimizu H. 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