{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T09:52:22Z","timestamp":1790243542729,"version":"4.1.0"},"reference-count":59,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"JSPS KAKENHI","award":["JP16K15972, JP19K10941"],"award-info":[{"award-number":["JP16K15972, JP19K10941"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Globally, multi-disciplinary advance care planning (ACP) in multi-facility settings for aging communities is essential; however, it does not consistently yield the desired outcomes. Japan\u2019s population is rapidly aging; nonetheless, no studies have examined comprehensive ACP implementation by diverse professionals across various community healthcare facilities. Within the context of an aging community, this study aimed to identify the barriers and facilitators to ACP implementation by multiple professionals in various healthcare facilities. A qualitative research design was employed. The study participants included 22 multidisciplinary members of a community-based palliative care (CBPC) team. Individual semi-structured interviews were conducted between September and October 2019. A total of 19 barriers and 19 facilitators were identified and categorized into seven practice domains: \u201cUnderstanding patients\u2019 intentions,\u201d \u201cFamily support,\u201d \u201cInformation sharing using tools,\u201d \u201cCollaboration among multiple professions,\u201d \u201cCross-facility and cross-departmental cooperation,\u201d \u201cRaising awareness in the community,\u201d and \u201cEfforts by implementation promoters and their departments.\u201d Barriers included \u201cInability to understand the patient\u2019s intentions,\u201d \u201cPhysical and psychological distance between patient and family,\u201d and \u201cDifferent information needs and sharing methods at each facility,\u201d among others. Facilitators included \u201cSkills for better understanding the true meaning of patients\u2019 intentions,\u201d \u201cCompatibility of daily tasks and ACP by utilizing tools,\u201d \u201cHuman connections between professionals in multiple facilities and departments,\u201d and \u201cEngagement with ACP implementation,\u201d among others. The study identified important domains for practical ACP implementation using a community-based palliative care team collaborating across multiple community facilities, as well as the barriers and facilitators. The findings indicate that multi-disciplinary, multi-facility ACP implementation in regions with aging populations requires establishing a regional collaborative network system and a human network. Healthcare professionals must develop practical ACP experience to identify its benefits while enhancing their skills as \u201cadvocates.\u201d<\/jats:p>","DOI":"10.1371\/journal.pone.0323976","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T17:54:28Z","timestamp":1748454868000},"page":"e0323976","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Barriers and facilitators of advance care planning practices in multi-disciplinary, multi-facility palliative care for Japan\u2019s aging population: A qualitative 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