Introduction Traditionally, in Asian cultures, family takes the central role in decision-making.¹ The Japanese Ministry of Health, Labour and Welfare also recommends discussion with the patient’s family to make decisions related to treatment or care.² Therefore, validating patient-centered care (PCC) and shared decision-making (SDM)³ is essential for the application of SDM in Japan.

Methods Several technical workshops (WS) were conducted to train physicians (Phys) and other healthcare providers (HCP) on SDM for the first time and analyzed SDM data from the first and last WS by structural equation modeling (SEM) to assess any shift to patient-centered decision-making.

The SDM skill training was conducted in teams of three who took on the roles of Provider, Patient, and Third-party.

Results The first and last WS had 155 and 145 participants, respectively. The participants varied in their clinical experience, ranging from under 5 to 25 years or more.

SEM analysis of SDM data revealed that the Provider played the central role in the first WS, influencing the Patient and Third party. The Provider’s negative impacts on the Third-party were observed.

In the last WS, however, the Patient took the central role, while the Provider and Third-party took on supportive roles.⁴

Discussion Japanese Phys and other HCPs are not educated on PCC and SDM. However, the results of the present study validated that providing appropriate SDM education for Phys and HCPs allows them to practice patient-centered decision-making. In Japan, there have been movements to promote decision-making centered on parties other than the patient due to cultural rationale, but the results of this study suggested the potential of adequate SDM education to encourage the implementation of PCC.

Conclusion Effective SDM education can encourage behavioral changes to provide patient-centered decision- making care despite the traditional, family-centered decision-making culture.

References

1. Yang Y, Qu T, Yang J, Ma B Leng AL. IJERPH. 2022;19(16):10071.

2. Ministry of Health, Labour and Welfare. The Nickname of ACP (Advance Care Planning) Has Been Decided as ‘Jinsei Kaigi’. Available online: https://www.mhlw.go.jp/stf/newpage_02615.html (accessed on 06 December 2023).

3. Barry MJ, Edgman-Levitan S. N Engl J. 2012;366:780–781.

4. Goto Y, Miura H, HealthCare. 2023;11(9):1356.