Advance care planning and hospice utilization among Japanese Americans: a scoping review

Although advance care planning (ACP) has increased in recent years, there is still a discrepancy in the utilization of these resources among the Asian American, Native Hawaiian, and Pacific Islander populations. We present the first scoping review of ACP and hospice utilization among Japanese Americans.

This scoping review was created in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020. A literature search was conducted using PubMed. The articles were screened, and the extracted articles then underwent thematic analysis.

A total of 438 articles were found, and 7 articles remained for extraction. Japanese Americans had a high rate of completion for advance directives, comparable to that of White Americans. Japanese Americans had lower rates of hospice utilization after adjusting for demographic and clinical characteristics, suggesting cultural and systemic influences. Key factors included lack of procedural knowledge, acculturation, and preferences for shared decision models.

Though Japanese Americans express interest in ACP, cultural and systemic barriers persist. Effective ACP must incorporate culturally sensitive education, family-inclusive approaches, and training in cross-cultural communication. Future research should disaggregate data, investigate socioeconomic influences, and develop strategies to improve ACP in this population.