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Intrinsic Religious Motivations Influencing Advance Care Planning in Japan: A Mixed-Methods Study.
Jun Miyashita1, Ayako Kohno2, Yosuke Yamamoto3
1Department of General Medicine (J.M.), Shirakawa Satellite for Teaching And Research (STAR), Fukushima Medical University, Shirakawa, Fukushima, Japan.
Journal of Pain and Symptom Management
|January 21, 2026
Summary
Intrinsic religious motivations are linked to higher rates of advance care planning (ACP) discussions among religious adults in Japan. Understanding these motivations can inform end-of-life care strategies.
Area of Science:
- Gerontology
- Sociology of Religion
- Bioethics
Background:
- The link between advance care planning (ACP) and religious beliefs is debated in Western contexts.
- Previous Japanese research indicated an association but lacked mechanistic insight.
Purpose of the Study:
- To quantitatively assess the relationship between ACP discussions and intrinsic religious motivations in Japan.
- To qualitatively explore how these motivations shape ACP discussions.
Main Methods:
- An explanatory sequential mixed-methods study involving 124 religious adults (aged 51-84) in Japan.
- Quantitative analysis used modified Poisson regression; qualitative analysis employed constructivist grounded theory.
- Participants were from Christian and Buddhist services in Tokyo, Ibaraki, and Fukushima.
Main Results:
- 31% of participants reported discussing ACP.
- Intrinsic religious motivations were significantly associated with a higher prevalence of ACP discussions (APR: 2.18).
- Qualitative findings revealed prayer, shared end-of-life experiences, and life reflection facilitated discussions.
Conclusions:
- Intrinsic religious motivations positively influence ACP discussions among Japanese Buddhists and Christians.
- This understanding can aid healthcare providers in developing palliative care and end-of-life decision-making strategies.
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