• Masanori Mori, ChanHelen Y LHYL0000-0003-4038-4654The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong., Cheng-Pei Lin, Sun-Hyun Kim, Raymond Ng Han Lip, Diah Martina, Kwok Keung Yuen, Shao-Yi Cheng, Sayaka Takenouchi, Sang-Yeon Suh, Sumytra Menon, Jungyoung Kim, Ping-Jen Chen, Futoshi Iwata, Shimon Tashiro, Oi Ling Annie Kwok, Jen-Kuei Peng, Hsien-Liang Huang, Tatsuya Morita, Ida J Korfage, RietjensJudith A CJAC0000-0002-0538-5603Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.Department of Design, Organization and Strategy, Faculty of Industrial Design Engineering, Delft University of, and Yoshiyuki Kizawa.
• Division of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan.
• Palliat Med. 2024 Oct 10: 26921632412840882692163241284088.

BackgroundIn Confucian-influenced Asian societies, explicit end-of-life conversations are uncommon and family involvement in decision-making is crucial, which complicates the adoption of culturally sensitive advance care planning.AimTo develop a consensus definition of advance care planning and provide recommendations for patient-centered and family-based initiatives in Asia.DesignA five-round Delphi study was performed. The rating of a definition and 84 recommendations developed based on systematic reviews was performed by experts with clinical or research expertise using a 7-point Likert scale. A median = 1 and an inter-quartile range = 0-1 were considered very strong agreement and very strong consensus, respectively.Setting/ParticipantsThe Delphi study was carried out by multidisciplinary experts on advance care planning in five Asian sectors (Hong Kong/Japan/Korea/Singapore/Taiwan).ResultsSeventy-seven of 115 (67%) experts rated the statements. Advance care planning is defined as "a process that enables individuals to identify their values, to define goals and preferences for future medical treatment and care, to discuss these values, goals, and preferences with family and/or other closely related persons, and health-care providers, and to record and review these preferences if appropriate." Recommendations in the domains of considerations for a person-centered and family-based approach, as well as elements, roles and tasks, timing for initiative, policy and regulation, and evaluations received high levels of agreement and consensus.ConclusionsOur definition and recommendations can guide practice, education, research, and policy-making in advance care planning for Asian populations. Our findings will aid future research in crafting culturally sensitive advance care planning interventions, ensuring Asians receive value-aligned care.

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