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New Insights into Personalized Care in Advance Care Planning
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New Insights into Personalized Care in Advance Care Planning

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Clinical Medicine, Cell, and Organism Physiology".

Deadline for manuscript submissions: 25 February 2026 | Viewed by 2469

Special Issue Editor

Dr. Mitsunori Nishikawa

E-Mail Website
Guest Editor
Aioi Geriatric Health Services Facility, Higashiura-cho, Chita-gun 470-2102, Japan
Interests: advance care planning

Special Issue Information

Dear Colleagues,

Advance Care Planning (ACP) is important for personalized care in accordance with the person's wishes.

Due to cognitive decline, the person's wishes may be unclear, making it difficult to respect them.

In addition, the person's wishes may conflict with the wishes of family members, or the person's wishes may conflict with the suggestions of healthcare providers.

In such cases, the degree to which the family's wishes are respected and the degree to which the medical provider's suggestions are respected may differ depending on the cultural background of the individual.

Although ACP is the same in both the West and the East in terms of making choices about future medical care, the above points are influenced by cultural differences.

In this Special Issue, we will focus on the medical aspects as well as cultural diversity; we invite original articles, reviews, and other papers to be submitted to this Special Issue in order to obtain new insights into ACP.

Dr. Mitsunori Nishikawa
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • advance care planning
  • choices about future medical care
  • cultural differences
  • diversity
  • personalized care choices

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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Research

10 pages, 459 KiB  
Article
Influence of Primary Care Physicians on End-of-Life Treatment Choices in Lung Cancer Diagnosed in the Emergency Department
by Tatsuyuki Kawahara, Nobuaki Ochi, Hirohito Kirishi, Yusuke Sunada, Ayaka Mimura, Naruhiko Ichiyama, Yoko Kosaka, Yasunari Nagasaki, Hidekazu Nakanishi, Hiromichi Yamane and Nagio Takigawa
J. Pers. Med. 2025, 15(8), 339; https://doi.org/10.3390/jpm15080339 - 1 Aug 2025
Viewed by 235
Abstract
Background: Lung cancer remains one of the leading causes of cancer-related mortality worldwide. While most diagnoses occur in outpatient settings, a subset of cases are incidentally identified during emergency department (ED) visits. The clinical characteristics and treatment decisions of these patients, particularly [...] Read more.
Background: Lung cancer remains one of the leading causes of cancer-related mortality worldwide. While most diagnoses occur in outpatient settings, a subset of cases are incidentally identified during emergency department (ED) visits. The clinical characteristics and treatment decisions of these patients, particularly in relation to social background factors such as living situation and access to primary care, remain poorly understood. Methods: We conducted a retrospective study of patients diagnosed with malignancies in the ED of a single institution between April 2018 and December 2021. Patients diagnosed with lung cancer within 60 days of an ED visit were included. Data on demographics, disease status, treatment decisions, and background factors—including whether patients lived alone or had a primary care physician (PCP)—were extracted and analyzed. Results: Among 32,108 patients who visited the ED, 148 were diagnosed with malignancy within 60 days; 23 had lung cancer. Of these, 69.6% had metastatic disease at diagnosis, and 60.9% received active treatment (surgery or chemotherapy). No significant associations were observed between the extent of disease and either living arrangement or PCP status. However, the presence of a PCP was significantly associated with the selection of best supportive care (p = 0.023). No significant difference in treatment decisions was observed based on age (cutoff: 75 years). Conclusions: Although social background factors such as living alone were not significantly associated with cancer stage or treatment choice, the presence of a primary care physician was associated with a higher likelihood of best supportive care being selected. This may indicate that patients with an established PCP have more clearly defined care goals at the end of life. These findings suggest that primary care access may play a role in shaping end-of-life care preferences, highlighting the importance of personalized approaches in acute oncology care. Full article
(This article belongs to the Special Issue New Insights into Personalized Care in Advance Care Planning)
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16 pages, 251 KiB  
Article
Personalized Care in Advance Care Planning with Cancer and Chronic Progressive Diseases Using the Go Wish Game
by Sara Alquati, Marta Perin, Simona Sacchi, Ludovica De Panfilis and Silvia Tanzi
J. Pers. Med. 2025, 15(5), 180; https://doi.org/10.3390/jpm15050180 - 30 Apr 2025
Viewed by 709
Abstract
Background: The Go Wish Game (GWG) is a card game designed to ease Advance Care Planning (ACP) discussions. It helps patients to consider their values and priorities, and to share them with families and healthcare professionals (HPs). Despite a general appreciation of the [...] Read more.
Background: The Go Wish Game (GWG) is a card game designed to ease Advance Care Planning (ACP) discussions. It helps patients to consider their values and priorities, and to share them with families and healthcare professionals (HPs). Despite a general appreciation of the GWG, mechanisms related to its implementation have been poorly investigated. Objective: to determine optimal strategies for integration of the GWG into clinical practice and to investigate the experiences of a Palliative Care Unit (PCU) trained in the use of the GWG. Methods: We performed a descriptive qualitative study. Data were collected through a focus group (FG) and we followed the thematic analysis. The PCU’s team described their experience using the GWG focusing on 15 patients (9 oncological, 6 non-oncological) patients, managed by the PCU. Results: Our data revealed five main themes, along with their subthemes: (1) personalizing the GWG proposal; (2) the role of the caregiver; (3) organizational aspects; (4) meaning of the GWG in clinical practice, and (5) dealing with patient’s priorities. Comparison of real-life cases has led to the identification of specific facilitators and barriers that can hinder or promote the use of the GWG for personalized medicine. Conclusions: Findings suggest that certain aspects still require attention in GWG implementation, particularly regarding the training and competencies (communicative, relational, ethical) of the healthcare professionals, and the process leading to the proposal of the GWG to the patient. Full article
(This article belongs to the Special Issue New Insights into Personalized Care in Advance Care Planning)
12 pages, 1144 KiB  
Article
Frailty as a Predictor of Post-Traumatic Stress Disorder After Advance Care Planning Communication Intervention by Trained Care Managers in Long-Term Care Service Users in Japan: A Secondary Analysis
by Mariko Miyamichi, Kyoko Oshiro, Shozo Okochi, Noriyasu Takeuchi, Tomoe Nakamura, Terumi Matsushima, Masako Okada, Yoshimi Kudo, Takehiro Ishiyama, Tomoyasu Kinoshita, Hideki Kojima and Mitsunori Nishikawa
J. Pers. Med. 2025, 15(4), 159; https://doi.org/10.3390/jpm15040159 - 21 Apr 2025
Viewed by 654
Abstract
Background/Objectives: Advance care planning is essential in a community; however, intervention studies by care managers remain scarce. This study aims to determine the relationship between frailty and post-traumatic stress disorder among long-term care service users (hereinafter referred to as “users”) following advance [...] Read more.
Background/Objectives: Advance care planning is essential in a community; however, intervention studies by care managers remain scarce. This study aims to determine the relationship between frailty and post-traumatic stress disorder among long-term care service users (hereinafter referred to as “users”) following advance care planning conversations with their care managers. Methods: We conducted a secondary analysis using raw data from the Japanese University Hospital Medical Information Network Study No. 000048573, published on 23 September 2024. In this previous study, trained care managers provided advance care planning conversation interventions to 30 users. Care managers conducted a convenience sample of 30 mentally and physically stable users who were 65 years old or older, had a family member or healthcare provider assigned, and had never used ACP. Our analysis in the present study focuses on the Clinical Frailty Scale and Impact of Events Scale-Revised, both of which measure post-traumatic stress disorder. Results: The Impact of Events Scale-Revised score was significantly higher in users with a clinical frailty score ≥ 5 compared to those with a clinical frailty score < 5. Logistic regression analysis, using the Impact of Events Scale-Revised as the objective variable, also revealed an association between a clinical frailty score ≥ 5 and a higher Impact of Events Scale-Revised. The four groups, selected through hierarchical cluster analysis for sensitivity analysis, demonstrated results consistent with the above analysis. Conclusions: The degree of post-traumatic stress disorder among users is associated with their degree of frailty following an advance care planning conversation with their care manager. Frailty in users may be a valuable predictor of stress related to advance care planning conversations. Users with a clinical frailty scale score ≥ 5 can be provided with more personalized care through more careful communication. University Hospital Medical Information Network Trial ID: 000048573. Full article
(This article belongs to the Special Issue New Insights into Personalized Care in Advance Care Planning)
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