Psychological profiles of readiness for advance care planning in super-aged Japan

Abstract

Advance care planning (ACP) helps ensure that future medical care reflects individuals’ values and preferences. However, little is known about how multiple psychological characteristics combine to shape readiness for ACP, particularly in Japan. This study aimed to identify psychological profiles of readiness for ACP among Japanese adults and to examine age-related differences in profile membership. A nationwide cross-sectional online survey was conducted among Japanese adults. After excluding inattentive respondents, data from 2,152 participants were analyzed. Six psychological constructs related to ACP readiness were assessed, and latent profile analysis was conducted to identify distinct psychological profiles. Age-related differences in profile membership were subsequently examined. Four psychological profiles were identified: Interested but procedurally hindered ( n = 1,346), Highly engaged in planning ( n = 401), Overconfident and procedurally avoidant ( n = 364), and Uninterested and unprepared ( n = 41). The profiles differed significantly across all psychological variables. Older adults were more likely to belong to the Highly engaged in planning profile. In contrast, younger and middle-aged adults were more frequently classified into the Overconfident and procedurally avoidant and Uninterested and unprepared profiles. Readiness for ACP comprises distinct psychological profiles rather than a single continuum of engagement. A person-centered perspective may provide a more comprehensive understanding of readiness and support the development of communication strategies tailored to individuals’ psychological characteristics.