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Wang X, Wu Y, Bai X, Qiao Q, Yu L, Ge L, Qi L, Zang S. Acceptance level of advance care planning and its associated factors among the public: A nationwide survey. BMC Palliat Care 2024; 23:201. [PMID: 39107758 PMCID: PMC11301855 DOI: 10.1186/s12904-024-01533-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 07/29/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Advance care planning (ACP) can contribute to individuals making decisions about their healthcare preferences in advance of serious illness. Up to now, the acceptance level and associated factors of ACP among the public in China remain unclear. This study aims to investigate the acceptance level of ACP in China and identify factors associated with it based on the socioecological model. METHODS A total of 19,738 participants were included in this survey. We employed a random forest regression analysis to select factors derived from the socioecological model. Multivariate generalized linear model analysis was then conducted to explore the factors that were associated with the acceptance level of ACP. RESULTS On a scale ranging from 0 to 100, the median score for acceptance level of ACP was 64.00 (IQR: 48.00-83.00) points. The results of the multivariate generalized linear model analysis revealed that participants who scored higher on measures of openness and neuroticism personality traits, as well as those who had greater perceptions of social support, higher levels of health literacy, better neighborly relationships, family health, and family social status, were more likely to accept ACP. Conversely, participants who reported higher levels of subjective well-being and greater family communication levels demonstrated a lower likelihood of accepting ACP. CONCLUSIONS This study identified multiple factors associated with the acceptance level of ACP. The findings offer valuable insights that can inform the design and implementation of targeted interventions aimed at facilitating a good death and may have significant implications for the formulation of end-of-life care policies and practices in other countries facing similar challenges.
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Affiliation(s)
- Xue Wang
- Department of Community Nursing, School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, China
| | - Yibo Wu
- School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Xinghua Bai
- Department of Radiation Oncology, The First Hospital of China Medical University, No.155 Nanjing Bei Street, Heping District, Shenyang, 110001, Liaoning Province, China
| | - Qiao Qiao
- Department of Radiation Oncology, The First Hospital of China Medical University, No.155 Nanjing Bei Street, Heping District, Shenyang, 110001, Liaoning Province, China
| | - Ling Yu
- Phase I Clinical Trails Center, The First Hospital of China Medical University, No.155 Nanjing Bei Street, Heping District, Shenyang, 110001, Liaoning Province, China
| | - Lina Ge
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Heping Area, Shenyang, 110004, Liaoning Province, China
| | - Li Qi
- School of Nursing, Qiqihar Medical University, No.333, Bukui North Street, Jianhua District, Qiqihar City, 161006, Heilongjiang Province, China
| | - Shuang Zang
- Department of Community Nursing, School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, China.
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Suen MHP, Chow AYM, Woo RKW, Yuen SK. What makes advance care planning discussion so difficult? A systematic review of the factors of advance care planning in healthcare settings. Palliat Support Care 2024:1-14. [PMID: 38766704 DOI: 10.1017/s1478951524000464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
OBJECTIVES Existing systematic reviews related to advance care planning (ACP) largely focus on specific groups and intervention efficacy or are limited to contextual factors. This research aims to identify the modifiable factors perceived by different users of ACP in healthcare settings and inform healthcare professionals about the factors affecting ACP practice. METHODS Five English-language databases (ProQuest, PubMed, CINAHL Plus, Scopus, and Medline) and two Chinese-language databases (CNKI and NCL) were searched up to November 2022. Empirical research identifying factors related to ACP in healthcare settings was included. ACP is defined as a discussion process on future end-of-life care. Thematic synthesis was performed on all included studies. RESULTS A total of 1871 unique articles were screened; the full texts of 193 were assessed by 4 reviewers, and 45 articles were included for analysis. Twenty-two (54%) studies were qualitative, 15 (33%) were quantitative, and 6 (13%) used mixed methods. Foci varied from 28 (62%) studies on a single subject group (either patient, family, or physician), 11 (25%) on 2 subject groups (either patient and family or patient and healthcare professional), and 6 (13%) covered 3 subject groups (patient, family, and healthcare professional). Among the 17 studies involving more than 1 subject group, only 2 adopted a dyadic lens in analysis. Complex interwoven factors were categorized into (1) intrapersonal factors, (2) interpersonal factors, and (3) socio-environmental factors, with a total of 11 themes: personal belief, emotions, the burden on others, timing, responsiveness, relationship, family dynamics, experience, person taking the lead, culture, and support. SIGNIFICANCE OF RESULTS Patients, families, and healthcare professionals are the essential stakeholders of ACP in healthcare settings. Factors are interweaved among the intrapersonal, interpersonal, and socio-environmental dimensions. Research is warranted to examine the dynamic interactions of the 3 essential stakeholders from a multidimensional perspective, and the mechanism of the interweaving of factors.
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Affiliation(s)
- Margaret Hay Ping Suen
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Amy Yin Man Chow
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
- Jockey Club End-of-Life Community Care Project, The University of Hong Kong, Hong Kong
| | | | - Sze Kit Yuen
- Caritas Medical Centre, Hospital Authority, Hong Kong
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Cheng L, Wang S, Sun J. Effect analysis of continuous care model in the management of chronic diseases in the elderly. Minerva Med 2024; 115:225-227. [PMID: 38197573 DOI: 10.23736/s0026-4806.23.08994-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Affiliation(s)
- Lin Cheng
- Department of Gerontology, Yantai Yuhuangding Hospital, Yantai, China
| | - Shanshan Wang
- Department of Gerontology, Yantai Yuhuangding Hospital, Yantai, China
| | - Jiangfeng Sun
- Department of Gerontology, Yantai Yuhuangding Hospital, Yantai, China -
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Lee HTS, Yang CL, Leu SV, Hu WY. Barriers to initiate a discussion about advance care planning among older Taiwanese residents of nursing homes and their families: A qualitative study. Appl Nurs Res 2024; 75:151766. [PMID: 38490796 DOI: 10.1016/j.apnr.2024.151766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 08/24/2023] [Accepted: 02/18/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND In Taiwan, the Patients' Right to Autonomy Act was enacted in 2019. However, advance care planning (ACP) implementation rates remain low in long-term care facilities. AIM This study explored the barriers to initiate a discussion about ACP among older Taiwanese residents of nursing homes and their families. METHODS A descriptive qualitative design was used. Face-to-face interviews were individually conducted with 38 participants (residents: 18; family members: 20), and data were analyzed through content analysis. RESULTS Five themes were identified: (1) having cultural or spiritual concerns (both groups), (2) prioritizing the bigger picture (family) (both groups), (3) waiting for the right time (both groups), (4) feeling unsure (residents), and (5) following the pace of the residents (family members). CONCLUSION The results indicate that discussing ACP with Chinese people and their families clashes with traditional Chinese culture. To implement ACP in long-term care facilities based in regions with ethnically Chinese populations, medical professionals must ensure that the residents and their family members understand advance directives and their role in ensuring a good death and must act as a bridge between residents and their family members to assist them in making consensual end-of-life-care decisions with residents.
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Affiliation(s)
- Hsin-Tzu Sophie Lee
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien City 97005, Taiwan.
| | - Chia-Ling Yang
- MacKay Junior College of Medicine, Nursing and Management, Taipei City 11260, Taiwan.
| | - Sei-Ven Leu
- Department of Computer Center, Tzu Chi University, Hualien City 97071, Hualien County, Taiwan
| | - Wen-Yu Hu
- Department of Nursing, National Taiwan University, Taipei City, Taiwan.
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Ling M, Chen P, He Q, Long Y, Cheng L, You C. Cognition and attitudes of hospice care among healthcare providers: a case study of Sichuan Province. BMC MEDICAL EDUCATION 2023; 23:953. [PMID: 38093198 PMCID: PMC10720220 DOI: 10.1186/s12909-023-04898-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 11/23/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Under the background of the increasing aging population and cancer burden in China, the role of hospice care has become increasingly prominent. The government has paid more attention to the development of hospice care and set up pilot hospitals to promote hospice care. Moreover, healthcare providers play a leading role in hospice care services. To improve the quality of hospice care, the National Health Commission of the People's Republic of China proposed to set up hospice care training bases in municipal or above-level hospitals with hospice care or relevant work foundations, and train healthcare providers on hospice care. This study aimed to investigate the current situation of cognition and attitudes about hospice care among healthcare providers and provide a theoretical basis for hospital training. METHODS We used a quantitative design. A questionnaire survey was conducted among 1591 healthcare providers from August 2022 to November 2022. SPSS 22.0 software was used to analyze the data. RESULTS As a significant way of continuing education for healthcare providers, hospital training hasn't been effectively exploited in hospice care education. The average score of hospice care knowledge among participants was (7.74 ± 2.242) and the average score of hospice care attitudes among participants was (4.55 ± 1.503). According to multivariate linear regression analysis, sex (p < 0.001), education levels (p < 0.001), and professional titles (p = 0.018) of participants had significant difference on the score of hospice care knowledge; education levels (p = 0.009) and professional titles (p = 0.016) of participants had significant difference on the score of hospice care attitudes. CONCLUSIONS There were some misunderstandings about hospice care among healthcare providers and their attitudes towards hospice care were inactive. It's suggested that hospitals should carry out professional and systematic education courses to help healthcare providers understand hospice care correctly, and participate in hospice care services actively.
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Affiliation(s)
- Meng Ling
- Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College, No.1 Maoyuan North Road, Shunqing District, Nanchong, Sichuan, China
| | - Pengru Chen
- Health Management Center, Second Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Qiaoying He
- Nursing Teaching and Research Office, Nanchong Health School of Sichuan Province, Nanchong, Sichuan, China
| | - Yi Long
- College of Basic Medicine, Zunyi Medical University, Zunyi, Guizhou, China
| | - Lei Cheng
- Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College, No.1 Maoyuan North Road, Shunqing District, Nanchong, Sichuan, China.
| | - Chuan You
- Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College, No.1 Maoyuan North Road, Shunqing District, Nanchong, Sichuan, China.
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Lee HTS, Yang CL, Hu WY. Impediments to Signing Advance Directives in Nursing Home Residents: A Qualitative Study. J Hosp Palliat Nurs 2023; 25:E65-E69. [PMID: 37249326 DOI: 10.1097/njh.0000000000000955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Although public opinion in Taiwan has shifted to favoring self-determination regarding end-of-life care, many nursing home residents still entrust their end-of-life care decision making to family members. This study examined Chinese cultural impediments to nursing home residents signing advance directives. A descriptive qualitative study was conducted using content analysis. In total, 18 nursing home residents participated in face-to-face interviews. Five main themes were identified: (1) bad omens, (2) inability, (3) traditional culture, (4) uncertainty, and (5) unmet needs. The death taboo that is a prominent feature of Chinese culture and the delivery of generic information are primary impediments. Therefore, health care providers should provide tailored information about advance directives, communicate directly with residents, ensure that residents understand the relationship between signing an advance directive and having a good death, and respect the final decisions of residents.
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Korkmaz Yaylagul N, Demirdas FB, Melo P, Silva R. Opinions of Older Individuals on Advance Care Planning and Factors Affecting Their Views: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105780. [PMID: 37239509 DOI: 10.3390/ijerph20105780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 04/28/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023]
Abstract
The objective of this systematic review is to present older individuals' views on the advance care planning (ACP) process and the factors affecting those opinions. The review contains search terms predetermined in the databases of CINAHL, MEDLINE (via PubMed), Academic Search Ultimate, Web of Science, Master FILE, and TR Dizin over the last 10 years (1 January 2012-31 December 2021) in English and Turkish. The studies were included in the research using inclusion (sample age ≥ 50, focusing on individuals' opinions on ACP) and exclusion (articles whose samples consisted of individuals with a specific disease, non-research articles) criteria. Quality assessment was conducted using the Mixed Methods Appraisal Tool. A narrative synthesis was used to collate findings. The most striking results are the positive perspectives increasing in parallel with the individuals' level of knowledge and experience about ACP. Variables affecting their views are advanced age, marital status, socioeconomic status, perception of remaining life expectancy, self-perceived health, number and stage of chronic diseases, religion, and cultural characteristics. This study offers guidance on the application and dissemination of ACP, empowering the use of this practice given the perspectives of older adults on ACP and the factors that affect them that the data show.
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Affiliation(s)
- Nilufer Korkmaz Yaylagul
- Department of Gerontology, Faculty of Health Sciences, University of Akdeniz, Antalya 07070, Turkey
| | - Fatma Banu Demirdas
- Department of Gerontology, Faculty of Health Sciences, University of Turgut Ozal, Malatya 44210, Turkey
| | - Pedro Melo
- Institute of Health Sciences, Universidade Católica Portuguesa, 4200-450 Porto, Portugal
- Centre for Interdisciplinary Research in Health, Universidade Católica Portuguesa, 4200-450 Porto, Portugal
| | - Rosa Silva
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal
- Porto Nursing School (ESEP), 4200-450 Porto, Portugal
- Portugal Center for Evidence Based Practice, A JBI Center of Excellence (PCEBP), 3030 Coimbra, Portugal
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Zhu T, Liu D, van der Heide A, Korfage IJ, Rietjens JAC. Preferences and Attitudes Towards Life-Sustaining Treatments of Older Chinese Patients and Their Family Caregivers. Clin Interv Aging 2023; 18:467-475. [PMID: 36994430 PMCID: PMC10042169 DOI: 10.2147/cia.s395128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/21/2023] [Indexed: 03/31/2023] Open
Abstract
Purpose The family plays a major role in medical decision-making in China. Little is known about whether family caregivers understand patients' preference for receiving life-sustaining treatments and are able to make decisions consistent with them when patients are incapable of making medical decisions. We aimed to compare preferences and attitudes concerning life-sustaining treatments of community-dwelling patients with chronic conditions and their family caregivers. Patients and Methods We conducted a cross-sectional study among 150 dyads of community-dwelling patients with chronic conditions and their family caregivers from four communities in Zhengzhou. We measured preferences for life-sustaining treatments (cardiopulmonary resuscitation, mechanical ventilation, tube feeding, hemodialysis, chemotherapy), who should decide, the timing of making decisions, and their most important consideration. Results The consistency of preferences for life-sustaining treatments between patients and family caregivers was poor to fair, with kappa values ranging from 0.071 for mechanical ventilation to 0.241 for chemotherapy. Family caregivers more frequently preferred each life-sustaining treatment for the patients than the patients themselves. More family caregivers than patients preferred the patient to make their own decisions about life-sustaining treatments (29% of patients and 44% of family caregivers). The most important considerations when deciding on life-sustaining treatments are family burden and the patient's comfort and state of consciousness. Conclusion There is a poor to fair consistency between community-dwelling older patients and their family caregivers in their preferences and attitudes towards life-sustaining treatments. A minority of patients and family caregivers preferred that patients make their own medical decisions. We recommend healthcare professionals to encourage discussions between patients and their families on future care to improve the mutual understanding within the family about medical decision-making.
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Affiliation(s)
- Tingting Zhu
- Department of Nursing and Health, Zhengzhou University, Zhengzhou, People’s Republic of China
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Dongling Liu
- Department of Nursing and Health, Zhengzhou University, Zhengzhou, People’s Republic of China
- Correspondence: Dongling Liu, Email
| | - Agnes van der Heide
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Ida J Korfage
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Judith A C Rietjens
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
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Lee HTS, Yang CL, Leu SV, Hu WY. Cultural impediments to frank communication regarding end-of-life care between older nursing home residents and their family members in Taiwan: a qualitative study. BMC Nurs 2022; 21:357. [PMID: 36517826 PMCID: PMC9749315 DOI: 10.1186/s12912-022-01143-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND When older nursing home residents and their families are faced with end-of-life care decisions in Taiwan, they make them in the context of traditional cultural norms and socioeconomic changes. Both parties (residents and their family members) are often unwilling to broach the topic, leading to a decisional impasse. The aim of this study was to understand difficult-to-raise issues related to end-of-life care by investigating the perspectives of older nursing home residents and their family members. METHODS This qualitative descriptive study was conducted using content analysis based on the Consolidated Criteria for Reporting Qualitative Research. Purposive sampling was used to select the participants, and sampling continued until data saturation. Data were collected using semi structured interviews, and related analyses were conducted using an inductive approach. RESULTS Ten residents and twelve family members were interviewed individually. Six main themes were identified: (1) the inevitability of a goodbye; (2) a good death; (3) going with or against traditional culture; (4) better a good death than a bad life; (5) abiding by the residents' decisions; and (6) being willing but unable to take care of residents. CONCLUSION Nursing home residents and their family members' thoughts on end-of-life care shifted toward the concept of a good death, and they even regarded death as a form of liberation. Health care providers may serve as mediators to counsel a resident and their family members separately, enabling them to speak up and understand each other's thoughts on end-of-life care before a decision is made so that neither party has regrets.
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Affiliation(s)
- Hsin-Tzu Sophie Lee
- grid.411824.a0000 0004 0622 7222Department of Nursing, Tzu Chi University of Science and Technology, Hualien City, 97005 Taiwan, Republic of China
| | - Chia-Ling Yang
- grid.507991.30000 0004 0639 3191Mackay Junior College of Medicine, Nursing and Management, Taipei City, 11260 Taiwan, Republic of China
| | - Sei-Ven Leu
- grid.411824.a0000 0004 0622 7222Department of Computer Center, Tzu Chi University, Hualien City, 97071 Hualien County Taiwan, Republic of China
| | - Wen-Yu Hu
- grid.19188.390000 0004 0546 0241Department of Nursing, National Taiwan University, Taipei City, Taiwan, Republic of China
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Ke LS, Cheng HC, Ku YC, Lee MJ, Chang SY, Huang HY, Lin YL. Older Adults' Behavioral Intentions Toward Advance Care Planning Based on Theory of Reasoned Action. J Hosp Palliat Nurs 2022; 24:00129191-990000000-00040. [PMID: 36155387 DOI: 10.1097/njh.0000000000000907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study aimed to explore the factors affecting the behavioral intentions of older adults toward advance care planning (ACP). A questionnaire survey was conducted at 2 medical wards and a senior activity center in northern Taiwan. Four hundred one participants were older adults aged over 65 years, comprising hospitalized patients, their caregivers, and members of a senior activity center. The regression model revealed that participant type (patient, caregiver, or community resident); financial support; discussion of ACP with family; and knowledge, attitudes, and subjective norms accounted for 46.3% of the variance in behavioral intentions. The behavioral intention of caregivers was higher than that of patients. The behavioral intention of participants who were financially dependent on the family was lower than that of pensioners. Regarding discussing ACP with family, older adults in the contemplation and preparation stages score higher on behavioral intention than those in the precontemplation stage. This study supports the theory of reasoned action. Older adults' ACP knowledge and attitudes need to be enhanced through education. Caregivers' behavioral intentions tend to perform ACP. Sharing their caring experiences may be a strategy for promoting ACP. Older adults' financial status affects their behavioral intentions. Therefore, financial planning should be performed early and should incorporate ACP.
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Shen Y, Zong Y, Yang Y, Wang Y, Suo T, Sun J, Zhang Z, Liu W, Li D, Gao R, Xing C. Acceptance of Advance Care Planning Among Young Adults in Shijiazhuang, China: A Mixed-Methods Study. Am J Hosp Palliat Care 2022:10499091221127983. [PMID: 36129148 DOI: 10.1177/10499091221127983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Context: In the event of accidental trauma, incurable disease and public health emergencies, young adults are unable to participate in their own medical decisions, family members face the huge decision-making pressure and medical resources of the society were unevenly distributed. Objective: The purposes of this study is to investigate the Advanced Care Planning (ACP) acceptance and examine its influencing factors using sequential explanatory mixed methods in order to provide a basis for the formulation of later interventions. Methods: A cross-sectional study of young adults (N = 785) and 12 other young adults from two other communities were investigated from January 2021 to February 2022. Descriptive statistics and multiple linear regressions were conducted. Content analysis was performed on the qualitative data. Results: The primary factors that contributed to the acceptance of ACP were the natural acceptance of death, being female, having a high level of education, having a loved one diagnosed with a chronic disease, and having heard of ACP. Among young adults, the acceptance of ACP may be impeded by a fear of the unknown nature of death, a poor understanding of ACP, and family-led decision-making. Discussion: Our study found that 77.1% had not heard of ACP before participating in the study and showed potential to accept ACP-related interventions. The study highlighted the importance of implementing regular young adult education courses, promoting routine ACP knowledge, individualized education, discussing family member's disease experiences, conducting family meetings, and identifying young adult responsibilities and roles in implement ACP for young adults in China.
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Affiliation(s)
- Yongqing Shen
- School of Nursing, 441322Hebei University of Chinese Medicine, Hebei, China
| | - Yijun Zong
- School of Nursing, 441322Hebei University of Chinese Medicine, Hebei, China
| | - Yanting Yang
- School of Nursing, 441322Hebei University of Chinese Medicine, Hebei, China
| | - Yongli Wang
- School of Nursing, 441322Hebei University of Chinese Medicine, Hebei, China
| | - Tingting Suo
- School of Nursing, 441322Hebei University of Chinese Medicine, Hebei, China
| | - Jiachen Sun
- School of Nursing, 441322Hebei University of Chinese Medicine, Hebei, China
| | - Zetao Zhang
- Research Center on Combining Medical and Care Services for Seniors, 33133Peking University, Beijing, China
| | - Wei Liu
- School of Nursing, 441322Hebei University of Chinese Medicine, Hebei, China
| | - Dongli Li
- School of Nursing, 441322Hebei University of Chinese Medicine, Hebei, China
| | - Rui Gao
- School of Nursing, 441322Hebei University of Chinese Medicine, Hebei, China
| | - Caiyi Xing
- School of Nursing, 441322Hebei University of Chinese Medicine, Hebei, China
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Yang Z, Chen P, Hou B, Zhang H. Advance Care Planning Among Elderly Acquired Immunodeficiency Syndrome Patients: A Qualitative Preference Study. J Hosp Palliat Nurs 2022; 24:E10-E17. [PMID: 35212662 DOI: 10.1097/njh.0000000000000824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Complications arising from human immunodeficiency virus may affect the ability of elderly AIDS patients to communicate and make decisions about future medical care. It is important for elderly AIDS patients to be able to express effectively their preferences for future treatments and care. This study explored preferences and influencing factors of advance care planning among elderly AIDS patients. A semistructured interview outline was developed based on the theory of planned behavior. A qualitative preference interview was conducted among 16 eligible elderly AIDS patients. Using thematic analysis, the data were analyzed and categorized into 3 themes and 9 subthemes that were classified under the theory of planned behavior framework. The 3 themes were as follows: a positive attitude toward advance care planning, a strong desire for family and social support, and some obstacles to discussing advance care planning in the current environment. These themes provided valuable insights to advance care planning educators and practitioners from different work environments and units to aid them in constructing future ACP intervention models for elderly AIDS patients.
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