Advance directives of lung cancer patients and caregivers in China: A cross sectional survey

Abstract

Background: This study aimed to investigate lung cancer patients and attitudes of their caregivers toward advance directives (ADs) in China. Methods: A cross sectional study was conducted in the Department of Oncology outpatient clinic in West China Hospital, Sichuan University. A questionnaire was used to survey the attitudes of lung cancer patients and caregivers toward ADs. Results: A total of 148 lung cancer patients and 149 caregivers were enrolled into the study. Of these, 94.6% and 89.9% of patients and caregivers had not heard of AD and none of those in the study had ever signed an AD. A total of 79.7% patients and 75.2% caregivers were willing to sign ADs after they were provided with information. Patients who preferred the end of life period to sign ADs were 5.4 times more likely to have ADs than patients who chose to sign ADs when their disease was diagnosed (P < 0.05, ). Caregivers who were reluctant to undergo chemotherapy when diagnosed with cancer were 2.16 times more likely to sign ADs than those willing to receive chemotherapy (P < 0.05, 95%CI [1.20-3.90]). Conclusions: In China, lung cancer patients and their caregivers showed lack of knowledge about ADs, and the completion rate of ADs was extremely low. However, participants were positive about ADs and public education on ADs may help to increase the completion rate of ADs in China.

The effect of refined nursing applied in the nursing room of thoracoscopic lung cancer radical operation in Southwestern China

“…Among them, lung cancer occupies the top spot due to its high morbidity and mortality. It is estimated that by 2025, there will be 1 million lung cancer patients in China (Sun et al, 2020;Feng et al, 2020;Xing et al, 2019). Therefore, lung cancer has replaced cardiovascular disease as the biggest factor threatening the safety of national survival.…”

Perspective on advanced directives among older adults in Shanghai: A qualitative study

“…In addition, The study indicated that relatively few aged citizens completed the forms due to lacing Internet technology abilities as the ‘Five Wishes’ forms were online and digital [ 24 ]. Furthermore, Chinese scholars conducted cross-sectional studies on the recognition, acceptance, knowledge, attitude and practice (KAP) of ADs using self-designed questionnaires among terminally ill patients, older adults and health professionals [ [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] ]. Overall, the recognition, acceptance, knowledge and KAP of ADs among the population improved over time [ [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] ].…”

“…Furthermore, Chinese scholars conducted cross-sectional studies on the recognition, acceptance, knowledge, attitude and practice (KAP) of ADs using self-designed questionnaires among terminally ill patients, older adults and health professionals [ [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] ]. Overall, the recognition, acceptance, knowledge and KAP of ADs among the population improved over time [ [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] ]. And health care professionals had a higher recognition and acceptance of ADs, better KAP of ADs compared with the other groups at the same time period [ [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] ].…”

“…Overall, the recognition, acceptance, knowledge and KAP of ADs among the population improved over time [ [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] ]. And health care professionals had a higher recognition and acceptance of ADs, better KAP of ADs compared with the other groups at the same time period [ [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] ]. Furthermore, the localization and legislation process of ADs in the mainland of China has been difficult, complicated and tortuous.…”

Prevalence and factors of discordance attitudes toward advance care planning between older patients and their family members in the primary medical and healthcare institution

“…The study clarified attitudes and preferences toward ACP in a relatively Chinese large sample mostly in tertiary hospitals but did not involve the elderly population in the primary medical and health care institution and the influence of functional status on ACP attitudes. Prior research has compared attitudes toward ACP between patients and family members, which has focused on specific diseases such as cancer and heart failure (13,14). Different from the other specialized wards with a certain specific disease, older patients in the geriatric wards in the primary medical and health care institution, may have advanced age, complex multimorbidity, multiple functional loss, and a higher proportion at the final stage of the disease.…”