Awareness and Attitudes Toward Advance Care Planning Among Community-Dwelling Older Adults in China: A Mixed-Methods Study

Zhu, Tingting; Shi, Yan; Yi, Jingna; Zhang, Qiushi; Zhao, Yanli; Gao, Qiaoqiao; Wang, Zichen; Li, Jiayin; Liu, Xuebing; Liu, Dongling

doi:10.1177/1049909120905255

Cited by 28 publications

(39 citation statements)

References 27 publications

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“…Results of this study share similarity with a study based in Hangzhou and Hong Kong, in that the majority of study respondents had not heard of palliative care [13][14][15]. The insufficient understanding regarding palliative and EoL care is also found in a number of other studies across different contexts such as Japan, China, Scotland, the United Kingdom and Italy [3,5,[21][22][23].…”

Section: Discussionsupporting

confidence: 76%

Knowledge of palliative care and preference of end of life care: a cross-sectional survey of residents in the Chinese socio-cultural background of Macao

et al. 2021

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Background Since the establishment of a hospice in the year 2000 and the development of a palliative care ward in 2019, there is no study examining public’s knowledge of palliative care, nor preference of end of life care in Macao. Aim Targeting Chinese residents of Macao, the current study has 3 goals: i) to understand the level of knowledge of palliative care, ii) to explore the preference of end of life treatments, and iii) to identify the associated factors of the preference of end of life treatments. Methods A cross-sectional questionnaire survey was conducted using a structured questionnaire. The study employed non-probability quota sampling through which Macao residents aged 18 and above were recruited between July and September 2020. Results A total of 737 responses were valid. The average correct rate of palliative care knowledge ranged from 40.4% to 85.5%. Pertaining to end of life treatments, 62.0% of the respondents chose comfort care. However, almost half of the respondents agreed that life-sustaining treatments should not be stopped under any circumstances. Respondents who scored higher in palliative care knowledge and those with secondary and tertiary education were associated factors of choosing comfort care rather than life-sustaining treatments. In addition, respondents who agreed that futile life-sustaining treatments should be stopped were also associated with preference for comfort care. Conclusion The understanding of palliative care amongst Macao residents is inadequate. Despite the public’s inclination towards comfort care, it is generally believed that life-sustaining treatments should not be stopped at the end of life. The study results suggest that not only the knowledge of palliative care should be enhanced amongst the general public in Macao, but information about life-sustaining treatments should also be offered to patients and families by healthcare professionals, in aiding end of life treatment decision making.

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Section: Discussionsupporting

confidence: 76%

Knowledge of palliative care and preference of end of life care: a cross-sectional survey of residents in the Chinese socio-cultural background of Macao

et al. 2021

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“…Values and beliefs associated with the “social-embeddedness” narrative are thought to be prominent within areas of Southern Europe ( Gordon & Paci, 1997 ; Meñaca et al, 2012 ) and Asia ( Shin et al, 2016 ; Zhu et al, 2020 ). Cross-national studies have shown higher prevalence of doctor–patient discussions about future treatment preferences and higher rates of formal appointments of substitute decision makers in Northern European (The Netherlands, Belgium) compared to Southern European (Italy, Spain) countries ( Evans et al, 2013 ).…”

mentioning

confidence: 99%

Association Between Region of Birth and Advance Care Planning Documentation Among Older Australian Migrant Communities: A Multicenter Audit Study

Sinclair

Sellars

Buck

et al. 2020

The Journals of Gerontology: Series B

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Objectives This study explored associations between birth region, socio-demographic predictors and advance care planning (ACP) uptake. Methods A prospective, multi-center, cross-sectional audit study of 100 sites across eight Australian jurisdictions. ACP documentation was audited in the health records of people aged 65 years or older accessing general practice (GP), hospital and long-term care facility (LTCF) settings. Advance care directives (ACD) completed by the person (‘person completed ACDs’) and ACP documents completed by a health professional or other person (‘health professional or someone else ACP’) were counted. Hierarchical multi-level logistic regression assessed associations with birth region. Results From 4187 audited records, 30.0% (1152/3839) were born outside Australia. ‘Person completed ACDs’ were less common among those born outside Australia (21.9% vs 28.9%, X2 (1, N = 3840) = 20.3, p & 0.001), while ‘health professional or someone else ACP’ was more common among those born outside Australia (46.4% vs 34.8%, X2 (1, N = 3840) = 45.5, p & 0.001). Strongest associations were found for those born in Southern Europe: ‘person completed ACD’ (OR = 0.56, 95% CI = 0.36-0.88), and ‘health professional or someone else ACP’ (OR = 1.41, 95% CI = 1.01-1.98). English-language proficiency and increased age significantly predicted both ACP outcomes. Discussion Region of birth is associated with the rate and type of ACP uptake for some older Australians. Approaches to ACP should facilitate access to interpreters and be sensitive to diverse preferences for individual and family involvement in ACP.

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“…4) Attitudes on ACP: there were 18 items of which included 1 question regarding the participants' previous experience in the last ve years, 1 item of the willingness of discussing ACP in the future, the rest of the items were measured on a 5-point Likert scale (from "strongly agree" to "strongly disagree") that was designed to assess under what circumstances the participant would feel it be better or not be better to express their living wishes. It had been reported that the internal consistency was 0.708, and the scale-content validity index of this Chinese version of the ACPQ was 0.921 [17].…”

Section: Survey Toolsmentioning

confidence: 81%

“…The Advance Care Planning Questionnaire (ACPQ) developed by Lai et al [16] to assess awareness, attitudes, and acceptance of ACP in Malaysian in 2016 was used in this study. It was translated into Chinese by Zhu et al in 2020 [17]. The ACPQ contained four domains, 1) Demographic information: there were sex, age, marital status, ethnicity, occupation, etc.…”

Section: Survey Toolsmentioning

confidence: 99%

Comparison of Awareness and Attitudes Toward Advance Care Planning Between Chinese Medical and Non-medical University Students

Liu¹,

Meng²,

Sun³

et al. 2021

Preprint

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Background: To date, there is a paucity of information on the discrepancies of awareness and attitudes towards ACP among university students in mainland China. The purposes of this study are to investigate the discrepancies in the awareness and attitudes toward advance care planning (ACP) between Chinese medical and non-medical university students and to identify the association between the awareness and attitudes toward ACP and medical education. A total of 718 university students included 290 medical students and 428 non-medical students from 12 universities in 4 provinces in mainland China were surveyed by using the Advance Care Planning Questionnaire (ACPQ). Results: More than half of the university students (59.89%) had never heard of ACP before; there were significant differences in the awareness regarding ACP between medical students and their non-medical peers (P<0.05); 82.45% of participants were more likely to consider discussing ACP in the future; there was no significant difference (P>0.05) in the previous experience last 5 years between the two groups except the item of “have been involved in the decision making of your treatment” (P=0.005); univariate analysis and multivariate linear regression analysis showed that medical education was the factor influencing the awareness of end-of-life (P=0.000) and proxy decision-maker (P=0.028) among university students. Conclusion: The awareness toward ACP of university students in mainland China remained limited, but their attitudes were positive. Medical students had a higher level of awareness regarding ACP than non-medical students, and medical education was the factor that promoted students to understand end-of-life care and proxy decision-maker. Establishing educational initiatives, developing models for peer-led ACP, and perfecting governmental policies should be emphasized.

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Awareness and Attitudes Toward Advance Care Planning Among Community-Dwelling Older Adults in China: A Mixed-Methods Study

Cited by 28 publications

References 27 publications

Knowledge of palliative care and preference of end of life care: a cross-sectional survey of residents in the Chinese socio-cultural background of Macao

Knowledge of palliative care and preference of end of life care: a cross-sectional survey of residents in the Chinese socio-cultural background of Macao

Association Between Region of Birth and Advance Care Planning Documentation Among Older Australian Migrant Communities: A Multicenter Audit Study

Comparison of Awareness and Attitudes Toward Advance Care Planning Between Chinese Medical and Non-medical University Students

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