J Hosp Palliat Nurs. 2021 Apr 1;23(2):178-186. doi: 10.1097/NJH.0000000000000734.
The incidence of chronic diseases among elderly patients increases annually with the accelerating aging process in China. Complications arising from the progression of these diseases may affect the ability of the aged to communicate and make decisions about future medical and personal care. This study aimed to investigate acceptance and influencing factors of advance care planning for community-dwelling elderly patients with chronic diseases in the Republic of China. Using a convergent parallel mixed-methods design, 471 elderly Chinese nationals older than 60 years with chronic diseases were recruited using convenience sampling. Quantitative data collection used Chinese versions of the Elderly Death Attitude Scale, Modified Barthel Index Rating Scale, and the Advance Care Planning Acceptance Questionnaire, followed by 14 patients drawn from the quantitative phase. Interviews were thematically analyzed. The results showed that attitude to death and quality of life were key predictors of advance care planning implementation preference, whereas family support and past medical experience were significant factors. The study highlighted the importance of conducting regular education about death, paying attention to quality of life, providing family support, and discussing past medical experience in order to implement advance care planning for elderly patients with chronic diseases in China.
中国老龄化进程加速，老年患者慢性病发病率逐年上升。这些疾病的进展所带来的并发症可能会影响老年人对未来医疗和个人护理的沟通和决策能力。本研究旨在探讨中华民国社区慢性病老年患者接受和影响预先护理计划的因素。采用汇聚平行混合方法设计，采用便利抽样法招募了 471 名年龄在 60 岁以上的中国慢性病老年公民。使用中文版本的老年人死亡态度量表、改良巴氏量表评定量表和预先护理计划接受问卷进行定量数据收集，随后对定量阶段的 14 名患者进行了访谈。对访谈进行了主题分析。结果表明，对死亡的态度和生活质量是预先护理计划实施偏好的关键预测因素，而家庭支持和过去的医疗经验是重要因素。该研究强调了在中国为慢性病老年患者实施预先护理计划时，定期进行死亡教育、关注生活质量、提供家庭支持和讨论过去医疗经验的重要性。
