Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing100045, China.
Hematology, The Third People's Hospital of Zhengzhou, Henan450000, China.
Palliat Support Care. 2023 Jun;21(3):477-482. doi: 10.1017/S1478951522000177.
This study aims to explore clinicians' practices and attitudes regarding advance care planning (ACP) in mainland China.
This study was a multicenter cross-sectional survey. Clinicians from tertiary hospitals in Beijing, Guangxi, and Inner Mongolia were invited to participate in the study. A questionnaire was formulated based on related literature to obtain information including demographic characteristics, and practices and attitudes toward ACP.
The total number of participants included 285 clinicians. The data response rate was 84.57%. Most of the clinicians had an inadequate understanding of ACP. Only a few clinicians had experience in participating or witnessing an ACP or related end-of-life discussions. Among 285 clinicians, 69.82% of clinicians were willing to introduce ACP to patients. Two hundred and thirty-eight (83.51%) clinicians wanted more education on ACP. Almost all clinicians believed that patients had the right to know about their diagnosis, prognosis, and available care options. Most clinicians (82.11%) regarded that ACP was partially feasible in mainland China. If clinicians had a serious illness, almost everyone was willing to find out their true health status and decide for themselves, and 81.40% wanted to institute an ACP for themselves. The biggest barriers to the use of ACP in mainland China were cultural factors. Statistical analysis revealed that some or good understanding level ( = 0.0052) and practical experience ( = 0.0127) of ACP were associated with the positive willingness.
ACP is still in its infancy in mainland China. Clinicians had inadequate understanding and minimal exposure to ACP. Most clinicians recognized the value and significance of ACP and had a positive attitude toward ACP. Clinicians need to be provided with education and training to promote their ACP practices. Culturally appropriate ACP processes and documents need to be developed based on Chinese culture and Chinese needs.
本研究旨在探讨中国大陆临床医生在预先医疗照护计划（ACP）方面的实践和态度。
本研究采用多中心横断面调查。邀请北京、广西和内蒙古的三级医院的临床医生参与研究。根据相关文献制定问卷，获取包括人口统计学特征、ACP 实践和态度等信息。
共纳入 285 名临床医生。数据应答率为 84.57%。大多数临床医生对 ACP 的了解不足。只有少数临床医生有参与或见证 ACP 或相关临终讨论的经验。在 285 名临床医生中，69.82%的临床医生愿意向患者介绍 ACP。238 名（83.51%）临床医生希望更多地接受 ACP 教育。几乎所有临床医生都认为患者有权了解自己的诊断、预后和可获得的治疗选择。大多数临床医生（82.11%）认为 ACP 在中国大陆部分可行。如果临床医生自己患有严重疾病，几乎所有人都愿意了解自己的真实健康状况并自行决定，81.40%的人希望为自己制定 ACP。ACP 在中国大陆应用的最大障碍是文化因素。统计分析显示，对 ACP 的部分或较好理解水平（ = 0.0052）和实践经验（ = 0.0127）与积极意愿相关。
ACP 在中国大陆仍处于起步阶段。临床医生对 ACP 的理解不足，接触甚少。大多数临床医生认识到 ACP 的价值和意义，并对 ACP 持积极态度。临床医生需要接受教育和培训，以促进他们的 ACP 实践。需要根据中国文化和中国需求，制定文化上适当的 ACP 流程和文件。
