J Hosp Palliat Nurs. 2022 Oct 1;24(5):E205-E211. doi: 10.1097/NJH.0000000000000879. Epub 2022 May 12.
The objective of this study was to explore factors influencing Taiwanese older adults' end-of-life (EOL) care preferences. A cross-sectional questionnaire survey was conducted in 2 geriatric wards of a veterans' hospital. Fifty-five older adults aged 65 years or older were included. Structured questionnaires were used to collect data regarding demographic characteristics, EOL care preferences, stages of change for advance care planning behaviors, and reluctance to burden others. The study revealed that nearly 60% of the participants preferred to let their spouses, adult children, or health care professionals make the decisions. Furthermore, 83.6% of the participants lived with their family members and were moderately to severely disabled with a certain degree of dependence on their family members. Sex, independence, discussion of advance care planning with family members, and completion of advance directives were significantly correlated with EOL care preferences. The regression model showed that the participants' discussion of advance care planning with their family members influenced their EOL care preferences. The results demonstrate that family is an essential consideration for older adults choosing EOL care. Accordingly, because Chinese culture focuses on family harmony, improving communication between older adults and their family members is crucial for promoting advance care planning.
本研究旨在探讨影响台湾老年人临终关怀偏好的因素。采用横断面问卷调查法,在一家退伍军人医院的 2 个老年病房进行。纳入 55 名年龄在 65 岁及以上的老年人。采用结构化问卷收集人口统计学特征、临终关怀偏好、预先医疗照护计划行为改变阶段以及不愿给他人带来负担等方面的数据。研究结果显示,近 60%的参与者希望由配偶、成年子女或医疗保健专业人员做出决策。此外,83.6%的参与者与家庭成员同住,且存在中度至重度残疾,在一定程度上依赖于家庭成员。性别、独立性、与家庭成员讨论预先医疗照护计划以及预先指示的完成情况与临终关怀偏好显著相关。回归模型显示,参与者与家庭成员讨论预先医疗照护计划会影响其临终关怀偏好。研究结果表明,家庭是老年人选择临终关怀的重要考虑因素。因此,由于中国文化注重家庭和谐,促进老年人与其家庭成员之间的沟通对于推广预先医疗照护计划至关重要。