Department of Family Medicine, Changhua Christian Hospital, Changhua 500, Taiwan.
Big Data Center, Changhua Christian Hospital, Changhua 500, Taiwan.
Int J Environ Res Public Health. 2022 Apr 26;19(9):5266. doi: 10.3390/ijerph19095266.
Advance care planning (ACP) and advance directives (ADs) ensure patient autonomy in end-of life care. The number of ADs made and followed in Taiwan is still lacking. This study aimed to determine the factors that influence the willingness to participate in ACP among outpatients in Taiwan. In this study, we conducted a cross-sectional survey based on convenient sampling methods. The questionnaire included questions about participants' basic sociodemographic information, knowledge of ACP, and awareness of ACP. A total of 198 adults who were outpatients of a family medicine clinic in an affiliated hospital in Taiwan were recruited. The associations between each variable were evaluated using the χ test. The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using the logistic regression method to examine the influence of each variable on willingness to participate in ACP. Being happy and being a healthcare professional were positively correlated with ACP participation. A lack of ACP knowledge (OR = 0.30 in model A and OR = 0.42 in model C), valuing "Reducing families' end-of-life decision-making burden" (OR = 2.53 in model B and OR = 2.65 in model C), and a "Belief in a good death" (OR = 4.02 in model B and OR = 4.10 in Model C) were the main factors affecting subjects' willingness to participate in ACP. Knowing which factors influence willingness to participate in ACP helps in the promotion of ACP. Continuously educating both the general public and healthcare professionals strengthens knowledge about the right to autonomy, about its associated laws, and about the ACP process, and thus, programs should be created to provide this education. Additionally, taking into account the differences between cultures can be helpful.
预先医疗照护计划（ACP）和预先指示（AD）可确保末期病患的自主决定。在台湾，AD 的制作和执行数量仍然不足。本研究旨在确定影响台湾门诊病患参与 ACP 的意愿的因素。本研究采用便利抽样方法进行横断面调查。问卷内容包括参与者的基本社会人口学资料、ACP 知识和 ACP 意识。共招募了台湾一家附属医院家庭医学科门诊的 198 名成年人。采用 χ 检验评估各变量之间的关联。使用逻辑回归法计算调整后的优势比（OR）和 95%置信区间（CI），以检查每个变量对参与 ACP 的意愿的影响。快乐和医疗专业人员身份与 ACP 参与呈正相关。缺乏 ACP 知识（模型 A 的 OR = 0.30 和模型 C 的 OR = 0.42）、重视“减轻家庭末期决策负担”（模型 B 的 OR = 2.53 和模型 C 的 OR = 2.65）以及“相信善终”（模型 B 的 OR = 4.02 和模型 C 的 OR = 4.10）是影响受试者参与 ACP 意愿的主要因素。了解影响参与 ACP 意愿的因素有助于推广 ACP。持续教育公众和医疗保健专业人员，加强对自主权利、相关法律和 ACP 过程的了解，并因此制定教育计划。此外，考虑到文化之间的差异可能会有所帮助。
