School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia.
Equity in Health and Wellbeing Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
PLoS One. 2024 Aug 20;19(8):e0309152. doi: 10.1371/journal.pone.0309152. eCollection 2024.
Advance personal planning (APP) involves planning for future periods of incapacity, including making legal decisions and documents. APP ensures that a person's values and preferences are known and respected. This study aimed to examine knowledge of APP, attitudes and confidence towards APP, and participation in APP activities among older people residing in regional and rural areas.
A cross-sectional survey was conducted with people aged over 65 years residing in and around regional towns in New South Wales, Australia. Participants responded to a social media advertisement or information provided through a community organisation. Data was collected via pen and paper survey or an online survey. The survey was developed for the study and included questions about the participant and their experiences with APP. Poisson regression modelling was conducted to explore the relationship between APP participation and APP knowledge, confidence and attitudes as well as the participant characteristics associated with APP participation.
Overall, 216 people completed the survey. Most participants had a will (90%) but only a third (32%) had documented an advance care directive. Knowledge of APP was low with only 2.8% of participants correctly answering all 6 knowledge questions. Participants had a positive attitude towards APP and high level of confidence that they could discuss APP issues with important people in their life. Those with increased knowledge, confidence and attitude towards APP were significantly more likely to participate in APP activities. Older age and having private health insurance were significantly associated with engaging in APP activities. Increased frailty and the presence of health conditions were not associated with increased APP participation.
There is a need to increase engagement with APP particularly among those who may be considered frail or have chronic health conditions. Increasing knowledge of, confidence and attitudes towards, APP could help to increase engagement in APP activities.
预先个人规划（APP）涉及对未来无能力时期的规划，包括做出法律决策和文件。APP 确保一个人的价值观和偏好得到了解和尊重。本研究旨在调查居住在澳大利亚新南威尔士州地区和农村地区的老年人对 APP 的了解、对 APP 的态度和信心以及参与 APP 活动的情况。
本研究采用横断面调查，调查对象为居住在澳大利亚新南威尔士州地区城镇及其周边地区、年龄在 65 岁以上的人群。参与者通过社交媒体广告或社区组织提供的信息做出回应。通过纸笔调查或在线调查收集数据。该调查是为本研究专门开发的，包括参与者及其 APP 体验相关问题。采用泊松回归模型探讨 APP 参与度与 APP 知识、信心和态度之间的关系，以及与 APP 参与相关的参与者特征。
共有 216 人完成了调查。大多数参与者（90%）拥有遗嘱，但只有三分之一（32%）制定了预嘱。APP 知识水平较低，只有 2.8%的参与者正确回答了所有 6 个知识问题。参与者对 APP 的态度积极，对与生活中重要人物讨论 APP 问题有很高的信心。对 APP 知识、信心和态度较高的参与者，参与 APP 活动的可能性显著更高。年龄较大和拥有私人医疗保险与参与 APP 活动显著相关。虚弱程度增加和存在健康状况与 APP 参与度增加无关。
需要增加 APP 的参与度，特别是在那些可能被认为虚弱或患有慢性健康状况的人群中。增加对 APP 的了解、信心和态度可能有助于增加 APP 活动的参与度。
