Rezaei Milad Asghardoust, Zahiri Ali, Kianian Toktam, Hashemi Elahe, Askari Ali, Golmohammadi Mobina, Mirsadeghi Amir, Barasteh Salman
Student Research Committee, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Departmentof Community Health and Geriatrics Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
BMC Public Health. 2025 Jan 7;25(1):78. doi: 10.1186/s12889-024-21209-x.
Advance care planning can help to align the care provided with the values, goals and preferences of patients at the end of life. Therefore, readiness for advanced care planning is considered a prerequisite and predictor of the patient's willingness to participate in the end of life conversation. The present study was conducted with the aim of investigating the factors affecting patients' readiness for advance care planning (RACP).
This systematic review was searched in 4 databases: PubMed, Scopus, Web of science, ProQuest using relevant keywords. No time limit was considered. The quality of the articles was assessed using Joanna Briggs Institute tool for qualitative studies and the Appraisal Tool for cross-sectional Studies. The data was analyzed based on the directed content analysis approach guided by the theory of planned behavior (TPB).
3227 primary article titles were identified. After removing duplicates, screening and final selection, 22 relevant articles remained for analysis. Factors affecting RACP were extracted based on the TPB. Attitude factors include "ACP training", "perceived experiences of health status", "Socio-demographic factors", and "psycho-spiritual readiness". Subjective norms include "social support and family participation" and "accessibility to health services". The perceived behavioral control includes "dialogue about ACP", "readiness actions", and "determining a proxy decision maker."
In this study, according to the theory of planning behavior, various factors have an effect on the RACP. Therefore, according to the collaborative and multifactorial nature of the factors affecting preparation for ACP, it is suggested that different effective dimensions should be considered according to the specific conditions of each patient and the stage of the disease. Therefore, health service providers should first measure the level of readiness of patients and families, and by understanding the factors affecting their readiness, they should conduct training or dialogue in the field of ACP.
临终前的预立医疗计划有助于使所提供的护理与患者的价值观、目标和偏好保持一致。因此，预立医疗计划的准备情况被视为患者参与临终讨论意愿的先决条件和预测指标。本研究旨在调查影响患者预立医疗计划准备情况（RACP）的因素。
使用相关关键词在4个数据库（PubMed、Scopus、科学网、ProQuest）中进行了该系统评价。未设定时间限制。使用乔安娜·布里格斯研究所定性研究工具和横断面研究评估工具对文章质量进行评估。基于计划行为理论（TPB）指导的定向内容分析法对数据进行分析。
共识别出3227篇原始文章标题。去除重复项、筛选并最终选定后，剩余22篇相关文章进行分析。基于TPB提取了影响RACP的因素。态度因素包括“ACP培训”、“对健康状况的感知体验”、“社会人口学因素”和“心理-精神准备情况”。主观规范包括“社会支持和家庭参与”以及“获得医疗服务的便利性”。感知行为控制包括“关于ACP的对话”、“准备行动”以及“确定替代决策者”。
在本研究中，根据计划行为理论，多种因素对RACP有影响。因此，鉴于影响ACP准备情况的因素具有协作性和多因素性质，建议根据每位患者的具体情况和疾病阶段考虑不同的有效维度。因此，医疗服务提供者应首先衡量患者及其家属的准备程度，并通过了解影响其准备程度的因素，在ACP领域开展培训或对话。
