The incidence of chronic diseases among elderly patients increases annually with the accelerating aging process in China. Complications arising from the progression of these diseases may affect the ability of the aged to communicate and make decisions about future medical and personal care. This study aimed to investigate acceptance and influencing factors of advance care planning for community-dwelling elderly patients with chronic diseases in the Republic of China. Using a convergent parallel mixed-methods design, 471 elderly Chinese nationals older than 60 years with chronic diseases were recruited using convenience sampling. Quantitative data collection used Chinese versions of the Elderly Death Attitude Scale, Modified Barthel Index Rating Scale, and the Advance Care Planning Acceptance Questionnaire, followed by 14 patients drawn from the quantitative phase. Interviews were thematically analyzed. The results showed that attitude to death and quality of life were key predictors of advance care planning implementation preference, whereas family support and past medical experience were significant factors. The study highlighted the importance of conducting regular education about death, paying attention to quality of life, providing family support, and discussing past medical experience in order to implement advance care planning for elderly patients with chronic diseases in China.
Complications arising from human immunodeficiency virus may affect the ability of elderly AIDS patients to communicate and make decisions about future medical care. It is important for elderly AIDS patients to be able to express effectively their preferences for future treatments and care. This study explored preferences and influencing factors of advance care planning among elderly AIDS patients. A semistructured interview outline was developed based on the theory of planned behavior. A qualitative preference interview was conducted among 16 eligible elderly AIDS patients. Using thematic analysis, the data were analyzed and categorized into 3 themes and 9 subthemes that were classified under the theory of planned behavior framework. The 3 themes were as follows: a positive attitude toward advance care planning, a strong desire for family and social support, and some obstacles to discussing advance care planning in the current environment. These themes provided valuable insights to advance care planning educators and practitioners from different work environments and units to aid them in constructing future ACP intervention models for elderly AIDS patients.
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