Attitudes Toward Advance Directives Among Patients and Their Family Members in China

Choi

Journal of Advanced Nursing

et al. 2019

Aims To develop a culturally relevant conceptual map to discover perceptions of a statutory form of advance directive (AD) for Hong Kong Chinese. Design This was the first study on AD using a concept mapping approach with two phases. Methods The data collection of the two phases was conducted from February 2016–February 2017. In Phase I, 96 participants were recruited using purposive sampling. In Phase II, multi‐dimensional scaling and hierarchical cluster analysis were used to create a concept map based on quantitative data. Results The map depicted six clusters of factors affecting the acceptance of AD, with their importance rating in decreasing order: Conditional factor, value system, process of AD, physical and illness factor, personal situation factor, and socio‐cultural factor. Conclusion The study adopted a comprehensive approach to unfolding the multi‐faceted factors affecting the acceptance of ADs by stakeholders. Strategies targeting the clusters could be developed to facilitate the discussion and completion of AD.

Section: Discussionsupporting

confidence: 90%

Unfolding and displaying the influencing factors of advance directives from the stakeholder's perspective: A concept mapping approach

Choi

Journal of Advanced Nursing

et al. 2019

“…Similarly, another study found that the rate at which Chinese patients with cancer will choose arti cial ventilation will increase by almost 20% if the treatment is free [13]. Another study also reported that a high proportion of Chinese patients with high educational level have heard of ADs and wanted to make ADs [14]. In our study, patients with brain tumours who had medical insurance for nonworking or working urban residents usually live in modern cities and had jobs.…”

Section: Predictors Of Preferring To Make Adssupporting

confidence: 55%

Advance Directives and End-of-Life Care: Knowledge and Preferences of Patients with Brain Tumours from Anhui, China

Wang

Zhang

Hong

et al. 2020

Preprint

Abstract Background: In Mainland China, the advance directives (ADs) and end-of-life care of patients with tumours, especially patients with brain tumours who may have lost consciousness or the ability to speak at the early stage of their illness, have been poorly acknowledged. Thus, this study aims to clarify the knowledge and preferences of the ADs and end-of-life care of patients with brain tumours and to investigate the predictors of patients’ preferences.Methods: This was a population-based cross-sectional survey that was conducted via face-to-face interviews. Information on the sociodemographic factors, brain tumour illness, knowledge and preferences of the advance decisions and end-of-life care of the patients were collected.Results: A total of 88.61% of the participants had never heard of ADs, but 65.18% would like to make ADs. Knowledge of ADs, receiving surgical treatment or radiotherapy, less than 70 years old, male, educational qualifications of college or beyond, childless, had medical insurance for nonworking or working urban residents and self-payment of medical expenses were predictors of preference for making ADs. A total of 79.43% participants would like to discuss end-of-life arrangements with medical staff, and 63.29% of participants were willing to receive end-of-life care although it could not delay death. A total of 65.82% patients with brain tumours wanted resuscitation, and as high as 45.45% of the patients thought that they did not need life support if they were in a persistent vegetative state. Brain primary tumours, ages of less than 70 years old, male, educational qualification of junior middle school or below, had children, had new rural cooperative medical insurance and had medical expenses paid by children or spouses were predictors of choosing appropriate palliative care.Conclusions：ADs and end-of-life care have been poorly acknowledged amongst patients with brain tumours in mainland China. Additional efforts should be encouraged amongst patients with primary brain tumours, those are undergoing surgery and radiotherapy and those who have low socioeconomic status. Appropriate decision-making timing is encouraged to promote AD amongst Chinese patients with brain tumours.

“…These independent predictors were related to education and costs. Similarly, another study found that the rate at which Chinese patients with cancer will choose arti cial ventilation will increase by almost 20% if the treatment is free [18]. Another study also reported that a high proportion of Chinese patients with high educational level have heard of ADs and wanted to make Ads [19].…”

Section: Predictors Of Preferring To Make Advance Directivesmentioning

confidence: 93%

Advance Directives and End-of-Life Care: Knowledge and Preferences of Patients with Brain Tumours from Anhui, China

Wang

Zhang

Hong

et al. 2020

Preprint

Background: In Mainland China, the advance directives (ADs) and end-of-life care of patients with tumours, especially patients with brain tumours who may have lost consciousness or the ability to speak at the early stage of their illness, have been poorly acknowledged. Thus, this study aims to clarify the knowledge and preferences of the ADs and end-of-life care of patients with brain tumours and to investigate the predictors of patients’ preferences.Methods: This was a population-based cross-sectional survey that was conducted via face-to-face interviews. Information on the sociodemographic factors, brain tumour illness, knowledge and preferences of the advance decisions and end-of-life care of the patients were collected.Results: A total of 88.61% of the participants had never heard of ADs, but 65.18% would like to make ADs. Knowledge of ADs, receiving surgical treatment or radiotherapy, less than 70 years old, male, educational qualifications of college or beyond, childless, had medical insurance for nonworking or working urban residents and self-payment of medical expenses were predictors of preference for making ADs. A total of 79.43% participants would like to discuss end-of-life arrangements with medical staff, and 63.29% of participants were willing to receive end-of-life care although it could not delay death. A total of 65.82% patients with brain tumours wanted resuscitation, and as high as 45.45% of the patients thought that they did not need life support if they were in a persistent vegetative state. Brain primary tumours, ages of less than 70 years old, male, educational qualification of junior middle school or below, had children, had new rural cooperative medical insurance and had medical expenses paid by children or spouses were predictors of choosing appropriate palliative care.ConclusionsADs and end-of-life care have been poorly acknowledged amongst patients with brain tumours in mainland China. Additional efforts should be encouraged amongst patients with primary brain tumours, those are undergoing surgery and radiotherapy and those who have low socioeconomic status. A longitudinal and comprehensive study is encouraged to promote a disease-specific ADs amongst Chinese patients with brain tumours.