Comparison of Awareness and Attitudes Toward Advance Care Planning Between Chinese Medical and Non-medical University Students

Abstract

Background: To date, there is a paucity of information on the discrepancies of awareness and attitudes towards ACP among university students in mainland China. The purposes of this study are to investigate the discrepancies in the awareness and attitudes toward advance care planning (ACP) between Chinese medical and non-medical university students and to identify the association between the awareness and attitudes toward ACP and medical education. A total of 718 university students included 290 medical students and 428 non-medical students from 12 universities in 4 provinces in mainland China were surveyed by using the Advance Care Planning Questionnaire (ACPQ). Results: More than half of the university students (59.89%) had never heard of ACP before; there were significant differences in the awareness regarding ACP between medical students and their non-medical peers (P<0.05); 82.45% of participants were more likely to consider discussing ACP in the future; there was no significant difference (P>0.05) in the previous experience last 5 years between the two groups except the item of “have been involved in the decision making of your treatment” (P=0.005); univariate analysis and multivariate linear regression analysis showed that medical education was the factor influencing the awareness of end-of-life (P=0.000) and proxy decision-maker (P=0.028) among university students. Conclusion: The awareness toward ACP of university students in mainland China remained limited, but their attitudes were positive. Medical students had a higher level of awareness regarding ACP than non-medical students, and medical education was the factor that promoted students to understand end-of-life care and proxy decision-maker. Establishing educational initiatives, developing models for peer-led ACP, and perfecting governmental policies should be emphasized.