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The Characteristics and Motivations of Taiwanese People toward Advance Care Planning in Outpatient Clinics at a Community Hospital

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  • Chih-Chieh Yen

    (Division of Hematology/Oncology, Department of Internal Medicine, Douliou Branch, National Cheng Kung University Hospital, Yunlin 640, Taiwan
    Institute of Clinical Medicine, School of Medicine, National Cheng Kung University, Tainan 704, Taiwan)

  • Cheng-Pei Lin

    (Institute of Community Health Care, School of Nursing, National Yang Ming Chiao Tung University, Taipei 112, Taiwan)

  • Yu-Ting Su

    (Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan)

  • Chiu-Hua Tsu

    (Department of Social Work, Douliou Branch, National Cheng Kung University Hospital, Yunlin 640, Taiwan)

  • Li-Mei Chang

    (Department of Nursing, Douliou Branch, National Cheng Kung University Hospital, Yunlin 640, Taiwan)

  • Zih-Jie Sun

    (Division of Family Medicine, Department of Internal Medicine, Douliou Branch, National Cheng Kung University Hospital, Yunlin 640, Taiwan
    Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
    Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan)

  • Bing-Sheng Lin

    (Division of Family Medicine, Department of Internal Medicine, Douliou Branch, National Cheng Kung University Hospital, Yunlin 640, Taiwan)

  • Jin-Shang Wu

    (Division of Family Medicine, Department of Internal Medicine, Douliou Branch, National Cheng Kung University Hospital, Yunlin 640, Taiwan
    Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
    Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan)

Abstract

Advance care planning (ACP) provides access to complete advance decisions (ADs). Despite the legalization of ACP in Taiwan, it is underutilized in community settings. The objective of this study is to describe the service at a community hospital in Southern Taiwan. We retrospectively analyzed participants who were engaged in ACP consultations from January 2019 to January 2020. The characteristics, motivations, content, and satisfaction of participants are reported. Factors associated with refusing life-sustaining treatments (LST) or artificial nutrition/hydration (ANH) were analyzed using multivariate logistic regression. Of the 178 participants, 123 completed the ACP. The majority were female (64.2%), aged 61 on average and more than 80% had never signed a do-not-resuscitate order. In the ADs, most participants declined LST (97.2%) and ANH (96.6%). Family-related issues (48.9%) were the most prevalent motivations. Rural residence (OR 8.6, p = 0.005), increased age (OR 7.2, p = 0.025), and reluctance to consent to organ donation (OR 5.2, p = 0.042) correlated with refusing LST or ANH. Participants provided a positive feedback regarding overall satisfaction (good, 83%) compared to service charge (fair/poor, 53%). The study demonstrated high AD completion when refusing LST or ANH. These findings may facilitate the development of ACP as a community-based service.

Suggested Citation

  • Chih-Chieh Yen & Cheng-Pei Lin & Yu-Ting Su & Chiu-Hua Tsu & Li-Mei Chang & Zih-Jie Sun & Bing-Sheng Lin & Jin-Shang Wu, 2021. "The Characteristics and Motivations of Taiwanese People toward Advance Care Planning in Outpatient Clinics at a Community Hospital," IJERPH, MDPI, vol. 18(6), pages 1-14, March.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:6:p:2821-:d:514388
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    References listed on IDEAS

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    1. Deborah Carr & Sara M. Moorman & Kathrin Boerner, 2013. "End-of-Life Planning in a Family Context: Does Relationship Quality Affect Whether (and With Whom) Older Adults Plan?," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 68(4), pages 586-592.
    2. Kathrin Boerner & Deborah Carr & Sara Moorman, 2013. "Family Relationships and Advance Care Planning: Do Supportive and Critical Relations Encourage or Hinder Planning?," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 68(2), pages 246-256.
    3. Cheng-Pei Lin & Jen-Kuei Peng & Ping-Jen Chen & Hsien-Liang Huang & Su-Hsuan Hsu & Shao-Yi Cheng, 2020. "Preferences on the Timing of Initiating Advance Care Planning and Withdrawing Life-Sustaining Treatment between Terminally-Ill Cancer Patients and Their Main Family Caregivers: A Prospective Study," IJERPH, MDPI, vol. 17(21), pages 1-13, October.
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    Cited by:

    1. Boram Kim & Jiyeon Choi & Ilhak Lee, 2022. "Factors Associated with Advance Directives Documentation: A Nationwide Cross-Sectional Survey of Older Adults in Korea," IJERPH, MDPI, vol. 19(7), pages 1-13, March.
    2. Noorhazlina Ali & Philomena Anthony & Wee Shiong Lim & Mei Sian Chong & Edward Wing Hong Poon & Vicki Drury & Mark Chan, 2021. "Exploring Differential Perceptions and Barriers to Advance Care Planning in Dementia among Asian Patient–Caregiver Dyads—A Mixed-Methods Study," IJERPH, MDPI, vol. 18(13), pages 1-15, July.

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