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Factors Associated with Advance Directives Documentation: A Nationwide Cross-Sectional Survey of Older Adults in Korea

Author

Listed:
  • Boram Kim

    (Division of Health Policy, Bureau of Health Policy, Ministry of Health and Welfare, Sejong-si 30113, Korea)

  • Jiyeon Choi

    (Division of Medical Law & Ethics, Department of Medical Humanities and Social Sciences, Yonsei University College of Medicine, Seoul 03722, Korea)

  • Ilhak Lee

    (Division of Medical Law & Ethics, Department of Medical Humanities and Social Sciences, Yonsei University College of Medicine, Seoul 03722, Korea
    The Asian Institute of Bioethics and Health Law, College of Medicine, Yonsei University, Seoul 03722, Korea)

Abstract

Advance directives (ADs) can support autonomy in making healthcare decisions and minimize unnecessary discomfort during the treatment process at the end of life (EOL). This study aimed to investigate the factors that influence AD documentation among community-dwelling older adults. We used data from the National Survey of Older Koreans which was conducted nationwide in 2020. Data from participants aged 65 years or older were extracted using stratified multistage cluster sampling and the survey was conducted through one-on-one interviews. A total of 9920 older adults were included in this study: 421 respondents (4.7%) claimed that they had prepared for AD. Multivariable logistic regression analysis showed that being 75 years or older, having higher educational attainment, higher income, having any chronic disease(s), being screened for dementia in the past, being against futile life-sustaining treatment, taking a lecture on death and being registered for organ donation were positively associated with AD. Furthermore, when health was rated as average, it was associated with reduced odds of AD documentation compared when health was rated as good. These results suggest that more targeted efforts are required to promote EOL discussions among older adults.

Suggested Citation

  • 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.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:7:p:3771-:d:776766
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    References listed on IDEAS

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    1. Hana Ko & SuJung Jung, 2021. "Association of Social Frailty with Physical Health, Cognitive Function, Psychological Health, and Life Satisfaction in Community-Dwelling Older Koreans," IJERPH, MDPI, vol. 18(2), pages 1-9, January.
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    3. Rurup, Mette L. & Onwuteaka-Philipsen, Bregje D. & van der Heide, Agnes & van der Wal, Gerrit & Deeg, Dorly J.H., 2006. "Frequency and determinants of advance directives concerning end-of-life care in The Netherlands," Social Science & Medicine, Elsevier, vol. 62(6), pages 1552-1563, March.
    4. Sok Man Leong & Kuai In Tam & Sok Leng Che & Ming Xia Zhu, 2021. "Prevalence and Predictors of Willingness to Make Advance Directives among Macao Chinese," IJERPH, MDPI, vol. 18(15), pages 1-11, July.
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