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

Chih-Chieh Yen, Cheng-Pei Lin, Yu-Ting Su, Chiu-Hua Tsu, Li-Mei Chang, Zih-Jie Sun, Bing-Sheng Lin and Jin-Shang Wu
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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
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
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

IJERPH, 2021, vol. 18, issue 6, 1-14

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.

Keywords: advance care planning; advance decisions; hospice and palliative care; community hospital (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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