Details

Autor(en) / Beteiligte

• Chu, Dachen
• Yen, Yung-Feng
• Hu, Hsiao-Yun
• Lai, Yun-Ju
• Sun, Wen-Jung
• Ko, Ming-Chung
• Huang, Li-Ying
• Chen, Chu-Chieh
• Curtis, J Randall
• Lee, Ya-Ling
• Huang, Sheng-Jean
• Malhotra, Chetna

Titel

Factors associated with advance directives completion among patients with advance care planning communication in Taipei, Taiwan

Ist Teil von

• PloS one, 2018-07, Vol.13 (7), p.e0197552-e0197552

Ort / Verlag

United States: Public Library of Science

Erscheinungsjahr

2018

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• Although advance directives (AD) have been implemented for years in western countries, the concept of AD is not promoted extensively in eastern countries. In this study we evaluate a program to systematically conduct advance care planning (ACP) communication for hospitalized patients in Taiwan and identify the factors associated with AD completion. In this retrospective evaluation of a clinical ACP program, we identified adult patients with chronic life-limiting illness admitted to Taipei City Hospital between April 2015 and January 2016. Trained healthcare providers held an ACP meeting to discuss patients' preference regarding end-of-life care and AD completion. A multiple logistic regression was performed to determine the factors associated with the AD completion. A total of 2878 patients were determined to be eligible for ACP during the study, among which 1798 (62.5%) completed ACP and data was available for 1411 patients (49.1%). Of the 1411 patients who received ACP communication with complete data, the rate of AD completion was 82.6%. The overall mean (SD) age was 78.2 (14.4) years. Adjusting for other variables, AD completion was associated with patients aged ≥ 85 years [adjusted odds ratio (AOR) = 1.80, 95% CI 1.21-2.67], critical illness (AOR = 1.17, 95% CI 1.06-1.30), and social workers participating in ACP meetings (AOR = 1.74, 95% CI 1.24-2.45). The majority of inpatients with chronic life-limiting illness had ACP communication as part of this ACP program and over 80% completed an AD. Our study demonstrates the feasibility of implementing ACP discussion in East Asia and suggests that social workers may be an important component of ACP communication with patients.