Factors Impacting Advance Decision Making and Health Care Agent Appointment among Taiwanese Urban Residents after the Passage of Patient Right to Autonomy Act
In recent years, advance care planning (ACP) promotion in Taiwan has expanded beyond clinical practice to the broader population. This study aims to investigate people’s attitudes toward ACP and to identify factors influencing their signing of advance directives (ADs) and appointment of health care...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-05-01
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| Series: | Healthcare |
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| Online Access: | https://www.mdpi.com/2227-9032/11/10/1478 |
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| author | Yi-Ling Wu Chun-Yi Yang Tsai-Wen Lin Pei-Han Shen Zong-Dar Tsai Ching-Nu Liu Chia-Chen Hsu Samuel Shih-Chih Wang Sheng-Jean Huang |
| author_facet | Yi-Ling Wu Chun-Yi Yang Tsai-Wen Lin Pei-Han Shen Zong-Dar Tsai Ching-Nu Liu Chia-Chen Hsu Samuel Shih-Chih Wang Sheng-Jean Huang |
| author_sort | Yi-Ling Wu |
| collection | DOAJ |
| description | In recent years, advance care planning (ACP) promotion in Taiwan has expanded beyond clinical practice to the broader population. This study aims to investigate people’s attitudes toward ACP and to identify factors influencing their signing of advance directives (ADs) and appointment of health care agents (HCAs). Methods: We identified 2337 ACP participants from consultation records between 2019 and 2020. The relationships among the participants’ characteristics, AD completion, and HCA appointment were investigated. Results: Of 2337 cases, 94.1% completed ADs and 87.8% were appointed HCAs. Welfare entitlement (OR = 0.47, <i>p</i> < 0.001), the place ACP progressed (OR = 0.08, <i>p</i> < 0.001), the participation of second-degree relatives (OR = 2.50, <i>p</i> < 0.001), and the intention of not being a family burden (OR = 1.65, <i>p</i> = 0.010) were significantly correlated with AD completion. The probability of appointing HCAs was higher in participants with family caregiving experience (OR = 1.42, <i>p</i> < 0.05), who were single (OR = 1.49, <i>p</i> < 0.05), and who expected a good death with dignity (OR = 1.65, <i>p</i> < 0.01). Conclusions: Our research shows that adopting ACP discussion in Taiwan is feasible, which encourages ACP conversation and facilitates AD completion. Implications: Male and younger adults may need extra encouragement to discuss ACP matters with their families. Limitations: due to sampling restrictions, our data were chosen from an urban district to ensure the integrity of the results. Furthermore, interview data could be collected in future research to supplement the quantitative results. |
| first_indexed | 2024-03-11T03:41:35Z |
| format | Article |
| id | doaj.art-7308df211fe54996b93ac83e1b2d8153 |
| institution | Directory Open Access Journal |
| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-03-11T03:41:35Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Healthcare |
| spelling | doaj.art-7308df211fe54996b93ac83e1b2d81532023-11-18T01:32:58ZengMDPI AGHealthcare2227-90322023-05-011110147810.3390/healthcare11101478Factors Impacting Advance Decision Making and Health Care Agent Appointment among Taiwanese Urban Residents after the Passage of Patient Right to Autonomy ActYi-Ling Wu0Chun-Yi Yang1Tsai-Wen Lin2Pei-Han Shen3Zong-Dar Tsai4Ching-Nu Liu5Chia-Chen Hsu6Samuel Shih-Chih Wang7Sheng-Jean Huang8Taipei City Hospital, Taipei 103212, TaiwanTaipei City Hospital, Taipei 103212, TaiwanNational Academy of Education Research, Taipei 237201, TaiwanTaipei City Hospital, Taipei 103212, TaiwanTaipei City Hospital, Taipei 103212, TaiwanTaipei City Hospital, Taipei 103212, TaiwanTaipei City Hospital, Taipei 103212, TaiwanDepartment of Health and Welfare, Tian-Mu Campus, College of City Management, University of Taipei, Taipei 111036, TaiwanNational Taiwan University Hospital, Taipei 100225, TaiwanIn recent years, advance care planning (ACP) promotion in Taiwan has expanded beyond clinical practice to the broader population. This study aims to investigate people’s attitudes toward ACP and to identify factors influencing their signing of advance directives (ADs) and appointment of health care agents (HCAs). Methods: We identified 2337 ACP participants from consultation records between 2019 and 2020. The relationships among the participants’ characteristics, AD completion, and HCA appointment were investigated. Results: Of 2337 cases, 94.1% completed ADs and 87.8% were appointed HCAs. Welfare entitlement (OR = 0.47, <i>p</i> < 0.001), the place ACP progressed (OR = 0.08, <i>p</i> < 0.001), the participation of second-degree relatives (OR = 2.50, <i>p</i> < 0.001), and the intention of not being a family burden (OR = 1.65, <i>p</i> = 0.010) were significantly correlated with AD completion. The probability of appointing HCAs was higher in participants with family caregiving experience (OR = 1.42, <i>p</i> < 0.05), who were single (OR = 1.49, <i>p</i> < 0.05), and who expected a good death with dignity (OR = 1.65, <i>p</i> < 0.01). Conclusions: Our research shows that adopting ACP discussion in Taiwan is feasible, which encourages ACP conversation and facilitates AD completion. Implications: Male and younger adults may need extra encouragement to discuss ACP matters with their families. Limitations: due to sampling restrictions, our data were chosen from an urban district to ensure the integrity of the results. Furthermore, interview data could be collected in future research to supplement the quantitative results.https://www.mdpi.com/2227-9032/11/10/1478advance care planningadvance directiveshealth care agentPatient Right to Autonomy Act |
| spellingShingle | Yi-Ling Wu Chun-Yi Yang Tsai-Wen Lin Pei-Han Shen Zong-Dar Tsai Ching-Nu Liu Chia-Chen Hsu Samuel Shih-Chih Wang Sheng-Jean Huang Factors Impacting Advance Decision Making and Health Care Agent Appointment among Taiwanese Urban Residents after the Passage of Patient Right to Autonomy Act Healthcare advance care planning advance directives health care agent Patient Right to Autonomy Act |
| title | Factors Impacting Advance Decision Making and Health Care Agent Appointment among Taiwanese Urban Residents after the Passage of Patient Right to Autonomy Act |
| title_full | Factors Impacting Advance Decision Making and Health Care Agent Appointment among Taiwanese Urban Residents after the Passage of Patient Right to Autonomy Act |
| title_fullStr | Factors Impacting Advance Decision Making and Health Care Agent Appointment among Taiwanese Urban Residents after the Passage of Patient Right to Autonomy Act |
| title_full_unstemmed | Factors Impacting Advance Decision Making and Health Care Agent Appointment among Taiwanese Urban Residents after the Passage of Patient Right to Autonomy Act |
| title_short | Factors Impacting Advance Decision Making and Health Care Agent Appointment among Taiwanese Urban Residents after the Passage of Patient Right to Autonomy Act |
| title_sort | factors impacting advance decision making and health care agent appointment among taiwanese urban residents after the passage of patient right to autonomy act |
| topic | advance care planning advance directives health care agent Patient Right to Autonomy Act |
| url | https://www.mdpi.com/2227-9032/11/10/1478 |
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