Research On The Acceptance Of Advanced Care Planning For The Elderly Patients

Objective:The purpose of this study is to determine the level of acceptance of Advance Care Planning(ACP)and to clarify the relevant factors that influence the acceptance of Advance Care Planning in elderly patients.Methods:Using the method of literature research and expert discussion,we designed a Patient’s Advance Care Planning Acceptance Questionnaire(ACPQ).Using the method of Delphi,22 experts have participated in two rounds of interview and further modified and determined the contents of the questionnaire.In April-July in 2017,the researchers was using questionnaire identified 190 eligible patients who were hospitalized in Fenyang Hospital of Shanxi Province with the convenience sampling method.Using unstructured interviews with 8 patients who were also participated in the interview.Using SPSS20.0 to conduct a statistical analysis of valid questionnaire data,record,organize interview data,and finally draw conclusions.Results:1.22 experts participated in two rounds of interviews and the expert’s coefficient of authority is 0.83.The Cronbach’s alpha of each dimension of the questionnaire was0.716,0.868,0.885,the total Cronbach’s alpha was 0.869,and the Split-half reliability was 0.816.The item-level content-validity index was 0.91-1.00,and the scale-level content-validity index was 0.97.The resulting formal questionnaire consists of three parts,a total of 19 entries.2.Elderly patients in the three parts of the questionnaire average score greater than 3points,indicating that elderly patients are willing to participate in the ACP discussion,support for the ACP.Univariate analysis showed that gender,marital status,and rescue experience the factors influencing the ACP acceptance in patients.Age,educational level,past occupation,annual income,payment method,other diagnosis and hospitalization frequency are the influencing factors.Multivariate analysis showed that the impact of education and other diagnoses accounted for 13.1% in the “patients’ attitudes” section;the impact of payment methods,number of hospitalizations,and other diagnoses accounted for 38.5% in the “patients’ feel” section;the impact of other diagnoses,education,and number of hospitalizations accounted for 38.5% in the “patients’ plans”section.3.Analysis of interview data to extract four themes: awareness of ACP;attitudes towards ACP;recommendations for the implementation of ACP;and implication factors related to ACP.The results showed that the patient’s physical condition was the main factor affecting theirs discussion or acceptance of ACP,and the patients accepted the ACP.Conclusion:1.The reliability and validity of the ACPQ questionnaire prepared by this study is scientific and scientific,which provides a tool for assessing patients’ attitudes toward the pre-emptive medical care plan.2.Through the survey combined with non-structural interview,the results show that elderly patients accept ACP,expressed supportive attitude.