Analysis Of Influencing Factors And The Acceptance Of The Advance Care Planning For The Hemodialysis Patients

Objective:The purpose of this study was to determine the attitudes,feeling and the intentions of Advance Care Planning(ACP)in hemodialysis patients.Investigate the relevance of death attitudes and advance care planning for hemodialysis patients.Methods:Using the convenient sampling method,200 patients from two blood purification centers in Luliang City were recruited for questionnaire survey from October 2018 to February 2019.The influential factors of ACP acceptance in hemodialysis patients were measured using general data questionnaire,adapted “Patient’s Advance Care Planning Questionnaire” and “Death Attitude Profile-Revised”.Mean value and standard deviations were used to describe patients’ attitudes and feeling on ACP,and multiple linear regression was used to analyze the influencing factors.Results:1.A total of 200 questionnaires were collected in this study,and 196 valid questionnaires,with a recovery rate of 98%.The mean score of the questionnaire for the Advance care planning for hemodialysis patients was greater than 3 points,indicating that hemodialysis patients are willing to participate in the discussion of ACP.2.The results of single factor analysis showed that gender,contact with dying people,experience of first aid,and self-care ability were not factors influencing of ACP acceptance in hemodialysis patients.age,occupation,education,marital status,religiousbeliefs,and medical insurance,family monthly income,understanding of life support treatment,and experience of talking about death are the factors influencing of ACP acceptance in hemodialysis patients.3.The results of multiple regression analysis of ACP attitudes and feelings in hemodialysis patients show that education,religious beliefs,discussing death-related topics with others,and understanding of life support treatment are important predictors of attitudes and feelings of ACP in hemodialysis patients,which can explain 42.9% of the total variation in ACP attitudes and feelings in hemodialysis patients.4.Hemodialysis patients’ death attitude scores are ranked from high to low as natural acceptance,death avoidance,fear of death,escape acceptance,and approach acceptance.The total score of ACP’s attitude and feeling in hemodialysis patients was positively correlated with natural acceptance(r = 0.414,P<0.01),escape acceptance(r =-0.333,P<0.01),fear of death(r =-0.407,P<0.01).death avoidance(r =-0.660,P<0.01).Conclusion:Hemodialysis patients generally accept ACP positively.Patients with high education,religious beliefs,who have discussed death issues with others,and understand life support treatment are more likely to receive ACP.It should be tailored to the patient’s values,culture and preferences.Identify patients who are more likely to participate in ACP for guidance.At the same time,relevant education was carried out in schools,communities,and hospitals to improve patients’ acceptance of ACP.