| Objectives Describe the status of awareness and attitude of Advance Care Plannin-g(ACP)among elderly patients with chronic diseases in hospital;To analyze the factors influencing the attitude of ACP among elderly patients with chronic diseases in hospital.Methods Based on convenient sampling method,totally 663 elderly patients with chronic diseases from 2 grade three hospitals in Tangshan were recruited for status analysis and influencing factors analysis.The survey tools included general data and disease data questionnaire,family information questionnaire,Advance Care Planning Questionnaire,Elderly Death Attitude Scale,Treatment Burden Questionnaire,Family Resilience Assessment Scale,Mishel Uncertainty in Illness Scale for Adults,and Health Literacy Scale.The data were analyzed by SPSS23.0 for statiatical analysis.one-way analysis includes Mann-whitney U rank-sum test /Kruskal-Wallis H rank-sum test and Pearson correlation analysis.Multiple linear stepwise regression analysis model was constructed to determine the influencing factors of attitude of ACP.Results 1 The awareness of the terminology of ACP for elderly patients with chronic diseases in hospital are as follows: only five people awareness ACP,accounting for 0.8%,and the highest awareness rate was letters power of attorney(132 patients),accounting for19.9%.Network media(17.1%)was the main channel for elderly patients with chronic diseases to receive these information.2 The score of elderly patients with chronic diseases of attitude of ACP was(45.81±11.26),71.8% of patients thought it was meaningful to discuss ACP,and 67% of patients were willing to participate in ACP discussion in the future.3 The results of single factor analysis showed that age,cultural level,place of residence,chronic diseases types,chronic diseases numbers,activities daily living(ADL),caregivers in hospital,in nearly five years experience(hospitalization experience,experience in participating in treatment decision-making,encounter with relatives and friends passing away,and relatives and friends receiving life-sustaining treatment),treatment burden,disease uncertainty are the factors influencing the attitude of ACP among elderly patients with chronic diseases(P<0.05).The family resilience(r=0.466,P<0.01),nature accept death(r=0.545,P<0.01),health literacy(r=0.462,P<0.01)with attitude of ACP total score was significantly positively correlation among elderly patients with chronic diseases.The death of fear(r=-0.428,P<0.01)and death avoidance(r=-0.300,P<0.01)were significantly negative correlation among elderly patients with chronic diseases.4 Multiple stepwise regression analysis results show that the natural accept for death,health literacy,fear death and anxiety,types of chronic diseases(cancer),friends receiving life-sustaining treatment,ADL,family resilience,treatment burden,number of sick were the influence factors attitude of ACP among elderly patients with chronic diseases in hospital.They explained 46% of the total variation in the equation.Conclusions 1 The elderly patients with chronic diseases in hospital shows a low level of ACP awareness.2 Generally elderly patients with chronic diseases in hospital have a positive attitude towards ACP.3 Using natural accept attitude of death,the less fear and anxiety,the higher the health literacy,nearly five years with relatives have Life-sustaining treatments experience,cancer,activities daily living more bad,the heavier treatment burden,with more family resilience and would be better.Figure2;Table18;Reference 105... |
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