Palliative care and social practice · 2025
Understanding attitudes and preferences towards advance care planning in older adults: Insights from a cross-sectional study in primary care.
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Anantapong Kanthee, Rangsee Pawara Na, Ananchaisarp Thareerat
Аннотация
BACKGROUND: Advance care planning (ACP) is crucial for ensuring quality end-of-life care, yet its implementation remains limited in Thailand.
OBJECTIVES: To understand the attitudes and preferences of older Thai adults towards ACP in primary care settings.
DESIGN: A cross-sectional study was conducted using structured interviews. Data on demographics, health status, attitudes, and preferences towards ACP were collected. Multivariable analysis was performed to identify factors associated with ACP attitudes and preferences.
SETTING/SUBJECTS: Participants aged 60 years or older at the Primary Care Unit of Songklanagarind Hospital, Thailand, between June and December 2022.
RESULTS: Among 250 participants, 60% had high comorbidity levels (Charlson Comorbidity Index >3). While most participants demonstrated high attitude levels towards ACP, over 40% did not want to make an ACP, and 37.2% wanted to postpone it. Higher educational levels (adjusted OR (aOR) = 2.17, 95% CI: 1.16-4.06) and prior ACP discussions (aOR = 4.08, 95% CI: 1.38-12.08) were significantly associated with high attitude levels. Participants with high attitude levels showed greater odds of desiring to engage in ACP (aOR = 2.81, 95% CI: 1.45-5.42). Those with higher education (aOR = 2.09, 95% CI: 1.1-3.98) and family members who received life-sustaining treatment (aOR = 1.9, 95% CI: 1.02-3.55) were more likely to prefer ACP engagement.
CONCLUSION: Tailored education and repeated ACP discussions are needed to bridge the gap between attitudes and engagement among older Thai adults.
OBJECTIVES: To understand the attitudes and preferences of older Thai adults towards ACP in primary care settings.
DESIGN: A cross-sectional study was conducted using structured interviews. Data on demographics, health status, attitudes, and preferences towards ACP were collected. Multivariable analysis was performed to identify factors associated with ACP attitudes and preferences.
SETTING/SUBJECTS: Participants aged 60 years or older at the Primary Care Unit of Songklanagarind Hospital, Thailand, between June and December 2022.
RESULTS: Among 250 participants, 60% had high comorbidity levels (Charlson Comorbidity Index >3). While most participants demonstrated high attitude levels towards ACP, over 40% did not want to make an ACP, and 37.2% wanted to postpone it. Higher educational levels (adjusted OR (aOR) = 2.17, 95% CI: 1.16-4.06) and prior ACP discussions (aOR = 4.08, 95% CI: 1.38-12.08) were significantly associated with high attitude levels. Participants with high attitude levels showed greater odds of desiring to engage in ACP (aOR = 2.81, 95% CI: 1.45-5.42). Those with higher education (aOR = 2.09, 95% CI: 1.1-3.98) and family members who received life-sustaining treatment (aOR = 1.9, 95% CI: 1.02-3.55) were more likely to prefer ACP engagement.
CONCLUSION: Tailored education and repeated ACP discussions are needed to bridge the gap between attitudes and engagement among older Thai adults.