The Readiness For Advance Care Planning And Its Influencing Factors Among Patients With Chronic Heart Failure

ObjectiveTo investigate the current situation of patients with chronic heart failure for Advance Care Planning(ACP)readiness,and analyze the influencing factors of ACP readiness,in order to further explore the intervention strategies of ACP preparedness Provide theoretical support.MethodsThis study adopts a questionnaire survey method.According to the inclusion and exclusion criteria,210 patients with chronic heart failure from July 2020 to January2021 were selected.Research tools include self-designed general information questionnaire,Charlson comorbidity index(CCI),ACP Readiness Questinnaire for patients with chronic diseases,Medical coping style questionnaire(MCMQ),Chinese version of the sense of life meaning scale,and Chinese Version of Templer’s Death Anxiety Scale(C-T-DAS).SPSS25.0 was used to sort and enter the data,use the mean and standard deviation to perform descriptive analysis of the current situation of ACP readiness;use single factor analysis(independent samples t test)and multiple linear regression methods to analyze ACP Factors affecting readiness.Results1.Current status of ACP readiness for patients with chronic heart failure: The total ACP readiness for patients with chronic heart failure is(76.38±9.83)points,of which attitude dimension(33.83±4.85)points;belief dimension(24.66±4.70)points;motivation dimension(24.63±5.60)points.The total score,attitude,belief,and motivation scores are all in the upper-middle level.2.Patients with chronic heart failure scored(21.50±5.11)points for coping styles,yielding coping styles scores(11.56±3.00)points,and avoiding coping styles scores(15.58±4.32)points.The total score of the meaning of life in patients with chronic heart failure is(38.29±6.32)points,which belongs to the middle level.Among them,there is a meaning of life dimension(21.36±3.86)points,and the dimension of finding the meaning of life is(16.93±2.97)points.The median score of death anxiety in patients with chronic heart failure was(7.57±2.11),death anxiety was at a high level,123 people(63.4%)had high death anxiety,and 71(36.6%)people had low death anxiety.3.Single factor analysis showsed that chronic heart failure of different age,education level,personal monthly income,bereavement experience in the past 5 years,family history of heart disease,disease course,cardiac emergency medical treatment experience,NYHA classification,Charlson comorbidity index classification There was a significant difference in ACP readiness scores between patients(P<0.05);the total ACP readiness score and its dimensions were significantly positively correlated with face-to-face coping styles,and significantly negatively correlated with avoidance and yielding coping styles;and life The total score of sense of meaning and each dimension show a positive correlation;the total score of sense of meaning and each dimension show a negative correlation.4.Multiple regression analysis showed that emergency medical experience,family history of heart disease,coping styles,avoidance coping styles,stress and pain,death of relatives in the past 5 years,and age are the main factors of ACP readiness for patients with chronic heart failure Influencing factors can explain 29.5% of the total variation(P<0.05).Conclusion1.Chronic heart failure patients are generally at the upper-moderate level of preparation for ACP,and are also at the upper-moderate level in terms of attitude,motivation and belief;in addition to avoiding and yielding coping styles,some patients also tend to adopt face coping styles;The sense of meaning of life belongs to the medium level;the level of death anxiety is high.2.The patients who adopt avoidance and yield coping styles and the higher the degree of death anxiety are,the less prepared they are for ACP;the patients who adopt face-to-face coping styles are better prepared for ACP.3.Chronic heart failure patients’ readiness for ACP is mainly affected by emergency cardiac medical care experience,family history of heart disease,death history of relatives in the past 5 years,age,coping style,and degree of death anxiety.Medical staff should understand their readiness for ACP Particularity,using a targeted health knowledge intervention system to improve patients’ readiness for ACP and improve the quality of life.