A Study On The Readiness Of Pre-established Medical Care Plans For Patients With Chronic Diseases And Its Influencing Factors

Background:Advance Care Planning(ACP)is a process in which patients discuss and communicate with relatives and medical staffs to determine the medical care treatments that are adopted when they lose decision-making ability in future,helps to maintain personal independent rights.The current development status in China is still in its infancy.In order to understand the feasibility of ACP implementation in chronic disease patients,this study explored patients' readiness status and influencing factors.Objectives:1.Describe the current status of ACP readiness in patients with chronic diseases;2.Determine the influencing factors of ACP readiness in patients with chronic diseases.Methods:Convenient sampling is adopted from Community Health Service Centers.Totally 168 patients with chronic diseases were recruited for status analysis and influencing factors analysis.The "ACP Readiness Questionnaire for patients with chronic diseases" was used to measure patients' ACP readiness.A series of instruments were used to measure the influencing factors of ACP readiness.Multiple linear regressions were used to determine the influencing factors of ACP readiness.Results:1.The overall score of ACP readiness was(86.33± 14.15),most were above the medium level.The average score of three dimensions were:attitude to ACP was(37.83 ±8.03),were above the medium level.Belief of ACP was(21.13±2.79),were on the high level.Motivation of ACP was(28.52±4.32),were above the medium level.2.Regression results showed that the influencing factors for ACP readiness were negative coping,positive coping,trust in physicians,duration of illness,experience of taking care families in end-of-life.Conclusions:1.This study used a self-designed "ACP Readiness Questionnaire for patients with chronic diseases" to investigate chronic patients.Results showed that patients'ACP readiness were mostly above the medium level.Indicating that ACP implementation is feasible.2.The factors affecting ACP readiness of patients with chronic diseases include:negative coping,positive coping,trust in physicians,duration of illness,experience of taking care families in end-of-life.The patients with longer duration of diseases,with less negative coping solutions,with more negative coping solutions,the higher level trust in doctors,with more experience of taking care families in end-of-life,ACP readiness would be better.