Factors associated with advance directives completion among patients with advance care planning communication in Taipei, Taiwan.

<h4>Background</h4>Although advance directives (AD) have been implemented for years in western countries, the concept of AD is not promoted extensively in eastern countries. In this study we evaluate a program to systematically conduct advance care planning (ACP) communication for hospit...

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Main Authors: Dachen Chu, Yung-Feng Yen, Hsiao-Yun Hu, Yun-Ju Lai, Wen-Jung Sun, Ming-Chung Ko, Li-Ying Huang, Chu-Chieh Chen, J Randall Curtis, Ya-Ling Lee, Sheng-Jean Huang
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2018-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0197552&type=printable
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author Dachen Chu
Yung-Feng Yen
Hsiao-Yun Hu
Yun-Ju Lai
Wen-Jung Sun
Ming-Chung Ko
Li-Ying Huang
Chu-Chieh Chen
J Randall Curtis
Ya-Ling Lee
Sheng-Jean Huang
author_facet Dachen Chu
Yung-Feng Yen
Hsiao-Yun Hu
Yun-Ju Lai
Wen-Jung Sun
Ming-Chung Ko
Li-Ying Huang
Chu-Chieh Chen
J Randall Curtis
Ya-Ling Lee
Sheng-Jean Huang
author_sort Dachen Chu
collection DOAJ
description <h4>Background</h4>Although advance directives (AD) have been implemented for years in western countries, the concept of AD is not promoted extensively in eastern countries. In this study we evaluate a program to systematically conduct advance care planning (ACP) communication for hospitalized patients in Taiwan and identify the factors associated with AD completion.<h4>Methods</h4>In this retrospective evaluation of a clinical ACP program, we identified adult patients with chronic life-limiting illness admitted to Taipei City Hospital between April 2015 and January 2016. Trained healthcare providers held an ACP meeting to discuss patients' preference regarding end-of-life care and AD completion. A multiple logistic regression was performed to determine the factors associated with the AD completion.<h4>Results</h4>A total of 2878 patients were determined to be eligible for ACP during the study, among which 1798 (62.5%) completed ACP and data was available for 1411 patients (49.1%). Of the 1411 patients who received ACP communication with complete data, the rate of AD completion was 82.6%. The overall mean (SD) age was 78.2 (14.4) years. Adjusting for other variables, AD completion was associated with patients aged ≥ 85 years [adjusted odds ratio (AOR) = 1.80, 95% CI 1.21-2.67], critical illness (AOR = 1.17, 95% CI 1.06-1.30), and social workers participating in ACP meetings (AOR = 1.74, 95% CI 1.24-2.45).<h4>Conclusion</h4>The majority of inpatients with chronic life-limiting illness had ACP communication as part of this ACP program and over 80% completed an AD. Our study demonstrates the feasibility of implementing ACP discussion in East Asia and suggests that social workers may be an important component of ACP communication with patients.
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spelling doaj-art-4aef335dd81d4d5bbb78a911ca6468822025-08-20T02:45:57ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01137e019755210.1371/journal.pone.0197552Factors associated with advance directives completion among patients with advance care planning communication in Taipei, Taiwan.Dachen ChuYung-Feng YenHsiao-Yun HuYun-Ju LaiWen-Jung SunMing-Chung KoLi-Ying HuangChu-Chieh ChenJ Randall CurtisYa-Ling LeeSheng-Jean Huang<h4>Background</h4>Although advance directives (AD) have been implemented for years in western countries, the concept of AD is not promoted extensively in eastern countries. In this study we evaluate a program to systematically conduct advance care planning (ACP) communication for hospitalized patients in Taiwan and identify the factors associated with AD completion.<h4>Methods</h4>In this retrospective evaluation of a clinical ACP program, we identified adult patients with chronic life-limiting illness admitted to Taipei City Hospital between April 2015 and January 2016. Trained healthcare providers held an ACP meeting to discuss patients' preference regarding end-of-life care and AD completion. A multiple logistic regression was performed to determine the factors associated with the AD completion.<h4>Results</h4>A total of 2878 patients were determined to be eligible for ACP during the study, among which 1798 (62.5%) completed ACP and data was available for 1411 patients (49.1%). Of the 1411 patients who received ACP communication with complete data, the rate of AD completion was 82.6%. The overall mean (SD) age was 78.2 (14.4) years. Adjusting for other variables, AD completion was associated with patients aged ≥ 85 years [adjusted odds ratio (AOR) = 1.80, 95% CI 1.21-2.67], critical illness (AOR = 1.17, 95% CI 1.06-1.30), and social workers participating in ACP meetings (AOR = 1.74, 95% CI 1.24-2.45).<h4>Conclusion</h4>The majority of inpatients with chronic life-limiting illness had ACP communication as part of this ACP program and over 80% completed an AD. Our study demonstrates the feasibility of implementing ACP discussion in East Asia and suggests that social workers may be an important component of ACP communication with patients.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0197552&type=printable
spellingShingle Dachen Chu
Yung-Feng Yen
Hsiao-Yun Hu
Yun-Ju Lai
Wen-Jung Sun
Ming-Chung Ko
Li-Ying Huang
Chu-Chieh Chen
J Randall Curtis
Ya-Ling Lee
Sheng-Jean Huang
Factors associated with advance directives completion among patients with advance care planning communication in Taipei, Taiwan.
PLoS ONE
title Factors associated with advance directives completion among patients with advance care planning communication in Taipei, Taiwan.
title_full Factors associated with advance directives completion among patients with advance care planning communication in Taipei, Taiwan.
title_fullStr Factors associated with advance directives completion among patients with advance care planning communication in Taipei, Taiwan.
title_full_unstemmed Factors associated with advance directives completion among patients with advance care planning communication in Taipei, Taiwan.
title_short Factors associated with advance directives completion among patients with advance care planning communication in Taipei, Taiwan.
title_sort factors associated with advance directives completion among patients with advance care planning communication in taipei taiwan
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0197552&type=printable
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