Ben P White1, Lindy Willmott1, Cheryl Tilse2, Jill Wilson2, Michele Ferguson3, Joanne Aitken4, Jeffrey Dunn5, Deborah Lawson6, Angela Pearce7, Rachel Feeney1. 1. Australian Centre for Health Law Research, Queensland University of Technology, Brisbane, Queensland, Australia. 2. School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia. 3. The University of Queensland, Queensland University of Technology, Brisbane, Queensland, Australia. 4. Cancer Council Queensland, Queensland, Australia. 5. University of Southern Queensland, Toowoomba, Queensland, Australia. 6. Cancer Council Victoria, Melbourne, Victoria, Australia. 7. Cancer Council New South Wales, Sydney, New South Wales, Australia.
Abstract
BACKGROUND: The community prevalence of advance care directives (ACD) is low despite known benefits of advance care planning for patients, families and health professionals. AIM: To determine the community prevalence of instructional and appointing ACD in New South Wales, Victoria and Queensland and factors associated with completion of these documents. METHODS: A telephone survey of adults living in New South Wales, Victoria and Queensland (n = 1175) about completion of instructional ACD (making their own decisions about future healthcare) and appointing ACD (appointing another to decide). Quota sampling occurred based on population size by state, gender and age, with oversampling in smaller jurisdictions (Victoria and Queensland). RESULTS: Overall response rate was 33%. Six per cent of respondents reported completing an instructional ACD while 12% reported completing an appointing ACD. Female gender, higher educational level, personal experience of a major health scare and being widowed were significant predictors of completing an instructional ACD. Older age, higher educational level and being widowed were significant predictors of completing an appointing ACD. CONCLUSIONS: Despite long-standing efforts to increase advance care planning, community prevalence of ACD remains low, particularly for instructional ACD. This study found some different predictors for instructional ACD compared with appointing ACD, and also a potential role for experiential factors in triggering uptake. These findings suggest supplementing general community awareness campaigns with more nuanced and targeted efforts to improve ACD completion.
BACKGROUND: The community prevalence of advance care directives (ACD) is low despite known benefits of advance care planning for patients, families and health professionals. AIM: To determine the community prevalence of instructional and appointing ACD in New South Wales, Victoria and Queensland and factors associated with completion of these documents. METHODS: A telephone survey of adults living in New South Wales, Victoria and Queensland (n = 1175) about completion of instructional ACD (making their own decisions about future healthcare) and appointing ACD (appointing another to decide). Quota sampling occurred based on population size by state, gender and age, with oversampling in smaller jurisdictions (Victoria and Queensland). RESULTS: Overall response rate was 33%. Six per cent of respondents reported completing an instructional ACD while 12% reported completing an appointing ACD. Female gender, higher educational level, personal experience of a major health scare and being widowed were significant predictors of completing an instructional ACD. Older age, higher educational level and being widowed were significant predictors of completing an appointing ACD. CONCLUSIONS: Despite long-standing efforts to increase advance care planning, community prevalence of ACD remains low, particularly for instructional ACD. This study found some different predictors for instructional ACD compared with appointing ACD, and also a potential role for experiential factors in triggering uptake. These findings suggest supplementing general community awareness campaigns with more nuanced and targeted efforts to improve ACD completion.
Authors: Karen M Detering; Kimberly Buck; Marcus Sellars; Helana Kelly; Craig Sinclair; Ben White; Linda Nolte Journal: BMJ Open Date: 2019-10-28 Impact factor: 2.692
Authors: Craig Sinclair; Marcus Sellars; Kimberly Buck; Karen M Detering; Ben P White; Linda Nolte Journal: J Gerontol B Psychol Sci Soc Sci Date: 2021-01-01 Impact factor: 4.077