Barriers that predict resistance to completing a living will

Area of Science:

• Medical Ethics
• Health Psychology
• Public Health

Background:

• Living wills, a component of advance care planning, facilitate patient autonomy in end-of-life medical decisions.
• Understanding patient-perceived barriers is crucial for improving the completion rates of advance directives.
• The Health Belief Model provides a framework for exploring health behaviors, including those related to advance care planning.

Purpose of the Study:

• To identify perceived barriers and benefits influencing medical outpatients and their family members in completing living wills.
• To explore the applicability of the Health Belief Model in understanding advance directive completion.

Main Methods:

• A questionnaire survey was administered to 176 medical outpatients and/or their family members.
• Data were analyzed using regression analysis to identify significant predictors of living will completion.

Main Results:

• For patients, significant barriers included a belief in prolonged life expectancy and difficulty in making definitive end-of-life care decisions.
• No significant barriers were identified when analyzing data from family members.
• The study suggests that living wills are perceived by patients as directly related to personal mortality.

Conclusions:

• A primary barrier to completing living wills is their association with personal death.
• Interventions aimed at increasing advance directive completion should address patients' perceptions of mortality and decision-making uncertainty.
• Further research is needed to explore family member perspectives and refine strategies for promoting advance care planning.