Determinants of preparation for future care among community-dwelling older adults with chronic diseases: A...

This study aimed to identify the influencing factors of preparation for future care among community-dwelling older adults with chronic diseases. A convergent mixed-method design was employed, collecting data from May to July 2024 in Hangzhou, Zhejiang Province, southeast China. Quantitative participants were recruited through convenience sampling and assessed using the Preparation for Future Care Needs Scale (PFCN), Health Literacy Management Scale (HeLMS), Family Adaptation, Partnership, Growth, Affection, and Resolve (APGAR), Chronic Illness Resource Survey Scale (CIRS), 10-item Connor-Davidson Resilience Scale (CD-RISC-10), and Brief Illness Perception Questionnaire (BIPQ), while qualitative participants were selected via maximum variation sampling for semi-structured interviews. Quantitative data were analyzed using multiple linear regression and network analysis, and qualitative data were examined through deductive thematic analysis. Findings from both strands were integrated through triangulation based on Andersen's behavioral model of health service utilization. In total, 362 and 16 older adults participated in the quantitative study and qualitative study, respectively. After integration, three themes and nine subthemes were identified as multidimensional factors influencing preparation for future care, including predisposing factors (beliefs in filial piety, family structure, age, health literacy), enabling factors (care resources, economic status, social support), and need factors (physical health and mental health). The findings emphasize the need for strategies addressing traditional beliefs, strengthen family and social support systems, and improve accessibility and quality of care resources, thereby fostering proactive preparation for future care among older adults with chronic conditions.