Advance Care Planning Intention and Associated Factors Among People With Dementia: A Mixed-Methods Study

Area of Science:

• Gerontology
• Public Health
• Sociology

Background:

• Advance care planning (ACP) is crucial for individuals with dementia to ensure their wishes are respected.
• Understanding ACP intentions in China's dementia population is vital for culturally sensitive care.
• Existing research often overlooks the specific socio-cultural context of dementia care in China.

Purpose of the Study:

• To investigate the prevalence of advance care planning intentions among people living with dementia in China.
• To identify individual, social, and cultural factors associated with these intentions.
• To inform the development of effective ACP interventions within the Chinese context.

Main Methods:

• An explanatory sequential mixed-methods design combining quantitative surveys and qualitative interviews.
• Quantitative surveys assessed ACP intentions and associated factors using established models (Knowledge-Attitude-Practice, Theory of Planned Behaviour).
• Qualitative semi-structured interviews explored participants' perceptions and experiences with ACP.

Main Results:

• A moderately high level of advance care planning behavioral intention was observed.
• Higher education, religious beliefs, greater ACP knowledge, positive attitudes, and stronger subjective norms were linked to increased intentions.
• Qualitative themes revealed positive attitudes tempered by limited awareness, the role of supportive relationships, and the influence of cultural norms on ACP engagement.

Conclusions:

• Advance care planning intentions in people with dementia are influenced by a complex interplay of social, familial, and individual factors.
• Public awareness campaigns, cultural sensitivity, and professional support are essential for promoting ACP.
• Further large-scale, multicenter studies are recommended to refine intervention strategies for ACP in China.