Understanding the Role of Knowledge in Advance Care Planning Engagement
| Autor: | Laura I. van Dyck, Andrea L. Paiva, Colleen A. Redding, Terri R. Fried |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Advance care planning
Gerontology Male Context (language use) Article law.invention 03 medical and health sciences Advance Care Planning 0302 clinical medicine Randomized controlled trial law Health care Medicine Humans 030212 general & internal medicine Patient participation General Nursing Aged business.industry Odds ratio Middle Aged Confidence interval Living Wills Anesthesiology and Pain Medicine Cross-Sectional Studies 030220 oncology & carcinogenesis Scale (social sciences) Neurology (clinical) business |
| Zdroj: | J Pain Symptom Manage |
| Popis: | Context Advance care planning remains underutilized. A better understanding of the role of education in promoting engagement is needed. Objectives To examine advance care planning knowledge and its relationship to engagement in middle-aged and older adults. Methods This cross-sectional study utilized baseline data from 921 participants age ≥55 years enrolled in the STAMP randomized controlled trial, including a knowledge scale consisting of seven questions regarding the purpose and mechanisms of advance care planning and measures of participation. Results Only 11.9% of participants answered all 7 questions correctly, and 25.6% of participants answered ≤3 correctly (defined as “low knowledge”). Low knowledge was independently associated with male gender (odds ratio [OR] 2.1, 95% confidence interval [CI]: 1.5, 3.0), non-white race (OR 1.5, 95% CI: 1.1, 2.2), older age (OR 2.2, 95% CI: 1.4, 3.4), lower income (OR 1.5, 95% CI: 1.1, 2.1), and lower education level (OR 2.9, 95% CI: 2.0, 4.1). Higher knowledge was independently associated with communicating with a loved one about quality versus quantity of life (OR 1.7, 95% CI: 1.2, 2.4) and with living will completion (OR 1.6, 95% CI: 1.0, 2.5), but not with healthcare agent assignment. Factors including race and education remained associated with engagement after accounting for knowledge. Conclusion Knowledge deficits regarding advance care planning are common and associated with the same sociodemographic factors linked to other healthcare disparities. While improving knowledge is an important component of intervention, it is unlikely sufficient in and of itself to increase engagement. |
| Databáze: | OpenAIRE |
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