Exploring the Issues of Advance Directives in Patients with Mild Dementia in Taiwan

被引:0
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作者
Chou, Hsi-Hsien [1 ,2 ]
机构
[1] Chung Shan Med Univ, Sch Med, Taichung 40201, Taiwan
[2] Chung Shan Med Univ Hosp, Dept Neurol, Taichung, Taiwan
关键词
advance directive; dementia; patient autonomy; quality of life; culture; OF-LIFE CARE; DECISION-MAKING; FAMILY; PHYSICIAN; ATTITUDES; CONSENT; GOALS;
D O I
暂无
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Due to cultural traditions, most Taiwanese do not have an advance directive or healthcare proxy. We explored how patients with mild dementia in Taiwan may still make self-determined decisions concerning advance directives for their healthcare and end-of-life care choices as the disease progresses. We examined 260 respondents with mild dementia at a Taiwan medical center: 199 patients who agreed (and 61 patients who disagreed) with the concept of advance directives completed a structured questionnaire. Multiple logistic regression models to determine the between-group differences revealed that the following were positively associated with approval of end-of-life directives: maintaining one's quality of life (adjusted odds ratio [AOR], 2.44; 95% CI: 1.07-5.53), discussion with family members (AOR, 3.50; 95% CI: 1.49-8.26), and friend support networks (AOR, 3.36; 95% CI: 1.34-8.43). Cardiopulmonary resuscitation (AOR, 0.27; 95% CI: 0.09-0.79) was negatively associated with approval. There was also a positive association between the support of the legal validity of end-of-life directives (OR, 1.93; 95% CI: 1.07-3.48), without other confounding factors. In Taiwanese society, we remain mindful of cultural influences that may impact patients, including maintaining one's quality of life, discussion with family members, and friend/support networks. These influences may help dementia patients complete their advance directives.
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页码:215 / 220
页数:6
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