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Prevalence of advance care directives in the community: a telephone survey of three Australian States.
Intern Med J. 2019 10; 49(10):1261-1267.IM

Abstract

BACKGROUND

The community prevalence of advance care directives (ACD) is low despite known benefits of advance care planning for patients, families and health professionals.

AIM

To determine the community prevalence of instructional and appointing ACD in New South Wales, Victoria and Queensland and factors associated with completion of these documents.

METHODS

A telephone survey of adults living in New South Wales, Victoria and Queensland (n = 1175) about completion of instructional ACD (making their own decisions about future healthcare) and appointing ACD (appointing another to decide). Quota sampling occurred based on population size by state, gender and age, with oversampling in smaller jurisdictions (Victoria and Queensland).

RESULTS

Overall response rate was 33%. Six per cent of respondents reported completing an instructional ACD while 12% reported completing an appointing ACD. Female gender, higher educational level, personal experience of a major health scare and being widowed were significant predictors of completing an instructional ACD. Older age, higher educational level and being widowed were significant predictors of completing an appointing ACD.

CONCLUSIONS

Despite long-standing efforts to increase advance care planning, community prevalence of ACD remains low, particularly for instructional ACD. This study found some different predictors for instructional ACD compared with appointing ACD, and also a potential role for experiential factors in triggering uptake. These findings suggest supplementing general community awareness campaigns with more nuanced and targeted efforts to improve ACD completion.

Authors+Show Affiliations

Australian Centre for Health Law Research, Queensland University of Technology, Brisbane, Queensland, Australia.Australian Centre for Health Law Research, Queensland University of Technology, Brisbane, Queensland, Australia.School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia.School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia.The University of Queensland, Queensland University of Technology, Brisbane, Queensland, Australia.Cancer Council Queensland, Queensland, Australia.University of Southern Queensland, Toowoomba, Queensland, Australia.Cancer Council Victoria, Melbourne, Victoria, Australia.Cancer Council New South Wales, Sydney, New South Wales, Australia.Australian Centre for Health Law Research, Queensland University of Technology, Brisbane, Queensland, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30785233

Citation

White, Ben P., et al. "Prevalence of Advance Care Directives in the Community: a Telephone Survey of Three Australian States." Internal Medicine Journal, vol. 49, no. 10, 2019, pp. 1261-1267.
White BP, Willmott L, Tilse C, et al. Prevalence of advance care directives in the community: a telephone survey of three Australian States. Intern Med J. 2019;49(10):1261-1267.
White, B. P., Willmott, L., Tilse, C., Wilson, J., Ferguson, M., Aitken, J., Dunn, J., Lawson, D., Pearce, A., & Feeney, R. (2019). Prevalence of advance care directives in the community: a telephone survey of three Australian States. Internal Medicine Journal, 49(10), 1261-1267. https://doi.org/10.1111/imj.14261
White BP, et al. Prevalence of Advance Care Directives in the Community: a Telephone Survey of Three Australian States. Intern Med J. 2019;49(10):1261-1267. PubMed PMID: 30785233.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of advance care directives in the community: a telephone survey of three Australian States. AU - White,Ben P, AU - Willmott,Lindy, AU - Tilse,Cheryl, AU - Wilson,Jill, AU - Ferguson,Michele, AU - Aitken,Joanne, AU - Dunn,Jeffrey, AU - Lawson,Deborah, AU - Pearce,Angela, AU - Feeney,Rachel, PY - 2018/10/23/received PY - 2019/01/21/revised PY - 2019/02/02/accepted PY - 2019/2/21/pubmed PY - 2020/5/2/medline PY - 2019/2/21/entrez KW - advance care planning KW - advance directive KW - end-of-life decision-making SP - 1261 EP - 1267 JF - Internal medicine journal JO - Intern Med J VL - 49 IS - 10 N2 - BACKGROUND: The community prevalence of advance care directives (ACD) is low despite known benefits of advance care planning for patients, families and health professionals. AIM: To determine the community prevalence of instructional and appointing ACD in New South Wales, Victoria and Queensland and factors associated with completion of these documents. METHODS: A telephone survey of adults living in New South Wales, Victoria and Queensland (n = 1175) about completion of instructional ACD (making their own decisions about future healthcare) and appointing ACD (appointing another to decide). Quota sampling occurred based on population size by state, gender and age, with oversampling in smaller jurisdictions (Victoria and Queensland). RESULTS: Overall response rate was 33%. Six per cent of respondents reported completing an instructional ACD while 12% reported completing an appointing ACD. Female gender, higher educational level, personal experience of a major health scare and being widowed were significant predictors of completing an instructional ACD. Older age, higher educational level and being widowed were significant predictors of completing an appointing ACD. CONCLUSIONS: Despite long-standing efforts to increase advance care planning, community prevalence of ACD remains low, particularly for instructional ACD. This study found some different predictors for instructional ACD compared with appointing ACD, and also a potential role for experiential factors in triggering uptake. These findings suggest supplementing general community awareness campaigns with more nuanced and targeted efforts to improve ACD completion. SN - 1445-5994 UR - https://www.unboundmedicine.com/medline/citation/30785233/Prevalence_of_advance_care_directives_in_the_community:_a_telephone_survey_of_three_Australian_States_ L2 - https://doi.org/10.1111/imj.14261 DB - PRIME DP - Unbound Medicine ER -