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Clinicians’ practices and attitudes regarding advance care planning in mainland China: A multicenter cross-sectional survey

Published online by Cambridge University Press:  14 March 2022

Siyu Cai
Affiliation:
Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
Xianjing Wang
Affiliation:
Hematology, The Third People's Hospital of Zhengzhou, Henan 450000, China
Ruixin Wang
Affiliation:
Beijing Key Laboratory of Pediatric Hematology Oncology; National Key Discipline of Pediatrics (Capital Medical University); Key Laboratory of Major Diseases in Children, Ministry of Education; Hematology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
Yuchen Zhou
Affiliation:
Pediatric Oncology Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
Xuan Zhou*
Affiliation:
Beijing Key Laboratory of Pediatric Hematology Oncology; National Key Discipline of Pediatrics (Capital Medical University); Key Laboratory of Major Diseases in Children, Ministry of Education; Hematology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
Xiaoxia Peng
Affiliation:
Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
*
Author for correspondence: Xiaoxia Peng, Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China. E-mail: pengxiaoxia@bch.com.cn; Xuan Zhou, Hematology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China. E-mail: bchppc@163.com

Abstract

Objectives

This study aims to explore clinicians’ practices and attitudes regarding advance care planning (ACP) in mainland China.

Methods

This study was a multicenter cross-sectional survey. Clinicians from tertiary hospitals in Beijing, Guangxi, and Inner Mongolia were invited to participate in the study. A questionnaire was formulated based on related literature to obtain information including demographic characteristics, and practices and attitudes toward ACP.

Results

The total number of participants included 285 clinicians. The data response rate was 84.57%. Most of the clinicians had an inadequate understanding of ACP. Only a few clinicians had experience in participating or witnessing an ACP or related end-of-life discussions. Among 285 clinicians, 69.82% of clinicians were willing to introduce ACP to patients. Two hundred and thirty-eight (83.51%) clinicians wanted more education on ACP. Almost all clinicians believed that patients had the right to know about their diagnosis, prognosis, and available care options. Most clinicians (82.11%) regarded that ACP was partially feasible in mainland China. If clinicians had a serious illness, almost everyone was willing to find out their true health status and decide for themselves, and 81.40% wanted to institute an ACP for themselves. The biggest barriers to the use of ACP in mainland China were cultural factors. Statistical analysis revealed that some or good understanding level (P = 0.0052) and practical experience (P = 0.0127) of ACP were associated with the positive willingness.

Significance of results

ACP is still in its infancy in mainland China. Clinicians had inadequate understanding and minimal exposure to ACP. Most clinicians recognized the value and significance of ACP and had a positive attitude toward ACP. Clinicians need to be provided with education and training to promote their ACP practices. Culturally appropriate ACP processes and documents need to be developed based on Chinese culture and Chinese needs.

Type
Original Article
Copyright
© The Author(s), 2022. Published by Cambridge University Press

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Footnotes

*

Xuan Zhou and Xiaoxia Peng contributed equally to this work.

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