Factors influencing attitudes toward advance directives in Korean older adults

Ji Eun Lee, Dong Wook Shin, Ki Young Son, Hyun Jung Park, Jae-Young Lim, Mi Soon Song, Yeon Hwan Park, Belong Cho

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Aim We aimed to determine the factors influencing attitudes toward advance directives in Korean older adults with consideration of an Asian cultural background. Methods We recruited community-dwelling older adults aged 60 years or older at a regional senior welfare center in Korea. Demographic factors and mental and physical health status were examined using questionnaires and a physical examination. The questionnaire also assessed perceived necessity of advance directives and related experiences. Results Most participants (79.32%) agreed that advance directives were necessary. Older adults with high education levels (odds ratio [OR] 2.31, 95% confidence interval [CI] 0.84–6.34), low economic status (OR 2.09, 95% C.I. 0.60–7.27), and poor cognitive function (adjusted odds ratio [aOR] 2.10, 95% CI 0.89–4.97) had a greater odds of agreeing that advance directives are necessary. All participants with self-care problems (9/9) and most participants with at risk status of physical functioning (13/14) reported agreement. Death-related experiences were also associated. Notably, individuals who had discussions on end-of-life care with family members showed a greater odds of agreeing that advance directives are necessary (aOR 2.12, 95% CI 0.88–5.11). Conclusions The factors associated with increased agreement that advance directives are necessary were high education level, low economic status, poor cognitive function, problems in self-care, poor physical functioning, death-related experiences. Especially, discussions of end-of-life care with family members increased the agreement. Thus, discussion on end-of-life care should be encouraged and the factors influencing older adults’ attitudes toward advance directives should be considered in developing policies for such discussion.

Original languageEnglish
Pages (from-to)155-161
Number of pages7
JournalArchives of Gerontology and Geriatrics
Volume74
DOIs
StatePublished - 1 Jan 2018

Fingerprint

Advance Directives
Terminal Care
confidence
Odds Ratio
family member
Confidence Intervals
Self Care
death
Cognition
experience
questionnaire
Senior Centers
Economics
demographic factors
Independent Living
Education
Korea
health status
economics
education

Keywords

  • Advance care planning
  • Advance directives
  • End-of-life
  • Family discussion
  • Personal experience

Cite this

Lee, Ji Eun ; Shin, Dong Wook ; Son, Ki Young ; Park, Hyun Jung ; Lim, Jae-Young ; Song, Mi Soon ; Park, Yeon Hwan ; Cho, Belong. / Factors influencing attitudes toward advance directives in Korean older adults. In: Archives of Gerontology and Geriatrics. 2018 ; Vol. 74. pp. 155-161.
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abstract = "Aim We aimed to determine the factors influencing attitudes toward advance directives in Korean older adults with consideration of an Asian cultural background. Methods We recruited community-dwelling older adults aged 60 years or older at a regional senior welfare center in Korea. Demographic factors and mental and physical health status were examined using questionnaires and a physical examination. The questionnaire also assessed perceived necessity of advance directives and related experiences. Results Most participants (79.32{\%}) agreed that advance directives were necessary. Older adults with high education levels (odds ratio [OR] 2.31, 95{\%} confidence interval [CI] 0.84–6.34), low economic status (OR 2.09, 95{\%} C.I. 0.60–7.27), and poor cognitive function (adjusted odds ratio [aOR] 2.10, 95{\%} CI 0.89–4.97) had a greater odds of agreeing that advance directives are necessary. All participants with self-care problems (9/9) and most participants with at risk status of physical functioning (13/14) reported agreement. Death-related experiences were also associated. Notably, individuals who had discussions on end-of-life care with family members showed a greater odds of agreeing that advance directives are necessary (aOR 2.12, 95{\%} CI 0.88–5.11). Conclusions The factors associated with increased agreement that advance directives are necessary were high education level, low economic status, poor cognitive function, problems in self-care, poor physical functioning, death-related experiences. Especially, discussions of end-of-life care with family members increased the agreement. Thus, discussion on end-of-life care should be encouraged and the factors influencing older adults’ attitudes toward advance directives should be considered in developing policies for such discussion.",
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Factors influencing attitudes toward advance directives in Korean older adults. / Lee, Ji Eun; Shin, Dong Wook; Son, Ki Young; Park, Hyun Jung; Lim, Jae-Young; Song, Mi Soon; Park, Yeon Hwan; Cho, Belong.

In: Archives of Gerontology and Geriatrics, Vol. 74, 01.01.2018, p. 155-161.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Factors influencing attitudes toward advance directives in Korean older adults

AU - Lee, Ji Eun

AU - Shin, Dong Wook

AU - Son, Ki Young

AU - Park, Hyun Jung

AU - Lim, Jae-Young

AU - Song, Mi Soon

AU - Park, Yeon Hwan

AU - Cho, Belong

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Aim We aimed to determine the factors influencing attitudes toward advance directives in Korean older adults with consideration of an Asian cultural background. Methods We recruited community-dwelling older adults aged 60 years or older at a regional senior welfare center in Korea. Demographic factors and mental and physical health status were examined using questionnaires and a physical examination. The questionnaire also assessed perceived necessity of advance directives and related experiences. Results Most participants (79.32%) agreed that advance directives were necessary. Older adults with high education levels (odds ratio [OR] 2.31, 95% confidence interval [CI] 0.84–6.34), low economic status (OR 2.09, 95% C.I. 0.60–7.27), and poor cognitive function (adjusted odds ratio [aOR] 2.10, 95% CI 0.89–4.97) had a greater odds of agreeing that advance directives are necessary. All participants with self-care problems (9/9) and most participants with at risk status of physical functioning (13/14) reported agreement. Death-related experiences were also associated. Notably, individuals who had discussions on end-of-life care with family members showed a greater odds of agreeing that advance directives are necessary (aOR 2.12, 95% CI 0.88–5.11). Conclusions The factors associated with increased agreement that advance directives are necessary were high education level, low economic status, poor cognitive function, problems in self-care, poor physical functioning, death-related experiences. Especially, discussions of end-of-life care with family members increased the agreement. Thus, discussion on end-of-life care should be encouraged and the factors influencing older adults’ attitudes toward advance directives should be considered in developing policies for such discussion.

AB - Aim We aimed to determine the factors influencing attitudes toward advance directives in Korean older adults with consideration of an Asian cultural background. Methods We recruited community-dwelling older adults aged 60 years or older at a regional senior welfare center in Korea. Demographic factors and mental and physical health status were examined using questionnaires and a physical examination. The questionnaire also assessed perceived necessity of advance directives and related experiences. Results Most participants (79.32%) agreed that advance directives were necessary. Older adults with high education levels (odds ratio [OR] 2.31, 95% confidence interval [CI] 0.84–6.34), low economic status (OR 2.09, 95% C.I. 0.60–7.27), and poor cognitive function (adjusted odds ratio [aOR] 2.10, 95% CI 0.89–4.97) had a greater odds of agreeing that advance directives are necessary. All participants with self-care problems (9/9) and most participants with at risk status of physical functioning (13/14) reported agreement. Death-related experiences were also associated. Notably, individuals who had discussions on end-of-life care with family members showed a greater odds of agreeing that advance directives are necessary (aOR 2.12, 95% CI 0.88–5.11). Conclusions The factors associated with increased agreement that advance directives are necessary were high education level, low economic status, poor cognitive function, problems in self-care, poor physical functioning, death-related experiences. Especially, discussions of end-of-life care with family members increased the agreement. Thus, discussion on end-of-life care should be encouraged and the factors influencing older adults’ attitudes toward advance directives should be considered in developing policies for such discussion.

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KW - End-of-life

KW - Family discussion

KW - Personal experience

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U2 - 10.1016/j.archger.2017.10.008

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