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To explore the current status and associated factors of advance care planning intentions among people living with dementia in China.
An explanatory sequential mixed-methods design was adopted.
The research is guided by the knowledge-attitude-practice model and the theory of planned behaviour. Quantitative surveys were used to assess advance care planning intentions and associated factors in people living with dementia, followed by qualitative semi-structured interviews to delve into participants' perceptions and feelings about advance care planning. Quantitative data were analysed using multiple linear regression, while qualitative data were analysed using thematic analysis.
The overall advance care planning behavioural intention was at a moderately high level. The quantitative results revealed that higher education level, certain religious beliefs, greater advance care planning knowledge, positive behavioural attitudes and stronger subjective norms were significantly positively associated with advance care planning intentions. Qualitative analysis identified three themes: positive attitude but limited ACP awareness, supportive relationships enable early ACP consideration and cultural norms shape willingness to engage in ACP.
Advance care planning intentions among people living with dementia are shaped by a combination of social, familial and individual factors. Increasing public awareness, addressing cultural challenges and establishing professional teams are crucial to promoting advance care planning practices. Future research should focus on larger, multicenter studies to enhance intervention strategies.
Although the attitude toward advance care planning is more positive, various factors need to be carefully considered in the process of constructing relative intervention strategies.
This study did not include patient or public involvement in its design, conduct or reporting.
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