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Advance care planning in the community: factors of influence
  1. Joshua Gallagher1,2,
  2. Timothy Bolt2,3 and
  3. Nanako Tamiya2,4
  1. 1 School of Global and Area Studies, University of Oxford, Oxford, UK
  2. 2 Health Services Research & Development Center, University of Tsukuba, Tsukuba, Japan
  3. 3 Department of Economics, Saitama University, Saitama, Japan
  4. 4 Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
  1. Correspondence to Joshua Gallagher, School of Global and Area Studies, University of Oxford, Oxford OX1 2JD, UK; joshuajmgallagher{at}gmail.com

Abstract

Objectives This study aims to identify factors among British community-based adults associated with advance care planning engagement. Factors are then compared among six domains of wishes: medical care, spiritual and religious needs, privacy and peace, dignified care, place of death and pain relief.

Methods Cross-sectional data were analysed from a stratified random sample of adults across Great Britain (England, Scotland and Wales) who were interviewed on their attitudes towards death and dying. Weighted multivariable logistic regression tested for associations with expressing any end-of-life wishes and then for each separate domain.

Results Analysis of 2042 respondents (response rate: 53.5%) revealed those less likely to have discussed their wishes were: male, younger, born in the UK, owned their residence, had no experience working in health or social care, had no chronic conditions or disabilities, had not experienced the death of a close person in the last 5 years and feel neither comfortable nor uncomfortable or uncomfortable talking about death. Additional factors among the six domains associated with having not discussed wishes include: having less and more formal education, no religious beliefs, lower household income and living with at least one other person.

Conclusions This study is the first to be conducted among a sample of community-dwelling British adults and the first of its kind to compare domains of end-of-life wishes. Our findings provide an understanding of social determinants which can inform a public health approach to end-of-life care that promotes advance care planning among compassionate communities.

  • communication
  • terminal care

Data availability statement

Data are available in a public, open access repository. Data used in this study are available under an End User License from the ReShare Data Repository operated by the UK Data Service. Accessed from: http://doi.org/10.5255/UKDA-SN-7476-1.

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Data availability statement

Data are available in a public, open access repository. Data used in this study are available under an End User License from the ReShare Data Repository operated by the UK Data Service. Accessed from: http://doi.org/10.5255/UKDA-SN-7476-1.

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Footnotes

  • Twitter @JoshJMGallagher

  • Contributors JG conceived the project, located the dataset, conducted analysis and drafted the paper. NT oversaw the project and gave feedback on the initial and subsequent drafts of the manuscript. TB gave critical feedback on subsequent drafts of the paper. All authors reviewed and approved the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.