Background Singapore’s Ministry of Health commissioned the Agency of Integrated Care (AIC) as the country’s National Care Integrator, to orchestrate health initiatives for the elderly. Through advocacy initiatives, AIC has pushed to increase advance-care-planning (ACP) engagement since 2011. ‘ACP week’, jointly organized by ACP providers occurs at a local roadshow. In conjunction, Project Happy Apples (PHA), a local community-initiative-project led by NUS medical students, conducts a public exhibition to raise ACP awareness. This study aims to investigate and identify predictors of attitudes towards ACP documentation among respondents.
Methods During the 2022 National ‘ACP Week’ Roadshow and PHA public exhibition, cross-sectional data on ACP documentation attitudes of 262 participants were collected anonymously. The 4 documentation attitudes markers are readiness to designate a nominated-healthcare-spokesperson (NHS), readiness to discuss EOL care with NHS, readiness to discuss EOL care with Health Care Professional (HCP), and readiness to document preferred EOL care, graded on a Likert scale of 1 to 5. Results were dichotomized into a low (1,2,3) and high readiness group (4,5) and multiple logistic regression models were built to investigate the associations between demographic variables and attitudes towards ACP documentations
Results The respondents comprised 79 (30.2%) males and 49 (20.8%) HCPs. The mean age was 43.5 (SD=17.4). Overall, 117 (44.7%) had prior serious illness experience (personal/friends/family) and 116 (44.3%) have heard of ACP. Age and prior serious illness experience (SIE) were significant predictors of readiness to discuss EOL care with HCP (Age: OR=1.83, 95%CI=1.04,3.32), (SIE: OR=3.90, 95%CI=1.38,14.0) and signing official papers about preferred EOL care (Age: OR=1.74, 95%CI=1.03,3.03), (SIE: OR=3.67, 95%CI=1.42,11.5).
Conclusion Age and prior serious illness experience were significantly associated with readiness to discuss EOL care with HCP and signing official papers about preferred EOL care. Advocacy programs targeting participants of different age groups and prior experience may be helpful.
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