Background Families play a primary role in the decision-making of LST (life-sustaining treatments).

Aim To explore the concern of families toward withholding LST for their relatives with COPD (chronic obstructive pulmonary disease) and its related factors.

Methods A cross-sectional descriptive research design was used in this study. Participants’ concern regarding withholding life-sustaining treatments was assessed from a validated questionnaire.

Results A total of 82 family caregivers participated in the study. Most of the respondents (83%) are the children or spouses of the patients. Over half of the families (56%) aware that the LST decision should be made by the patients themselves, although they reported that they had not known their loved one’s willingness toward end of life care yet. If death is inevitable, 80% of the families would like patients to receive comfort care rather than life-prolonging treatments. Of all LST options, the most acceptable treatment was intravenous medications. There was less willing to receive high burden treatments. Families displayed poor knowledge about LST. Families’ knowledge of LST was not related to LST intentions. This study found a significant relationship between LST intentions and age, education level, and knowing the patients’ willingness regarding treatment preferences  (p < 0.05).

Discussion More dialogue is needed between families and patients.

Conclusion The findings of this study can serve as a foundation for family-based advance care planning strategies as we strive to build a mutual communication of LST with families.