A systematic review of non-seriously ill community-dwelling asians' views on advance care planning
Document Type
Article
Publication Date
12-1-2023
Abstract
Objectives: To systematically synthesize the views of community-dwelling Asians on Advance care planning and to summarize the factors and reasons affecting their uptake of ACP. Design: Mixed-methods systematic review (PROSPERO: CRD42018091033). Setting and Participants: Asian adults (>= 18 years old) living in the community globally. Methods: Medline (Ovid), Web of Science, CINAHL (EBSCO), Open Grey, and Google Scholar were searched from inception to June 30, 2022. Qualitative, quantitative, or mixed-methods studies reporting on the views of non-seriously ill community-dwelling Asian adults on ACP or the factors influencing their ACP uptake were included. Secondary research, studies not published in English, or studies not available as full text were excluded. Two independent teams of researchers extracted data, assessed methodologic quality, and performed the data analysis. Data analysis was conducted using the multistep convergent integrated approach based on Joanna Briggs Institute methodology for mixed-methods systematic review. Results: Fifty-eight studies were included. Non-seriously ill community-dwelling Asians were willing to engage in ACP (46.5%-84.4%) although their awareness (3.1%-42.9%) and uptake of ACP remained low (14.0%-53.4%). Background factors (sociodemographic factors, and health status, as well as experience and exposure to information) and underlying beliefs (attitude toward ACP, subjective norm, and perceived behavioral control) were found to affect their uptake of ACP. A conceptual framework was developed to facilitate a proper approach to ACP for this population. Conclusions and Implications: A flexible approach toward ACP is needed for non-seriously ill communitydwelling Asians. There is also a need to raise end-of-life and ACP literacy, and to explore ways to narrow the gap in the expectations and implementation of ACP so that trust in its effective execution can be built. (c) 2023 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
Keywords
Advance care planning, advance directives, systematic review, Asian people, community-dwelling adult, attitude
Divisions
primarycare
Funders
University of Malaya Research Grant [Grant no. RP048D-17HTM]
Publication Title
Journal of the American Medical Directors Association
Volume
24
Issue
12
Publisher
Elsevier Science Inc
Publisher Location
STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA