The Intention to Engage in Advanced Care Planning among Patients with Heart Failure
Keywords:
intentio, advance care planning, heart failure, theory of planned behaviorAbstract
This study aimed to 1) examine the intention to engage in advanced care planning, and 2) examine the differences in the intention to engage in advanced care planning among patients with heart failure, based on the New York Heart Association [NYHA] functional class, experience in caring for family members with terminal illnesses, and experience with perceived advanced care planning. A part of Ajzen’s theory of planned behavior, the concept of advanced care planning, and a literature review were used as a research framework. 196 participants with heart failure from outpatient departments of five tertiary hospitals in the Public Health Region 4, Thailand, were recruited based on the inclusion criteria: Simple random sampling was used to select participants who met the inclusion criteria. Instruments used for collecting data included 1) a demographic data form and 2) the Intentions for Advanced Care Planning Questionnaire [I-ACPQ]. Five experts validated the I-ACPQ, and the content validity index (CVI) was 1. The reliability of the instrument was tested among 30 patients with heart failure, and Cronbach's alpha was found to be 0.84. Data were analyzed using descriptive statistics and Chi-squared statistics.
This study revealed that the average age of the participants was 60.32 years (SD = 14.09). Most of the participants were male 52.55% (n = 103), 50% (n = 98) had graduated from primary school, 98.98% (n = 194) had co-morbidity, 58.16 (n = 114) had NYHA functional class II, 74.49% (n = 146) had no experience in caring for family members with terminal illnesses, 76.02% (n = 149) had no experience with perceived advanced care planning, and the intentions to engage in advanced care planning were at a moderate level (mean = 3.29, SD = 0.94). The participants with a different NYHA functional class showed no significant difference in the intention to engage in advance care planning. In contrast, different experiences in caring for family members with terminal illnesses and different experiences with perceived advanced care planning revealed statistically significant differences in the intention to engage in advanced care planning (p < .01)
Future studies should assess the intention to engage in advanced care planning among patients with heart failure with NYHA Functional Class II-IV, with an equal ratio in each class.
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