title: The Attitudes of Chinese Cancer Patients and Family Caregivers toward Advance Directives.
abstract: Advance directives (ADs) have been legislated in many countries to protect patient autonomy regarding medical decisions at the end of life. China is facing a serious cancer burden and cancer patients' quality at the end of life should be a concern. However, limited studies have been conducted locally to gather information about attitudes toward ADs. The purpose of this study was to investigate the attitudes of Chinese cancer patients and family caregivers toward ADs and to explore the predictors that are associated with attitudes. The study indicated that although there was low awareness of ADs, most cancer patients and family caregivers had positive attitudes toward ADs after related information was explained to them. Participants preferred to discuss ADs with medical staff when they were diagnosed with a life-threatening disease. Preferences for refusing life-sustaining treatment and choosing Hospice-Palliative Care (HPC) at the end of life would increase the likelihood of agreeing with ADs. This suggests that some effective interventions to help participants better understand end-of-life treatments are helpful in promoting ADs. Moreover, the development of HPC would contribute to Chinese cancer patients and family caregivers agreeing with ADs.
authors.affiliation: Department of Health Service Management, Public Health School of Sun Yat-sen University, Guangzhou 510060, China. Qiu.z@yahoo.com.
authors.forename: Qiu
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: State Key Laboratory of Oncology in South China, Department of Preventive Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China. xiechb@sysucc.org.cn.
authors.forename: Chuanbo
authors.initials: C
authors.lastname: Xie
authors.affiliation: State Key Laboratory of Oncology in South China, Department of Preventive Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China. Xieshh@sysucc.org.cn.
authors.forename: Shanghang
authors.initials: S
authors.lastname: Xie
authors.affiliation: State Key Laboratory of Oncology in South China, Department of Preventive Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China. qingliusysu@yahoo.com.
authors.forename: Qing
authors.initials: Q
authors.lastname: Liu
mesh_terms: D016223:Advance Directives / Q000523:psychology*; D000368:Aged; D001290:Attitude; D001364:Awareness; D017028:Caregivers / Q000523:psychology*; D002681:China; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*
keywords: Chinese; advance directives; attitudes; cancer patients; family caregivers