Open AccessAssociated factors for discussing advance directives with family physicians by noncancer outpatients in Japan
Author(s) -
Hamada Shuhei,
Haruta Junji,
Hamano Jun,
Maeno Takami,
Maeno Tetsuhiro
Publication year - 2019
Publication title -
journal of general and family medicine
Language(s) - English
Resource type - Journals
ISSN - 2189-7948
DOI - 10.1002/jgf2.238
Subject(s) - medicine , worry , odds ratio , confidence interval , family medicine , logistic regression , multivariate analysis , cross sectional study , disease , quality of life (healthcare) , nursing , psychiatry , anxiety , pathology
Background Advance directives (ADs) are seldom discussed between primary care physicians (PCPs) and their patients, especially those with noncancer diseases. The aim was to identify the factors associated with discussing AD by noncancer patients with their physicians. Methods This cross‐sectional study was conducted in a hospital or clinic from October to December 2017. Physicians chose eligible noncancer patients aged 20 years or older to respond to an anonymous self‐completed questionnaire inquiring about the objective variable “I want to discuss AD with my doctor,” as well as basic characteristics, and facilitators and barriers to discussing AD identified in previous studies. The physicians responded to a survey comprising the Palliative Performance Scale (PPS) and inquiring about the disease category for each patient. Data were analyzed using binomial logistic regression analysis. Results A total of 270 patients (valid response rate, 79.6%) were included. Multivariate analysis identified a period of visit to the study site ≥ 3 years (odds ratio [OR], 2.07; 95% confidence interval [CI], 1.05‐4.10), physicians who are very good at taking care of patients’ disease (OR, 12.68; 95% CI, 1.12‐143.22), and patients’ worry about their quality of life (QOL) in the future (OR, 2.69; 95% CI, 1.30‐5.57) as facilitators for discussing AD with physicians, and PPS ≤ 90 (OR, 0.51; 95% CI, 0.26‐0.98) as a barrier. Conclusions Our study indicates that patients’ future QOL concerns, a long period of visit to a hospital, and the presence of physical symptoms were associated with the willingness of noncancer patients to discuss AD with PCPs.