Awareness and attitudes towards advance care planning in primary care: role of demographic, socioeconomic and religiosity factors in a cross-sectional Lebanese study

BMJ Open. 2021 Oct 28;11(10):e052170. doi: 10.1136/bmjopen-2021-052170.

Abstract

Objective: To assess awareness and attitudes towards engaging in advance care planning (ACP) and their relationship with demographic, socioeconomic and religiosity factors among Lebanese middle-aged to older-aged adults in primary care.

Design: A cross-sectional survey study.

Setting: Tertiary referral hospital in Beirut, Lebanon.

Participants: A total of 215 middle-aged to older-aged adults.

Results: Out of 215 participants, 18.6% of participants knew about ACP; 94% favoured truth-telling; 87.4% favoured healthcare autonomy; 77.2% favoured documenting their own health values and preferences; and 29.3% were willing to undergo life-prolonging interventions. Among participants who were aware of ACP, 67.5% preferred ACP documentation and 85% had negative attitudes towards life-sustaining interventions. Women were more aware about ACP than men. Those who were willing to undergo life-prolonging interventions were found to be men and had higher religiosity scores.

Conclusion: Large deficit in ACP awareness was evident despite the high preference for healthcare autonomy. Medical and public health efforts should strive to enhance patients' ACP awareness and engagement in ACP while considering factors relevant to gender, culture and religiosity.

Keywords: adult palliative care; geriatric medicine; primary care.

MeSH terms

  • Adult
  • Advance Care Planning*
  • Attitude
  • Cross-Sectional Studies
  • Demography
  • Female
  • Humans
  • Male
  • Middle Aged
  • Primary Health Care
  • Socioeconomic Factors