Aims: Awareness of advance care planning (ACP) and uptake of advance care directives (ACD) are low amongst Chinese globally, despite its proven benefits in patient outcomes. This study aimed to investigate the prevalence of ACD and to explore factors associated with awareness of ACP in elderly Chinese living in New South Wales (NSW), Australia.
Methods: A cross-sectional survey-based quantitative study was conducted in Chinese people aged 65 or older, spoke Mandarin or Cantonese as their first language and without a formal diagnosis of dementia. Participants’ baseline characteristics and responses to survey were summarised. The prevalence of ACD was calculated and logistic regression analysis was conducted to assess factors associated with awareness of ACP.
Results: 54 surveys were completed between April 2023 to April 2024. 12 out of the 54 participants (22%) had heard of ACP and the prevalence of ACD completion was 5.6%. Having a specialist was associated with a higher likelihood of knowing about ACP (OR 8.25, 95% CI 1.41-158, p=0.053). Participants with a university degree or above were more likely to have appointed a substitute decision maker. Most respondents were interested in learning more about ACP.
Conclusions: The awareness of ACP and uptake of ACD are low in elderly community-dwelling Chinese in NSW. Some barriers identified include lack of culturally and linguistically appropriate materials and education programs, and lack of delegation among health professionals to initiate the conversation. There is an urgent need to address these barriers in order to improve awareness of ACP and completion of ACD.