Factors Influencing Family Surrogates’ Intention with Regard to Do-Not-Resuscitate Directive for Patients with Dementia

Yu Chiung Fang, Ming Chyi Pai, Liang Chao Wang, Ya Ping Yang, Chung Yi Li, Feng Ping Lee, Jing Jy Wang

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: To investigate the prevalence of family surrogates’ do-not-resuscitate (DNR) intention for patients with dementia (PwD), and factors influencing family surrogates’ decisions. Methods: This is a descriptive and cross-sectional study. Patients with dementia and their family surrogates from Dementia Outpatient Clinic of a teaching hospital in southern Taiwan were included. Data were collected using chart review and questionnaire survey. Influential factors were analyzed using multiple logistic regression. Results: One hundred and forty of the 223 participants (62.8%) have intention to sign DNR consents for their dementia relatives. Factors influencing the intention were: (1) Comorbid with musculoskeletal diseases or diabetes (p < .05); (2) psychological symptoms of repetitive wording and behavior (p < .05); (3) spouse (p < .05) and lineal relatives (p < .01); (4) previous discussion between families and patient about DNR directive (p = .001); (5) believers of Taiwan folk belief (Buddhism or Taoism) (p < .05). Conclusions: Advanced dementia patients cannot express intention about their end-of-life care and depend on family surrogates to decide for them. Our study showed that spouse and direct relatives, comorbidities of musculoskeletal disease or diabetes, psychological symptoms of repetitive wording and behavior, previous discussion about patients’ intention, and believers of Taiwan folk belief are all positive influencing factors for surrogates to consent DNR directive for patients. Our findings are important in promoting DNR directive for PwD. Clinical implications: Our results may help to promote DNR decisions for dementia patients, especially in Chinese populations.

Original languageEnglish
Pages (from-to)495-503
Number of pages9
JournalClinical Gerontologist
Volume42
Issue number5
DOIs
Publication statusPublished - 2019 Jan 1

Fingerprint

dementia
Dementia
Taiwan
Musculoskeletal Diseases
spouse
chronic illness
Spouses
Taoism
Buddhism
Religious Philosophies
Disease
outpatient clinic
Psychology
comorbidity
Terminal Care
cross-sectional study
Ambulatory Care Facilities
Teaching Hospitals
Comorbidity
logistics

All Science Journal Classification (ASJC) codes

  • Social Psychology
  • Health(social science)
  • Clinical Psychology
  • Gerontology
  • Geriatrics and Gerontology

Cite this

@article{6e14c4d0af2044f08dbaed747e38d6c5,
title = "Factors Influencing Family Surrogates’ Intention with Regard to Do-Not-Resuscitate Directive for Patients with Dementia",
abstract = "Objective: To investigate the prevalence of family surrogates’ do-not-resuscitate (DNR) intention for patients with dementia (PwD), and factors influencing family surrogates’ decisions. Methods: This is a descriptive and cross-sectional study. Patients with dementia and their family surrogates from Dementia Outpatient Clinic of a teaching hospital in southern Taiwan were included. Data were collected using chart review and questionnaire survey. Influential factors were analyzed using multiple logistic regression. Results: One hundred and forty of the 223 participants (62.8{\%}) have intention to sign DNR consents for their dementia relatives. Factors influencing the intention were: (1) Comorbid with musculoskeletal diseases or diabetes (p < .05); (2) psychological symptoms of repetitive wording and behavior (p < .05); (3) spouse (p < .05) and lineal relatives (p < .01); (4) previous discussion between families and patient about DNR directive (p = .001); (5) believers of Taiwan folk belief (Buddhism or Taoism) (p < .05). Conclusions: Advanced dementia patients cannot express intention about their end-of-life care and depend on family surrogates to decide for them. Our study showed that spouse and direct relatives, comorbidities of musculoskeletal disease or diabetes, psychological symptoms of repetitive wording and behavior, previous discussion about patients’ intention, and believers of Taiwan folk belief are all positive influencing factors for surrogates to consent DNR directive for patients. Our findings are important in promoting DNR directive for PwD. Clinical implications: Our results may help to promote DNR decisions for dementia patients, especially in Chinese populations.",
author = "Fang, {Yu Chiung} and Pai, {Ming Chyi} and Wang, {Liang Chao} and Yang, {Ya Ping} and Li, {Chung Yi} and Lee, {Feng Ping} and Wang, {Jing Jy}",
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Factors Influencing Family Surrogates’ Intention with Regard to Do-Not-Resuscitate Directive for Patients with Dementia. / Fang, Yu Chiung; Pai, Ming Chyi; Wang, Liang Chao; Yang, Ya Ping; Li, Chung Yi; Lee, Feng Ping; Wang, Jing Jy.

In: Clinical Gerontologist, Vol. 42, No. 5, 01.01.2019, p. 495-503.

Research output: Contribution to journalArticle

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AU - Fang, Yu Chiung

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AU - Li, Chung Yi

AU - Lee, Feng Ping

AU - Wang, Jing Jy

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N2 - Objective: To investigate the prevalence of family surrogates’ do-not-resuscitate (DNR) intention for patients with dementia (PwD), and factors influencing family surrogates’ decisions. Methods: This is a descriptive and cross-sectional study. Patients with dementia and their family surrogates from Dementia Outpatient Clinic of a teaching hospital in southern Taiwan were included. Data were collected using chart review and questionnaire survey. Influential factors were analyzed using multiple logistic regression. Results: One hundred and forty of the 223 participants (62.8%) have intention to sign DNR consents for their dementia relatives. Factors influencing the intention were: (1) Comorbid with musculoskeletal diseases or diabetes (p < .05); (2) psychological symptoms of repetitive wording and behavior (p < .05); (3) spouse (p < .05) and lineal relatives (p < .01); (4) previous discussion between families and patient about DNR directive (p = .001); (5) believers of Taiwan folk belief (Buddhism or Taoism) (p < .05). Conclusions: Advanced dementia patients cannot express intention about their end-of-life care and depend on family surrogates to decide for them. Our study showed that spouse and direct relatives, comorbidities of musculoskeletal disease or diabetes, psychological symptoms of repetitive wording and behavior, previous discussion about patients’ intention, and believers of Taiwan folk belief are all positive influencing factors for surrogates to consent DNR directive for patients. Our findings are important in promoting DNR directive for PwD. Clinical implications: Our results may help to promote DNR decisions for dementia patients, especially in Chinese populations.

AB - Objective: To investigate the prevalence of family surrogates’ do-not-resuscitate (DNR) intention for patients with dementia (PwD), and factors influencing family surrogates’ decisions. Methods: This is a descriptive and cross-sectional study. Patients with dementia and their family surrogates from Dementia Outpatient Clinic of a teaching hospital in southern Taiwan were included. Data were collected using chart review and questionnaire survey. Influential factors were analyzed using multiple logistic regression. Results: One hundred and forty of the 223 participants (62.8%) have intention to sign DNR consents for their dementia relatives. Factors influencing the intention were: (1) Comorbid with musculoskeletal diseases or diabetes (p < .05); (2) psychological symptoms of repetitive wording and behavior (p < .05); (3) spouse (p < .05) and lineal relatives (p < .01); (4) previous discussion between families and patient about DNR directive (p = .001); (5) believers of Taiwan folk belief (Buddhism or Taoism) (p < .05). Conclusions: Advanced dementia patients cannot express intention about their end-of-life care and depend on family surrogates to decide for them. Our study showed that spouse and direct relatives, comorbidities of musculoskeletal disease or diabetes, psychological symptoms of repetitive wording and behavior, previous discussion about patients’ intention, and believers of Taiwan folk belief are all positive influencing factors for surrogates to consent DNR directive for patients. Our findings are important in promoting DNR directive for PwD. Clinical implications: Our results may help to promote DNR decisions for dementia patients, especially in Chinese populations.

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