Factors influencing the willingness of older cancer patients to receive palliative care in advance care planning in southern Taiwan

Abstract

ABSTRACT This study investigates the factors influencing the willingness of older cancer patients to receive palliative care, considering the ‘person-centered’ approach to advance care planning in Taiwan. Autonomy challenges are prevalent among these patients. The retrospective study, conducted at a tertiary teaching hospital in southern Taiwan from June 2020 to December 2022, included 195 eligible older cancer patients. Logistic regression was utilized to analyze factors influencing their willingness for palliative care. The optimal logistic regression analysis identified five key factors associated with receiving palliative care: age (OR, 0.42; 95% CI, 0.20–0.92), educational level (OR, 2.82; 95% CI, 1.27–6.25), metastatic disease (OR, 4.62; 95% CI, 2.08–10.27), hospice and palliative care knowledge (OR, 1.32; 95% CI, 1.11–1.57), and attitude (OR, 1.22; 95% CI, 1.12–1.33). The findings suggest that younger, more educated patients with metastatic disease, higher knowledge of hospice and palliative care, and positive attitudes toward these services were more likely to receive palliative care. Patients’ awareness of hospice and palliative care, attitudes shaped by such awareness, and disease status significantly influenced their willingness to undergo palliative care. This highlights the increasing vulnerability of older cancer patients to decision-making challenges as their illness progresses, emphasizing the importance of initiating conversations about advance care planning early on. Healthcare practitioners are urged to actively advocate for these discussions, particularly considering the decline in decision-making capacity as the disease advances. Future research should focus on empowering individuals in making end-of-life care choices.