晚期癌症患者预立医疗照护计划参与行为影响因素的系统综述

傅艺玲, 吴茜, 罗晓庆, 吴艾泓, 夏雪兰, 郑敏

Factors influencing advance care planning engagement behavior in patients with advanced cancer: a systematic review

FU Yiling, WU Qian, LUO Xiaoqing, WU Aihong, XIA Xuelan, ZHENG Min

表5 定量研究描述性分析结果

Tab 5 Descriptive analysis results of quantitative study

COM-B TDF Influencing factor Specific description Capability Psychological capability Knowledge Knowledge of ACP →The percentage of patients willing to engage in ACP increased after understanding the concept, process, and importance of advance directive[16] Behavioural regulation Knowledge of the time of disease diagnosis →Patients who know about the diagnosis of the disease for longer are more likely to engage in ACP[18] Subjective life expectancy →Patients who are expected to live only a few months are less likely to prefer aggressive treatment[27] Physical capability Skills Disease symptom burden →The greater the burden of symptoms, the less likely patients are to sign advance directives or health care powers of attorney[29] Opportunity Social opportunity Social influences Family support →Family members not objecting is an important factor in discussing ACP[32] Social support →Patients with higher social support are more willing to engage in ACP[18] Doctor-patient relationship →Poor doctor-patient relationship leads to low acceptance of ACP[15] Dependent children →Patients with dependent children are more likely to prefer aggressive treatment and less likely to engage in ACP[34] Physical opportunity Environmental context and resources Housing type →Patients without private housing are more willing to engage in ACP[20] Hospice service center →Whether or not to establish a hospice service center is a factor influencing whether or not patients choose to participate in ACP[30] Motivation Reflective motivation Intentions ACP attitude →The sense of life meaning is the main factor influencing patients' attitude towards ACP[16] Goals ACP belief →Patients want to ensure a comfortable end-of-life and avoid pain[20] Beliefs about capabilities ACP motivation →The reason that hinders patients from engaging in ACP is that patients think that their relatives can make decisions for them or that their wishes may change in the future[20] Automatic motivation Emotion Anxiety and depression →Patients who participated in ACP had significantly higher anxiety and depression scores than those who did not participate in ACP[33]