Acceptance of advance care planning and influencing factors from the perspective of the life cycle: a cross-sectional study.

Background: Advance care planning is an important part of palliative care. Public acceptance is a prerequisite for the widespread development and implementation of advance care planning. However, little is known about the level of public's acceptance and influencing factors of advance care planning across different life cycles.

Methods: A cross-sectional study in mainland China was conducted from June 20 to August 31, 2022. We used multi-stage sampling strategy to recruit participators. A stepwise linear regression analysis was used to examine the influencing factors in different life cycles (nonage, mature age, middle age and old age).

Results: The final sample size was 18,002. The average acceptance score of advance care planning of the public throughout the entire life cycle was 64.03. The average score in nonage was 67.13, which is the highest. The average score in mature age was 63.87, in middle age was 63.51, and in old age was 63.54. Multiple linear stepwise regression results indicated that death education support level, well-being index, neighbor relations, health literacy, family social status, and siblings were influencing factors in nonage. Medical insurance, injury events, multiple properties, death education support level, health literacy, family social status, neighbor relation, social support, family health, media contact, and well-being index were influencing factors in mature age. In middle age, region, living alone, depression, debt, houses, death education support level, health literacy, social support, and family social status were influencing factors. In old age, injury event, death education support level, neighbor relation, well-being index, siblings and children were influencing factors.

Conclusions: This study is the first to compare the Chinese people with different life cycles. It found that the public's acceptance and influencing factors of advance care planning varied across different life cycles. Governments and health care personnel should emphasize autonomy and initiate advance care planning based on different life cycles and individual approaches, then introduce appropriate public health policies into newer and broader fields.