Knowledge and attitudes regarding the Patient Autonomy Act and behavioral intention regarding signing advance decision among in-patients' family members
Journal
Taiwan Journal of Public Health
Journal Volume
39
Journal Issue
3
Pages
342-349
Date Issued
2020
Author(s)
Abstract
Objectives: To investigate the understanding of and attitude toward the "Patient Right to Autonomy Act" (hereafter, Patient Autonomy Act) among family members of hospitalized patients and their behavioral intention in advance decision (AD). Methods: A structured and specifically tailored questionnaire was used to conduct interviews with 80 family members of patients in the intensive care unit, medical, and surgical wards of a national university hospital in Taipei. Results: (1) Only 49.8% of the interviewees were aware of the Patient Autonomy Act; however, the understanding of its content was very high, with a correct rate of 71.88%. The results indicated that most interviewees were in favor of the concept of patient autonomy. However, most interviewees were also unclear regarding the difference between the Patient Autonomy Act and euthanasia (assisted death). Women had a better grasp of this distinction than did men (correct rate = 35.00% vs. 13.75%). Married individuals demonstrated a better understanding of the Patient Autonomy Act than unmarried individuals did. (2) More than 90% of the interviewees were willing to engage in advance care planning; however, only 51.25% of the interviewees were willing to sign an AD. Interviewees who judged that they had a good quality of health were more inclined to sign an AD. (3) In case of terminal illness, interviewees' medical decisions were primarily concerned with whether the patient recovers consciousness after treatment, whether they were still able to move autonomously, and whether treatment would incur a financial burden. However, interviewees' medical decisions varied depending on whether the decision was to be taken in connection with themselves, their parents, or their spouses. (4) Notably, most of the interviewees did not think that after signing the Patient Autonomy Act, the medical staff would stop providing treatment or care, nor did they think that signing it was equivalent to simply waiting for death. Conclusions: Although family members of hospitalized patients do not fully understand the Patient Autonomy Act, most of them comprehend that the legislation respects "the treatment wishes of individuals." Therefore, a large proportion of the population is in favor of the concept of individual autonomy. When confronted with their own terminal illness, Taiwanese people adopt different medical decisions than when faced with that of a parent or a spouse. This indicates that the government should strengthen awareness of AD, thereby avoiding decision-making quandaries in cases of terminal illness.
Publisher
Chinese Public Health Association of Taiwan
Type
journal article