Association between Advance Care Planning for Older Adults and Family Caregivers’ Sense of Security in Home Care Settings: A Prospective Cohort Study
Table 1
Participants’ characteristics and implementation rate of advance care planning.
Total (n = 169)
Family caregivers’ relationship with clients
Spouses (n = 94)
Children (n = 75)
n (%)
n (%)
n (%)
Mean ± SD
Mean ± SD
Mean ± SD
Characteristics of clients
Age
85.6 ± 6.4
82.4 ± 5.7
89.7 ± 4.8
<0.001c
Gender
Male
84 (49.7)
68 (72.3)
16 (21.3)
<0.001a
Family composition
Living alone
11 (6.5)
0 (0.0)
11 (14.7)
<0.001b
Living with spouse
65 (38.5)
63 (67.0)
2 (2.7)
<0.001a
Living with others (other than spouse)
93 (55.0)
31 (33.0)
62 (82.7)
<0.001a
Diseases (multiple answers allowed)
Dementia
65 (38.5)
24 (25.5)
41 (54.7)
<0.001a
Cerebrovascular disease
58 (34.3)
35 (37.2)
23 (30.7)
0.372a
Heart failure
34 (20.1)
18 (19.1)
16 (21.3)
0.725a
Cardiovascular disease (other than heart failure)
28 (16.6)
20 (21.3)
8 (10.7)
0.065a
Cancer
26 (15.4)
14 (14.9)
12 (16.0)
0.843a
Diabetic/metabolic/endocrine disease
25 (14.8)
15 (16.0)
10 (13.3)
0.633a
Digestive system disease
21 (12.4)
8 (8.5)
13 (17.3)
0.084a
Chronic obstructive pulmonary disease
20 (11.8)
12 (12.8)
8 (10.7)
0.675a
Neurological disease
20 (11.8)
15 (16.0)
15 (6.7)
0.063a
Musculoskeletal disease
14 (8.3)
5 (5.3)
9 (12.0)
0.117a
Fractures
10 (5.9)
2 (2.1)
8 (10.7)
0.024b
Pneumonia
9 (5.3)
5 (5.3)
4 (5.3)
0.628b
Urologic disease
8 (4.7)
6 (6.4)
2 (2.7)
0.225b
Renal disease
7 (4.1)
2 (2.1)
5 (6.7)
0.140b
Psychiatric disorder (other than dementia)
6 (3.6)
2 (2.1)
4 (5.3)
0.241b
Refractory skin ulcer
5 (3.0)
2 (2.1)
3 (4.0)
0.394b
Autoimmune disease
3 (1.8)
1 (1.1)
2 (2.7)
0.416b
Others
2 (1.2)
0 (0.0)
2 (2.7)
0.195b
Physical functiond
Moderate and severe
83 (49.1)
35 (37.2)
48 (64.0)
0.001a
Cognitive impairment levele
Severe
67 (40.1)
25 (27.2)
42 (56.0)
<0.001a
Medical procedure
Not receiving medical procedure
112 (66.3)
62 (66.0)
50 (66.7)
0.923a
Service use
Welfare equipment
110 (65.1)
60 (63.8)
50 (66.7)
0.701a
Outpatient visit
81 (47.9)
50 (53.2)
31 (41.3)
0.125a
Regular home-visit by physicians
68 (40.2)
31 (33.0)
37 (49.3)
0.031a
Adult daycare
64 (37.9)
29 (30.9)
35 (46.7)
0.035a
Home help service
57 (33.7)
22 (23.4)
35 (46.7)
0.001a
Home-visit rehabilitation
44 (26.0)
22 (23.4)
22 (29.3)
0.383a
Home medical treatment management instruction
35 (20.7)
18 (19.1)
17 (22.7)
0.575a
Short stay
28 (16.6)
12 (12.8)
16 (21.3)
0.137a
Daycare with rehabilitation
23 (13.6)
16 (17.0)
7 (9.3)
0.148a
Home bathing service
20 (11.8)
6 (6.4)
14 (18.7)
0.014a
Home-visit dental care
12 (7.1)
6 (6.4)
6 (8.0)
0.684a
Home-visit by pharmacists
8 (4.7)
4 (4.3)
4 (5.3)
0.509b
Temporary home-visit by physicians
8 (4.7)
4 (4.3)
4 (5.3)
0.509b
Outpatient rehabilitation
2 (1.2)
2 (2.1)
0 (0.0)
0.308b
Characteristics of family caregivers
Age
71.9 (10.4)
79.7 ± 5.5
62.3 ± 6.0
<0.001c
Gender
Male
47 (28.1)
26 (28.0)
21 (28.4)
0.952a
Relationship with the clients (spouse or child)
Spouse
94 (55.6)
Employment status
No employment or absent
129 (79.1)
81 (92.0)
48 (64.0)
<0.001a
Economic situation
Having sufficient financial resources
21 (12.5)
15 (16.1)
6 (8.0)
0.113a
Family caregivers having burden
60 (35.5)
27 (36.0)
33 (35.1)
0.904a
Family caregivers’ sense of security regarding home care
Sense of security score (T0)
20.7 ± 3.7
20.3 ± 4.0
21.2 ± 3.2
0.108c
Sense of security score (T2)
20.8 ± 3.6
20.4 ± 3.9
21.3 ± 3.0
0.089c
Positive change in the sense of security score
84 (49.7)
45 (47.9)
39 (52.0)
0.594a
ACP was conducted
91 (53.8)
44 (46.8)
47 (62.7)
0.040a
ACP = advance care planning; SD = standard deviation; T0 = first time-point; T2 = three months later time-point. aChi-square test. bFisher’s exact test. cWelch’s t-test. dAssessed using the bedridden levels of the Ministry of Health, Labour, and Welfare (Ranks J and A–C); Moderate and Severe: Ranks B and C. eAssessed using the rating of dementia of the Ministry of Health, Labour and Welfare (Grades I–IV and M); and Severe: Grades III, IV, and M.
