| Summary: | 碩士 === 國立臺北護理健康大學 === 護理研究所 === 106 === The purpose of this study was to explore the factors associated with the intension and decision-making of patients with advanced cancers in regards to “Advanced Hospice Palliative Care and Life Sustaining Care Choices of Intent(AHPCLSCCI)”. A cross-sectional and correlational research design was used in this paper. A convenience sample of 90 patients with advanced cancers was recruited from a Medical Center in Taipei. Data were collected by using face to face questionnaires, including questions on demographics, disease characteristics, families’ opinions, Patient – Physician Communication, Charlson comorbidity index, Karnofsky physical function scale, M.D. Anderson Symptom Inventory, AHPCLSCCI indention and decision, Hospice Palliative Medicine Knowledge Scale, and Decisional Conflict Scale. Of the 90 respondents, 11 (12.2%) of the respondents signed AHPCLSCCI within three months. 65 patients (72.2%) were willing but hadn’t signed yet and 14(15.6%) patients had no intention of signing at all. Results of chi-square test and one way ANOVA, showed that patients’ signing of the AHPCLSCCI were associated with their religion, families’ opinions, discussion with families, conformity of opinions among family members and the patient, Physician – Patient communication, knowledge, and decisional conflict. Results of logistic regression showed that Physician – Patient communication, families’ opinions”, and knowledge were important predictors of the intention of signing the AHPCLSCCI. These three factors explained 45% of variance in the intention of signing. However, only the parameter for Physician – Patient communication was statistically significant. Patients who discussed AHPCLSCCI with their care providers have a greater likelihood of becoming signees. According to patient’s preference for discussing the AHPCLSCCI, the doctor is the medical staff whom the patients most want to discuss with for the first time (56.7%). Patients’ preferred timing for discussing and receiving information on AHPCLSCCI is when their cancers can't be treated (44.4%). Therefore, in the future, we shall respect patient autonomy and according to patient's preference, increase the number of family conferences held to improved patient-doctor communication. Clarifying and educating patients and their family members with information on the AHPCLSCCI will help alleviate the amount of confusion patients may feel regarding their decisions.
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