The relationship between knowledge, attitude, experience and beliefs on decision making of living will in patients with chronic obstructive pulmonary disease
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ABSTRACT
Background: Making a living will allows patients to make independent decisions about end-of-life care, especially patients with chronic obstructive pulmonary disease (COPD), which tends to deteriorate uncertainly. This research aimed to study the relationship between knowledge, experience, attitude, and beliefs on the decision to make a living will in patients with COPD.
Design: A cross-sectional analytical study in patients with COPD, Na thawi District, Songkhla Province, from October 1, 2024, to February 28, 2025
Methods: A questionnaire contained general information, symptoms, and severity of the disease, disease perception, attitude, knowledge, beliefs, and the desire to make a living will. Data were analyzed using descriptive statistics and logistic regression.
Results: Two hundred twenty-five participants, most of whom were male with lower education than a bachelor’s degree, were selected. Other data included marital status, Buddhist religion, low income, and a median age of 59 years. The factors that were significantly associated with the decision to make a living will were knowledge of living will (OR = 112.2; 95%CI: 2.37-5312.62; p = 0.016) and attitude towards living will (OR = 10.6; 95%CI: 2.31-48.59; p < 0.001). Experience with living will (OR = 0.83; 95%CI: 0.58-1.19; p = 0.326) and beliefs about living will (OR = 0.83; 95%CI: 0.34-2.06; p < 0.692), as well as demographic factors such as gender, age, marital status, education, religion, income and living with family showed no significant relationship with the decision to make a living will.
Conclusions: The important factors that significantly influenced decisions regarding a living will in patients with COPD were adequate knowledge about living wills and positive attitudes. Demographic factors, experience, and beliefs were not found to have a statistically significant relationship.
Keywords: living will, COPD, Attitude, knowledge, beliefs about death, advance care planning
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