Abstract

Objectives

This study explored associations between birth region, sociodemographic predictors, and advance care planning (ACP) uptake.

Methods

A prospective, multicenter, cross-sectional audit study of 100 sites across 8 Australian jurisdictions. ACP documentation was audited in the health records of people aged 65 years or older accessing general practice (GP), hospital, and long-term care facility (LTCF) settings. Advance care directives (ACDs) completed by the person (“person completed ACDs”) and ACP documents completed by a health professional or other person (“health professional or someone else ACP”) were counted. Hierarchical multilevel logistic regression assessed associations with birth region.

Results

From 4,187 audited records, 30.0% (1,152/3,839) were born outside Australia. “Person completed ACDs” were less common among those born outside Australia (21.9% vs 28.9%, X² (1, N = 3,840) = 20.3, p < .001), while “health professional or someone else ACP” was more common among those born outside Australia (46.4% vs 34.8%, X² (1, N = 3,840) = 45.5, p < .001). Strongest associations were found for those born in Southern Europe: “person completed ACD” (odds ratio [OR] = 0.56, 95% confidence interval [CI] = 0.36–0.88), and “health professional or someone else ACP” (OR = 1.41, 95% CI = 1.01–1.98). English-language proficiency and increased age significantly predicted both ACP outcomes.

Discussion

Region of birth is associated with the rate and type of ACP uptake for some older Australians. Approaches to ACP should facilitate access to interpreters and be sensitive to diverse preferences for individual and family involvement in ACP.

中文翻译：

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澳大利亚较老的移民社区中出生地区和提前护理计划文件之间的关联：多中心审计研究

摘要

目标

这项研究探讨了出生地区，社会人口统计学预测因素与预先护理计划（ACP）摄入之间的关联。

方法

对澳大利亚8个司法管辖区的100个地点进行的前瞻性，多中心，横断面审计研究。ACP文档已在65岁或65岁以上的老年人的健康记录中进行了审核，这些患者具有全科医生（GP），医院和长期护理机构（LTCF）的设置。对由该人完成的预先护理指示（ACD）和由卫生专业人员或其他人（“卫生专业人员或其他ACP”）完成的ACP文件进行计数。分层多级逻辑回归评估与出生地区的关联。

结果

在4,187份经审核的记录中，30.0％（1,152 / 3,839）出生于澳大利亚以外的地方。在澳大利亚以外出生的人中，“由个人填写的ACD”较少见（21.9％对28.9％，X ²（1，N = 3,840）= 20.3，p <.001），而“卫生专业人员或其他ACP”则更为常见在澳大利亚以外出生的人中（46.4％vs 34.8％），X ²（1，N = 3,840）= 45.5，p<.001）。在南欧出生的人中发现了最强的关联：“个人完成ACD”（优势比[OR] = 0.56，95％置信区间[CI] = 0.36-0.88），以及“卫生专业人员或其他ACP”（OR = 1.41，95％CI = 1.01-1.98）。英语水平和年龄增长显着预测了两种ACP结果。

讨论区

出生地区与一些澳大利亚老年人的ACP摄取率和类型有关。ACP的方法应便于与口译员接触，并对个人和家庭参与ACP的各种偏好敏感。