Associations of Health Literacy, Personality Traits, and Pro-individualism with the Willingness to Complete Advance Directives in Taiwan

Overview

Journal BMC Palliat Care

Publisher Biomed Central

Specialty Critical Care

Date 2023 Jul 9

PMID 37424005

Authors

Duan-Rung Chen

Hui-Ching Weng

Affiliations

Soon will be listed here.

Abstract

Background: Studies indicated that patients with advance directives (ADs) have a generally better quality of life near death. Yet, the concept of ADs is relatively new in East Asian countries. This study examined the associations between health literacy, pro-individualism in end-of-life (EOL) decisions (i.e., EOL pro-individualism), and master-persistence personality traits with the willingness to complete ADs.

Methods: The data is from a representative data of 1478 respondents from the 2022 Taiwan Social Change Survey. Generalized structural equation modeling (GSEM) was used to conduct path analysis.

Results: Nearly half of the respondents (48.7%) were willing to complete ADs. Health literacy has direct and indirect effects through EOL pro-individualism values on the willingness to complete ADs. Noncognitive factors such as mastery-persistence personality traits and EOL pro-individualism values enhanced the willingness to complete ADs.

Conclusion: A personalized communication strategy, mindful of personality dimensions and cultural values, can address individual fears and concerns, promoting the benefits of advance care planning (ACP). These influences can provide a roadmap for healthcare providers to customize their approach to ACP discussions, improving patient engagement in AD completion.

Citing Articles

Cross-sectional survey on public attitudes and factors related to physician-assisted dying in Taiwan.

Chen D, Kuo C, Wu K BMJ Open. 2025; 15(1):e089388.

PMID: 39819930 PMC: 11751988. DOI: 10.1136/bmjopen-2024-089388.

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