Awareness, Attitudes, and Willingness of Young Adults in Mainland China Regarding Advance Care Planning: A Cross-Sectional Study

Abstract

Background: Advance care planning (ACP) can help healthy young adults enhance their sense of responsibility and can assist others to complete their own end-of-life wishes. Therefore, this study assessed the awareness and attitudes of young adults toward ACP to check their willingness to participate in ACP to popularized it. Purpose: The purpose of this study was to explore the awareness and attitudes of ACP among young adults in mainland China, and determine factors associated with their willingness to participate in ACP. Methods: A total of 1312 Chinese young adults were surveyed by using the Advance Care Planning Questionnaire (ACPQ) between December 2020 and May 2021 in Jiangsu Province, China. Results: The level of young adults’ awareness of ACP was low, but the attitude toward ACP was positive. Monthly income, encouraged by others to participate in ACP, and death-related experiences in the last five years can affect the willingness of ACP among young adults. Conclusion: This study indicated a low awareness but supportive attitude toward ACP amongst young adults in mainland China. Patient education, public advocacy, and future research on young adult-centered models of shared decision-making are needed to increase young adults’ understanding of ACP and to enable them decision-making empowerment.