Doctor Facilitated Denial: A Barrier to Advance Care Planning Among COPD Patients.

Abstract

Background: Many severe COPD patients are unaware of their treatment options and lack motivation for advance care planning. It is crucial to increase patient awareness regarding their chronic conditions.

Methods: The InformedTogether decision aid was used in outpatient clinical visits to inform patients about their COPD prognosis. Audio-recorded visits were analyzed for how denial, self-perceived health, and trust impacted patient motivation to make an advance care plan.

Results: Of the 26 patients, 4 (15.38%) showed an increase in motivation, 20 (76.92%) had no change, and 2 (7.69%) showed a decrease in motivation. Denial facilitated by physicians did not significantly affect motivation (p = 0.543). Self-perceived health also had no significant impact on motivation, with 68.00% rating their health as poor, 16.00% as fair, and 16.00% as good (p = 0.847). Trust in the physician's information was generally high, with 64.00% reporting high trust, but did not lead to an increase in motivation (p = 0.512).

Conclusion: Denial, self-perceived health, and trust did not significantly affect patient motivation to make an advance care plan. This study suggests that barriers to increasing motivation remain, and further research on external factors may be helpful to improve patient participation in end-of-life care planning.