ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Psychological Therapy and Psychosomatics
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1652534
Acceptance level and influencing factors of advance care planning among patients with schizophrenia in China: A cross-sectional survey
Provisionally accepted
- 1Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- 2Guangzhou Medical University, Guangzhou, China
- 3The Seventh Affiliated Hospital Sun Yat-sen University, Shenzhen, China
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Objective: This study aimed to explore the current acceptance of advance care planning (ACP) among patients with schizophrenia and investigate the influencing factors.A cross-sectional study was conducted from September 2023 to January 2024 using a convenience sampling method. A total of 225 patients with schizophrenia were selected from a Grade A, Class III Psychiatric Hospital and the Department of Psychiatry of a Grade A, Class III General Hospital in Guangzhou, China. The Advance Care Planning Readiness Scale, the Chinese version of the Brief Neurocognitive Test Battery(C-BCT), the Brief Psychiatric Rating Scale(BPRS), and the Medication Adherence Questionnaire(MAQ) were used to survey the patients with schizophrenia.Results: Mean ACP readiness score was 84.76±11.97, with 55.6% showing high acceptance.Readiness positively correlated with age (r=0.161, p=0.021) and hospitalization frequency (r=0.235, p=0.001), and negatively with symptom severity (r=-0.159, p=0.022). Patients with comorbidities (p=0.001) or personal/family health crises (p=0.033) had higher readiness.Regression analysis identified cognitive impairment, religious beliefs, hospitalization frequency, and medication adherence as key predictors (R²=0.118, p<0.001), explaining 11.8% of variance.Conclusions: Schizophrenia patients demonstrate higher than average ACP acceptance, with 55.6% of the patients showing a high level of acceptance. Improved medication adherence, frequent hospitalizations, religious beliefs and reduced thinking disorder severity. Culturally sensitive health education is recommended to facilitate ACP discussions in clinical practice.
Keywords: Advance Care Planning, Schizophrenia, Cross-sectional, Influencing factors, Acceptance level
Received: 09 Jul 2025; Accepted: 30 Jul 2025.
Copyright: © 2025 Liang, Huang, Tang, Li, Huang, Zhou and Xia. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Shicong Liang, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
Zhi-Chun Xia, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
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