Knowledge, attitude and willingness towards hospice care among older adult patients and their family members in the geriatric department in Hubei Province, China: a multi-centre cross-sectional study.

Abstract

To investigate the knowledge, attitude and willingness (KAW) towards hospice care among older adult patients and their family members within the geriatric department of Hubei province, and to situate these findings within the broader context of public awareness and the health system's multidisciplinary approach to end-of-life care. A cross-sectional survey. Demographic information and KAW scores were collected through a self-made questionnaire. Data were analysed using descriptive statistics, t-tests, ANOVA and path analysis. This study was conducted across five tertiary hospitals in Hubei province between June and December 2023. Willingness towards hospice care. Knowledge and attitude towards hospice care, and their relationships with demographic factors. A total of 390 patients participated in this study, with 205 (52.56%) being male with a mean age of 69.75±8.01 years. The KAW scores were 4.88±5.14 (range: 0-14), 33.04±4.60 (range: 11-55) and 20.59±2.70 (range: 9-45), respectively. Family members scored 7.04±5.20 (range: 0-14) for knowledge, 37.20±3.61 (range: 11-55) for attitude and 22.35±3.59 (range: 6-30) for willingness. Path analysis revealed that in patients, knowledge (β=0.33, p<0.001) and attitude (β=0.11, p<0.001) directly affected willingness. Additionally, factors like education and residence had indirect effects. In family members, direct effects on willingness were found for knowledge (β=0.35, p<0.001) and attitude (β=0.20, p<0.001), with education also affecting indirectly. Both older adult patients and their family members demonstrated insufficient knowledge, yet a moderate attitude and willingness towards hospice care. Family members manifested a more proactive willingness to engage in hospice care. Based on these findings, targeted educational interventions are recommended, particularly focusing on improving hospice care knowledge among patients with lower education levels and those residing in rural areas. Additionally, involving family members more actively in care discussions may enhance acceptance and utilisation of hospice care services.