Multidimensional factors influencing the completion of advance directives among community-dwelling older Koreans

초록

Purpose: This study aimed to examine the multidimensional factors associated with the completion ofadvance directives (ADs) among community-dwelling older Koreans, guided by conceptual frameworksdeveloped in Asian contexts. Methods: Data from the 2023 National Survey of Older Koreans (sixth wave) were analyzed for 9,951community-dwelling older Koreans aged 65 years or older. Complex sample cross-tabulation and binarylogistic regression analyses were conducted. Results: In total, 11.1% of community-dwelling older Koreans had completed an AD. Significant factorsassociated with AD completion were identified across four domains—personal situation: age, educationallevel, religion, and housing preference in the event of poor health; socio-cultural: presence of children,participation in social activities and satisfaction with social relationships; physical and illness: the numberof chronic diseases; and value system: awareness of hospice and palliative services, participation indeath preparedness education, and documentation of organ donation. Conclusion: Among older Koreans, AD completion represents more than a documentation process; itreflects a complex decision-making process shaped by their values and life circumstances, underscoringthe need for supportive interventions. As the highest AD completion rates are found among older adults,related policies should be aligned with older adult-centered policy frameworks.

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