Longer disease course, higher NYHA functional class, higher educational level, and greater social support significantly predicted high advance care planning readiness in patients with chronic heart failure.
Cross-Sectional (n=313)
No
Advance care planning readiness in chronic heart failure patients is heterogeneous and influenced by education, disease duration, NYHA class, and social support, highlighting the need for targeted death education.
Effect estimate: OR 2.968 (95% CI 1.976-4.457)
p-value: p=<0.001
Objective A cross-sectional study was conducted in a tertiary A-level general hospital in Wuhan, China. The study aimed to explore the latent profiles of advance care planning (ACP) readiness among patients with chronic heart failure (CHF), analyze the influencing factors of different profiles, and compare the differences in death attitudes between profiles. Methods From February to December 2025, a total of 313 CHF patients were recruited by convenience sampling from the Department of Cardiovascular Medicine, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology. The participants were investigated using a general information questionnaire, the ACP Readiness Scale, the Death Attitude Profile-Revised, and the Social Support Rating Scale. Latent profile analysis (LPA) was conducted using Mplus 8.3 to identify latent profiles of ACP readiness. Binary logistic regression was used to explore the influencing factors of profile membership, and the Bolck-Croon-Hagenaars (BCH) method was employed to compare differences in death attitudes between the latent profiles. Results Two latent profiles of ACP readiness were identified: the “low ACP readiness” group (56.87%) and the “high ACP readiness” group (43.13%). Binary logistic regression showed that higher educational level, longer disease course, higher NYHA functional class, and greater social support were statistically significant positive predictors of belonging to the “high ACP readiness” group ( P 0.05). The BCH analysis revealed that the “low ACP readiness” group scored significantly higher on fear of death and death avoidance than the “high ACP readiness” group, while the “high ACP readiness” group scored significantly higher on natural acceptance ( P 0.05). No significant differences were found between the two groups in approach acceptance or escape acceptance ( P 0.05). Conclusion There is significant heterogeneity in ACP readiness among CHF patients. Educational level, disease course, NYHA functional class, and social support are important factors influencing profile membership. The two profiles differ significantly in fear of death, death avoidance, and natural acceptance. Healthcare providers should develop targeted intervention strategies based on the characteristics of different profiles and strengthen death education to enhance patients' ACP readiness.
Lin et al. (Wed,) conducted a cross-sectional in Chronic heart failure (n=313). Longer disease course, higher NYHA functional class, higher educational level, and greater social support significantly predicted high advance care planning readiness in patients with chronic heart failure.