Work

Analysis of middle-aged and older adults’ willingness concerning living wills and associated factors

Year: 2026

Type: article

Abstract: Objective To investigate the current status of Living Will willingness among middle-aged and older adults in Shenzhen, China, and to systematically identify its associated influencing factors. Methods Based on the Theory of Planned Behavior and the Life Course Theory, a cross-sectional survey was conducted from May 2023 to February 2024. A total of 519 middle-aged and older adults were recruited in Shenzhen. Data were collected using a general information questionnaire, a Living Will knowledge questionnaire, a Living Will attitude scale, a family APGAR scale, a health status scale, and a social support scale. Chi-square test, Mann–Whitney U test, and Firth penalized logistic regression analysis were employed to identify associated factors. Results The proportion of participants with a positive willingness toward creating a Living Will was 64.7%. Significant influencing factors included age ( p = 0.033), being a healthcare professional ( p = 0.033), being a civil servant or employee of a public institution/enterprise ( p = 0.033), experience of witnessing a rescue or death ( p = 0.033), knowledge score ( p = 0.032), attitude score ( p = 0.007), family function ( p = 0.003), subjective social support ( p = 0.009), and utilization of social support ( p = 0.027). Furthermore, an educational level of college or above ( p = 0.053), monthly income ( p = 0.067), religious belief ( p = 0.073), physical health status ( p = 0.073), psychological health status ( p = 0.099), and objective social support ( p = 0.055) showed borderline significance. Conclusion Middle-aged and older adults in Shenzhen demonstrated a relatively positive willingness regarding Living Wills. Nine protective factors were identified, including a higher education level, presence of religious belief, higher monthly income, experience of witnessing medical rescue or death, better knowledge of Living Wills, a positive attitude toward Living Wills, good family function and psychological status, and strong social support.

Source: Frontiers in Public Health

DOI: 10.3389/fpubh.2025.1743077

Authors: Linyu Jiang, Yuwan Duan, Daping Li

Institution: Guangdong Medical College

Language: English

Topic: Palliative Care and End-of-Life Issues

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801