Hospice Palliative Care Cognition and Willingness for Prolonged Mechanical Ventilation in Taiwan

Background: Increasing case numbers of prolonged mechanical ventilation (PMV) in Taiwan, over half of family members of PMV patients in capital city felt upset to decide prolonged mechanical ventilation. This study aims to analyze the hospice palliative care cognitions and willingness of the main caregivers of family for prolonged mechanical ventilation patients in Taiwan. Methods: This study used a structured questionnaire (average Content validity index value is 0.96 (0.73-1.00), Kuder-Richardson Formula (KR-20) coefficient is 0.78) as a research tool to target 601 valid questionnaires for 64 respiratory care institutions that provide prolonged mechanical ventilation care in Taiwan. Based on different stages of care unit, which are intensive care unit (ICU) for acute stage, respiratory care center (RCC) for subacute, respiratory care ward (RCW) and home care for chronic ventilatory dependent. We sought to explore cognitive understanding of the Hospice Palliative Care Act at each stage, and the willingness to sign the acceptance of palliative care. Results: There were 70.55% who had heard of the Hospice Palliative Care Act, only 42.33% of respondents had information from medical staff. The average cognitive score of the 601 valid questionnaires recovered was 51.35 ± 29.50 points, the cognitive score of primary care family for awareness of the Hospice Palliative Care Act were ranked in the order of home care (56.37 ± 24.91 points), RCW (53.92 ± 30.79 points), RCC (48.08 ± 29.35 points) and ICU (47.00 ± 31.75 points). A total of 66.22% (50.8+16.14%) of the family members accept do not resuscitation orders when their family (PMV patient) member needs life-sustaining treatment. In the signing of their own advanced directives for hospice or palliative care part, 67.55% of the family members expressed their willingness to accept. Conclusions: The result of our finding that low cognition and high willingness for the main family of PMV with hospice palliative care but low medical staff offering this information. This relative information is needed.