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Sellars M, Tran J, Nolte L, et al. Public knowledge, preferences and experiences about medical substitute decision-making: a national cross-sectional survey. BMJ Support Palliat Care. 2021;doi: 10.1136/bmjspcare-2020-002619.
Sellars, M., Tran, J., Nolte, L., White, B., Sinclair, C., Fetherstonhaugh, D., & Detering, K. (2021). Public knowledge, preferences and experiences about medical substitute decision-making: a national cross-sectional survey. BMJ supportive & palliative care, . https://doi.org/10.1136/bmjspcare-2020-002619
Sellars, Marcus, et al. "Public knowledge, preferences and experiences about medical substitute decision-making: a national cross-sectional survey." BMJ supportive & palliative care vol. (2021). doi: https://doi.org/10.1136/bmjspcare-2020-002619
Sellars M, Tran J, Nolte L, White B, Sinclair C, Fetherstonhaugh D, Detering K. Public knowledge, preferences and experiences about medical substitute decision-making: a national cross-sectional survey. BMJ Support Palliat Care. 2021 Mar 15; doi: 10.1136/bmjspcare-2020-002619. Epub 2021 Mar 15. PMID: 33722813.
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BMJ Support Palliat Care. 2021 Mar 15; doi: 10.1136/bmjspcare-2020-002619. Epub 2021 Mar 15.

Public knowledge, preferences and experiences about medical substitute decision-making: a national cross-sectional survey.

BMJ supportive & palliative care

Marcus Sellars, Julien Tran, Linda Nolte, Ben White, Craig Sinclair, Deirdre Fetherstonhaugh, Karen Detering

Affiliations

  1. Department of Health Services Research & Policy, The Australian National University, Canberra, Australian Capital Territory, Australia [email protected].
  2. Advance Care Planning Australia, Austin Health, Melbourne, Victoria, Australia.
  3. Australian Centre for Health Law Research, Queensland University of Technology, Brisbane, Queensland, Australia.
  4. Australian Research Council Centre of Excellence in Population Ageing Research, University of New South Wales, Sydney, New South Wales, Australia.
  5. Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia.
  6. School of Psychology, University of New South Wales, Sydney, New South Wales, Australia.
  7. Australian Centre for Evidence Based Aged Care, La Trobe University, Melbourne, Victoria, Australia.
  8. Faculty of Health, Arts and Innovation, Swinburne University, Melbourne, Victoria, Australia.

PMID: 33722813 DOI: 10.1136/bmjspcare-2020-002619

Abstract

OBJECTIVE: To describe the Australian adult public's knowledge and experiences regarding substitute decision-making for medical decisions and their preferences for obtaining information about the substitute decision-maker (SDM) role.

METHODS: This is a national cross-sectional online survey of the Australian adult public. The survey examined participants' advance care planning (ACP) awareness and experience, SDM experiences and preferences for obtaining more information about SDM, and participant knowledge about SDM.

RESULTS: Of 1586 people who opened the survey, 1120 (70.6%) were included in the final sample. 13% (n=142) of participants indicated they had acted as an SDM. A median score of two correct responses out of five showed low to moderate knowledge about the SDM role among all participants, with only 33% reporting awareness of SDM laws existing in Australia. While most (59%) participants ranked a health professional as their preferred source of obtaining information about supporting SDMs, few participants who had been an SDM (n=64, 45%) reported obtaining any support in making medical decisions. The median SDM knowledge scores for people who had discussed ACP (3.0 vs 2.0, U=1 45 222, z=6.910, p<0.001), documented their ACP preferences (3.0 vs 2.0, U=71 984, z=4.087, p<0.001) or acted in the SDM role (3.0 vs 2.0, U=56 353, z=-3.694, p<0.001) were significantly higher compared with those who had not.

CONCLUSIONS: The Australian public may have low to moderate knowledge about the SDM role and access only minimal support when making challenging medical decisions.

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Keywords: end of life care

Conflict of interest statement

Competing interests: None declared.

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