SynthesisBMC palliative care2026
Factors associated with participation in advance care planning among people with different degrees of cognitive impairment: a systematic review.
Synthesis in BMC palliative care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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8 authors.
Funding
Abstract
backgroundCognitive function and decision-making ability are crucial for participation in advance care planning (ACP). People with different degrees of cognitive impairment face considerable difficulty and exhibit significant heterogeneity in their participation in ACP.
methodsSix English electronic databases (Embase, PubMed, Cochrane Library, PsycINFO, CINAHL, and Web of Science) and four Chinese databases (CNKI, CBM, Wanfang, and VIP) were searched from inception to February 18, 2024. The QualSyst tool was used to evaluate the study quality. Thematic synthesis was used to analyze the data.
resultsThirty-seven papers were included, comprising 21 qualitative, 9 quantitative, and 7 mixed studies. Factors related to ACP antecedents (sociodemographic characteristics, ACP perception, prior ACP experience, disease-related factors, and socio-cultural context) and ACP attributes (ACP procedural elements and ACP supportive mechanisms) influenced the participation of people with different degrees of cognitive impairment in ACP, but some differences were also found. Difficulty in accepting the disease and decision conflicts were not found to have an effect on mild cognitive impairment. Care network relationship was not found to influence mild to moderate dementia. Relying on surrogate decisions, decision conflicts, ACP data storage and informal social support were not found to influence moderate to severe dementia.
conclusionsThis study determined common and specific factors influencing the ACP participation of people with different degrees of cognitive impairment. The results could provide evidence for developing targeted interventions for promoting people with different degrees of cognitive impairment to participate in ACP.
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