ArticleBMC palliative care2026
Family communication, death taboo, and advance directives: a cross-sectional study of institutionalized older adults in China.
Article in BMC palliative care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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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Who cites it
2 citing papers in PubMed.
- Willingness to participate in advance care planning among older adults with relatively high educational attainment in a continuing care retirement community of the Beijing-Tianjin-Hebei region: a qualitative study.BMC palliative care · 2026Article
- Breaking the silence: the effectiveness of a dialogue-based intervention on family functioning and psychological distress among young adults in a Chinese context.Frontiers in psychology · 2026Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA conceptually guided framework examining how family communication relates to advance directive completion rates among older adults may offer useful insights for improving end-of-life decision-making in aging societies. However, persistent inconsistencies across studies remain unresolved, coupled with limited mechanistic explanations.
methodThe data are derived from a field survey project conducted in August 2023, targeting older adults residing in a public elder care institution in Hangzhou, China. This project collected data from 571 participants regarding their inclination toward death taboo, attitudes toward advance directives, and decisions on advance directive formulation. Moderation modeling and marginal analysis are employed to examine the relationships among family communication, death taboo, and advance directive completion.
resultsA total of 25.09% of participants report avoiding discussions about death in family settings, while 57.27% perceive advance directives as beneficial, and 21.72% formulate a personal advance directive. Family communication is associated with an 11.44% higher probability of advance directive completion, whereas death taboo shows a significant interaction effect, with the positive association attenuated at higher levels of death taboo.
conclusionThis study suggests that higher levels of death taboo are associated with a weaker relationship between family communication and advance directive completion. We interpret this pattern cautiously within a family protectionism framework, where death taboo may reflect protective information shielding within family networks and may also be linked to a “fear-of-fear” dynamic.
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