Evidence map›Paper›PMID 42165276›Full record

ArticlePalliative & supportive care2026

Frailty and the confidence to plan ahead: Decision-making self-efficacy and advance care planning among older adults receiving home healthcare.

Chi Hsien Huang, Cheng-Pei Lin, Kelly Yen-Chih Chen, Jung-Yu Liao, Shao-Yi Cheng, Wei-Zhe Tseng, Hiroyuki Umegaki, Hsien-Cheng Chang, Chia-Ming Li, Wen-Jung Sun and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Palliative & supportive 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.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Chi Hsien HuangDepartment of Family Medicine and Community Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.ORCID https://orcid.org/0000-0002-4619-5144
Cheng-Pei LinInstitute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan.ORCID https://orcid.org/0000-0001-5810-8776
Kelly Yen-Chih ChenDepartment of Family Medicine and Community Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
Jung-Yu LiaoDepartment of Health Promotion and Health Education, National Taiwan Normal Universityhttps://ror.org/059dkdx38, Taipei, Taiwan.
Shao-Yi ChengDepartment of Family Medicine, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan.
Wei-Zhe TsengDepartment of Family Medicine and Division of Geriatrics and Gerontology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Hiroyuki UmegakiDepartment of Community Healthcare & Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Hsien-Cheng ChangOffice of the Commissioner, Keelung City Health Bureau, Keelung, Taiwan.
Chia-Ming LiFamily Medicine Department, National Taiwan University Hospital Beihu Branchhttps://ror.org/03nteze27, Taipei, Taiwan.
Wen-Jung SunDepartment of Family Medicine, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan, Taiwan.
Hung-Yi ChiouInstitute of Population Health Sciences, National Health Research Instituteshttps://ror.org/02r6fpx29, Miaoli, Taiwan.
Sang-Ju YuHome Clinic Dulan, Taitung, Taiwan.
Chao A HsiungNational Center for Geriatrics and Welfare Research, National Health Research Institutes, Miaoli, Taiwan.
Ping-Jen ChenDepartment of Family Medicine and Division of Geriatrics and Gerontology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe relationship between frailty, self-efficacy, and advance care planning (ACP) remains unclear in Asia. This study examined how frailty status relates to decisional self-efficacy, ACP engagement, and advance directive completion among older adults receiving home healthcare in Taiwan.

methodsA cross-sectional analysis was conducted using baseline data from a nationwide cohort in Taiwan. Participants (

resultsPatients with greater frailty had lower odds of high decisional self-efficacy (CFS: 8-9: odds ratio [OR] = 0.38, 95% confidence interval [CI] = 0.14-1.07) but higher odds of ACP engagement (CFS: 6: OR = 3.38, 95% CI = 1.40-8.17; CFS: 7: OR = 2.52, 95% CI = 1.08-5.89) compared with mildly frail individuals. However, this increase did not extend linearly to the very severely frail group. Advance directive completion remained low across all frailty levels (4.8-10.0%) and was not significantly associated with frailty status.

conclusionsFrailty was associated with lower decisional self-efficacy but higher readiness for ACP, revealing a divergence between perceived confidence and planning motivation. Despite greater engagement, advance directive completion remained low. Stage-sensitive, values-based approaches may help bridge the gap between intention and documentation across the frailty spectrum.

Indexed as

Advance Care PlanningDecision MakingFrail ElderlyFrailtySelf EfficacyAgedAged, 80 and overCross-Sectional StudiesFemaleHome Care ServicesHumansMaleSurveys and QuestionnairesTaiwanadvance care planningdecision-makingFrailtyhome healthcareself-efficacy

Identifiers

PMID42165276
PMCPMC13202402

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.