Study on the current status and influencing factors of cognition and attitudes toward advance care planning among breast cancer patients

Corresponding author: 李媛, 21298993@qq.com

DOI: 10.12201/bmr.202603.00049

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  Abstract: Objective To identify factors affecting breast cancer patients attitudes toward advance care planning (ACP) based on the Ottawa Decision Support Framework, and provide evidence for clinical interventions. Methods A convenience sample of 428 breast cancer patients completed the ACP Questionnaire and scales for death attitude, family resilience, health literacy, and treatment burden. Factors were analyzed across three dimensions: decision perception, significant others’ attitudes/behaviors, and health cognition. Results The mean ACP attitude score was (46.82±19.90). Key influencing factors included time since diagnosis awareness, death attitude, treatment burden, family resilience, relatives/friends’ life-sustaining treatment experience, and health literacy (all P<0.05), explaining 48% of total variance. The three dimensions contributed additional explanatory power of 29.6%, 1.2%, and 60%, respectively. Conclusion Breast cancer patients hold a moderately high attitude toward ACP. Decision perception and health cognition exert strong impacts, while significant others’ attitudes/behaviors have a weaker effect. Strengthening ACP education, fostering a rational view of death, and boosting social support are critical to improving patients’ ACP participation.

  Key words: Breast cancer patients; Advance care planning (ACP); Attitude; Influencing factors; The ottawa decision sopport frame

  Submit time: 12 March 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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  1	2026-02-02	10.12201/bmr.202603.00049V1	Download

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