Skip to content
DraconiticResearch
Search Sources API
220,788 studies31 sourcesUpdated 35 min ago
Peer-reviewedCC BY-NC-ND 4.0BMC Palliative Care

Advance care planning: awareness and readiness amongst stroke survivors undergoing inpatient rehabilitation in a multi-ethnic Asian country: an exploratory study

  • Anna Rosiana1,2
  • Llewelyn Yi Chang Tan2
  • Serene Leong Hwee Tan3,2
  • Lee Yang Chua4
  • Keng He Kong2
4 affiliations
  1. 1Division of Rehabilitation Medicine, Department of Medicine, National University Hospital, Singapore, Singapore
  2. 2Department of Rehabilitation Medicine, Tan Tock Seng Hospital, Address: 1 Tan Tock Seng Link, Singapore, 307382 Singapore
  3. 3Department of Nursing, Advanced Practice Nurse (Specialty Nursing), Tan Tock Seng Hospital, Singapore, Singapore
  4. 4Department of Care and Counselling, Tan Tock Seng Hospital, Singapore, Singapore
Read full textDOICite

Abstract

Background: Stroke remains a major contributor to morbidity and mortality worldwide. Survivors have strong reasons to engage in Advance Care Planning (ACP), yet ACP remains relatively new in Asia. This study aimed to (1) investigate awareness and attitudes towards ACP among stroke survivors admitted to an inpatient rehabilitation centre; (2) assess their readiness for ACP discussions after stroke; and (3) identify factors influencing ACP awareness and willingness to engage in ACP in Singapore.

Methods: A cross-sectional study was conducted among stroke survivors admitted to an inpatient rehabilitation centre in Singapore between June 2022 and July 2023. Eligible participants were adults without significant cognitive impairment or aphasia. Clinical data were extracted from medical records and survey were conducted. Logistic regression analyses identified factors associated with pre-stroke ACP awareness and willingness to learn more about ACP.

Results: A total of 101 stroke survivors were recruited. Thirty-three participants (32.7%) had pre-stroke awareness of ACP, and 11 (11.8%) had completed ACP prior to stroke. Among 89 participants without pre-existing ACP, 71 (79.8%) were willing to learn more, and 70 (78.8%) agreed to referral for further ACP discussion. Univariate analyses showed that female gender (OR 2.632; p = 0.042) and higher education level (OR 1.952; p = 0.008) were significant positive factors associated with having pre-stroke ACP awareness. Among participants without prior ACP, female gender was the only significant positive factor associated with the willingness to learn more about ACP (OR 5.850; p = 0.025).

Conclusion: ACP awareness and completion rates remain low in Singapore’s multiethnic Asian population. Education level and gender influence ACP awareness and uptake. The inpatient rehabilitation setting represents a key opportunity to engage stroke survivors in ACP discussions. Targeted strategies addressing educational and gender disparities should be integrated into stroke rehabilitation programmes.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12904-026-02247-1.

Related

  1. Effectiveness of the AVANT neurorehabilitation training program on stroke rehabilitation awareness and practice in Vietnam
    Tuyen Van Nguyen, Linh Quang Nguyen, Ngoc Hoang Nguyen +2
    Journal of medicine and lifePeer-reviewedCC BYFull textGeneral medicineEurope PMC
  2. Remote Multicomponent Rehabilitation in Intensive Care Unit Survivors
    Brenda M O'Neill, Judy Martina Bradley, Bronwen A. Connolly +77
    JAMAPeer-reviewedLicence not stated12 citedGeneral medicineOpenAlex
  3. Awareness, Accessibility, Authenticity, and Appropriateness: Multilevel Determinants of Research Engagement Among Underrepresented AYA Cancer Survivors
    Lauren V. Ghazal, Jacob Dogtir, J. Lea Brown +8
    Cancer Control: Journal of the Moffitt Cancer CenterPeer-reviewedCC BY-NC 4.0Full textEpidemiology & public healthPMC
  4. Plasma Vitamin C, 25-Hydroxyvitamin D, and the Lactate-to-Albumin Ratio at PICU Admission in Survivors and Non-Survivors of Phoenix-Defined Pediatric Sepsis and Septic Shock: An Exploratory Prospective Cohort Study
    Jesús J. Martínez-García, Adrian Canizalez-Román, Ricardo Zatarain-Lopez +11
    Pediatric reportsPeer-reviewedCC BYFull textGeneral medicineEurope PMC
  5. H2FPEF Score and Charlson Comorbidity Index as Independent Predictors of Cardiovascular Outcomes in Elderly Patients Undergoing Geriatric Rehabilitation
    Nicolas Dayer, Denise Auberson, Henri Lu +7
    Clinical cardiologyPeer-reviewedCC BYFull textCardiovascular medicineEurope PMC

Cite

BibTeXRIS
BibTeX
@article{rosiana2026advance,
  title = {{Advance care planning: awareness and readiness amongst stroke survivors undergoing inpatient rehabilitation in a multi-ethnic Asian country: an exploratory study}},
  author = {Anna Rosiana and Llewelyn Yi Chang Tan and Serene Leong Hwee Tan and Lee Yang Chua and Keng He Kong},
  journal = {BMC Palliative Care},
  year = {2026},
  month = aug,
  doi = {10.1186/s12904-026-02247-1},
  url = {https://doi.org/10.1186/s12904-026-02247-1},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Advance care planning: awareness and readiness amongst stroke survivors undergoing inpatient rehabilitation in a multi-ethnic Asian country: an exploratory study
AU  - Anna Rosiana
AU  - Llewelyn Yi Chang Tan
AU  - Serene Leong Hwee Tan
AU  - Lee Yang Chua
AU  - Keng He Kong
PY  - 2026
DA  - 2026/08/12
JO  - BMC Palliative Care
DO  - 10.1186/s12904-026-02247-1
UR  - https://doi.org/10.1186/s12904-026-02247-1
AB  - Background: Stroke remains a major contributor to morbidity and mortality worldwide. Survivors have strong reasons to engage in Advance Care Planning (ACP), yet ACP remains relatively new in Asia. This study aimed to (1) investigate awareness and attitudes towards ACP among stroke survivors admitted to an inpatient rehabilitation centre; (2) assess their readiness for ACP discussions after stroke; and (3) identify factors influencing ACP awareness and willingness to engage in ACP in Singapore.  Methods: A cross-sectional study was conducted among stroke survivors admitted to an inpatient rehabilitation centre in Singapore between June 2022 and July 2023. Eligible participants were adults without significant cognitive impairment or aphasia. Clinical data were extracted from medical records and survey were conducted. Logistic regression analyses identified factors associated with pre-stroke ACP awareness and willingness to learn more about ACP.  Results: A total of 101 stroke survivors were recruited. Thirty-three participants (32.7%) had pre-stroke awareness of ACP, and 11 (11.8%) had completed ACP prior to stroke. Among 89 participants without pre-existing ACP, 71 (79.8%) were willing to learn more, and 70 (78.8%) agreed to referral for further ACP discussion. Univariate analyses showed that female gender (OR 2.632; p = 0.042) and higher education level (OR 1.952; p = 0.008) were significant positive factors associated with having pre-stroke ACP awareness. Among participants without prior ACP, female gender was the only significant positive factor associated with the willingness to learn more about ACP (OR 5.850; p = 0.025).  Conclusion: ACP awareness and completion rates remain low in Singapore’s multiethnic Asian population. Education level and gender influence ACP awareness and uptake. The inpatient rehabilitation setting represents a key opportunity to engage stroke survivors in ACP discussions. Targeted strategies addressing educational and gender disparities should be integrated into stroke rehabilitation programmes.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12904-026-02247-1.
SN  - 1472-684X
ER  -