A Cross- Sectional Survey of Public Awareness and Knowledge of Advance Care Planning

Aim: The aim of this study was to explore current public awareness, knowledge, and attitudes in relation to ACP. Subject and methods: A cross-sectional series survey design was used. Questions were included in the Northern Ireland Life and Times Survey, administered to two independent samples in 2018 and 2022. Statistical analysis included descriptive statistics and linear regression analysis. Results: Knowledge of ACP was low across both timepoints, and engagement was even lower; 25% at timepoint 1 and 33% at timepoint 2 wanted to learn more about ACP, and 47% strongly agreed/agreed that they were in good health and did not want to think about ACP. There was agreement with the benefits of ACP in terms of comfort, knowing they have left guidance about their wishes (83.3%) but concerns also exist around wishes being respected (52%). Conclusions: Public knowledge and engagement with ACP are low. Attitudes to ACP are conflicting and misconceptions persist. Emphasis is needed on reframing ACP with the general public. There is a need for a societal shift and a change in culture and practice for the public to engage meaningfully with ACP. Consideration should be given to the ways in which education of the general public is approached. Strategies both within and without the healthcare system should be utilised effectively.