COVID-19 Risk Perceptions and Intentions to Engage in Familial Advance Care Planning: The Mediating Role of Death Anxiety
- 3 October 2021
- journal article
- research article
- Published by Taylor & Francis Ltd in Journal of Health Communication
- Vol. 26 (10), 684-695
- https://doi.org/10.1080/10810730.2021.1998844
Abstract
Advance care planning (ACP) is the process of communicating about end-of-life (EOL) care with loved ones. Due to the deadly nature of COVID-19, ACP is vital. Unfortunately, fewer than 30% of American patients engage in ACP. In addition to low motivation, people experiencing death anxiety (DA) similarly avoid ACP. This finding coincides with predictions from terror management theory (TMT) that people avoid DA-arousing behaviors. Guided by the theory of planned behavior (TPB) and the health belief model (HBM), we posited COVID-19 risk perceptions would be positively associated with determinants of health behavior, including intention to share and ask loved ones about EOL wishes, as well as the associated attitudes, norms, and level of perceived behavioral control regarding ACP. Guided by TMT, we posited that DA negatively mediated relationships between COVID-19 risk perceptions and these behavioral determinants. An MTurk participant sample (N = 522) completed a survey about COVID-19 risk perceptions, DA, and health behavior determinants in the context of ACP. Results indicate COVID-19 risk perceptions were rarely directly related to these determinants. However, results of PROCESS mediation models examining the role of DA in these relationships reveal a different picture. While direct relationships were rarely significant, DA negatively mediated most relationships between COVID-19 risk perceptions and behavioral determinants. Our results indicate DA demotivates EOL communication during the COVID-19 pandemic; a concerning yet important finding due to the increased importance of ACP in the context of a deadly disease like COVID-19.Keywords
Funding Information
- George Mason University
This publication has 67 references indexed in Scilit:
- Use of Role Model Stories to Overcome Barriers to Hospice among African AmericansJournal of Palliative Medicine, 2011
- A Meta-Analysis of the Effectiveness of Health Belief Model Variables in Predicting BehaviorHealth Communication, 2010
- Two Decades of Terror Management Theory: A Meta-Analysis of Mortality Salience ResearchPersonality and Social Psychology Review, 2010
- Understanding Advance Care Planning as a Process of Health Behavior ChangeJournal of the American Geriatrics Society, 2009
- Perceived Threat, Risk Perception, and Efficacy Beliefs Related to SARS and Other (Emerging) Infectious Diseases: Results of an International SurveyInternational Journal of Behavioral Medicine, 2009
- A Clinical Framework for Improving the Advance Care Planning Process: Start with Patients' Self‐Identified BarriersJournal of the American Geriatrics Society, 2008
- Associations Between End-of-Life Discussions, Patient Mental Health, Medical Care Near Death, and Caregiver Bereavement AdjustmentJAMA, 2008
- Revised susceptibility, benefits, and barriers scale for mammography screeningResearch in Nursing & Health, 1999
- The theory of planned behaviorOrganizational Behavior and Human Decision Processes, 1991
- Effectiveness of a Death-Education Program in Reducing Death Anxiety of Nursing StudentsOMEGA - Journal of Death and Dying, 1991