{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T19:52:15Z","timestamp":1791575535353,"version":"4.3.4"},"reference-count":53,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2023R1A2C2007393"],"award-info":[{"award-number":["2023R1A2C2007393"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003052","name":"Ministry of Trade, Industry and Energy","doi-asserted-by":"publisher","award":["20012462"],"award-info":[{"award-number":["20012462"]}],"id":[{"id":"10.13039\/501100003052","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing Open"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To examine factors associated with family caregivers' attitudes toward withholding life\u2010sustaining treatments (LSTs) for older adults with dementia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross\u2010sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A questionnaire survey assessed advance care planning (ACP) knowledge, perceptions of a good death, caregiver burden, and attitudes toward withholding LSTs using previously developed instruments. Hierarchical regression was supplemented by bootstrap confidence intervals, robust inference, and a reduced clinical sensitivity model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>Data were collected from 113 family caregivers of older adults with dementia in South Korea from August 28 to September 12, 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Spouse and child caregivers reported more favourable attitudes than other relatives across the main and sensitivity analyses. The association with ACP knowledge was sensitive to model specification and inference method. Associations with religious affiliation, prior family discussion, and perceptions of a good death were not consistently supported in robustness analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings suggest areas for further study in caregiver education and early ACP discussions. They do not establish causal effects or demonstrate that changing caregivers' attitudes improves care outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for Nursing Practice<\/jats:title>\n                    <jats:p>Nurses can support accessible ACP education and timely, values\u2010based discussions with older adults and their families, adapting communication to each person's decision\u2010specific capacity and preferences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Reporting Method<\/jats:title>\n                    <jats:p>The study was reported according to the STROBE guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>No Patient or Public Contribution<\/jats:title>\n                    <jats:p>The study was designed as a researcher\u2010led questionnaire survey, without patient or public involvement in its design, conduct, analysis, interpretation, or reporting. Family caregivers participated only as survey respondents.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nop2.70922","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T19:15:43Z","timestamp":1791573343000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors Associated With Family Caregivers' Attitudes Toward Withholding Life\u2010Sustaining Treatment in Older Adults With Dementia: A Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1891-4073","authenticated-orcid":false,"given":"Kukjin","family":"Kim","sequence":"first","affiliation":[{"name":"Graduate School, Kyung Hee University  Seoul South Korea"},{"name":"Department of Nursing Seojeong University  Yangju\u2010si South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8279-1319","authenticated-orcid":false,"given":"Yoonah","family":"Noh","sequence":"additional","affiliation":[{"name":"Graduate School, Kyung Hee University  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1483-0633","authenticated-orcid":false,"given":"Jia","family":"Lee","sequence":"additional","affiliation":[{"name":"College of Nursing Science, Kyung Hee University  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/20503121211000918"},{"key":"e_1_2_13_3_1","first-page":"112","article-title":"An Investigative Research on the Attitudes of Intensive Care Unit Nurses and Families on Terminating Life Support","volume":"9","author":"Byun E. K.","year":"2003","journal-title":"Journal of Korean Clinical Nursing Research"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17020557"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.21086\/ksles.2020.08.27.4.473"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2021.06.002"},{"issue":"6","key":"e_1_2_13_7_1","first-page":"585","article-title":"Estimating the Validity of the Korean Version of Expanded Clinical Dementia Rating (CDR) Scale","volume":"19","author":"Choi S. H.","year":"2001","journal-title":"Journal of the Korean Neurological Association"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269216316673552"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13644\u2010012\u20100064\u20103"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.3758\/BRM.41.4.1149"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03339599"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16953"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/nur.4770150406"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0030222820945082"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.4103\/0972\u20102327.192890"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.87960"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.5977\/jkasne.2013.19.3.330"},{"key":"e_1_2_13_18_1","unstructured":"Jeong H. S.2010.\u201cPerceptions of a Good Death Among Physicians and Nurses in One Region. Master's Thesis.\u201d Graduate School of Life Sciences Catholic University of Pusan Busan South Korea."},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/NJH.0000000000000750"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.2185\/jrm.2999"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.16881\/jss.2015.01.26.1.345"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.12925\/jkocs.2019.36.4.1373"},{"key":"e_1_2_13_23_1","unstructured":"Lee J.2021.\u201cAdvancement Strategy for an International Life\u2010Sustaining Treatment Decision System.\u201d The Korean Society for Medical Ethics 2021 Conference.https:\/\/www.youtube.com\/watch?v=mKZDGGOOTSI&t=250s."},{"key":"e_1_2_13_24_1","volume-title":"Research on the Advance Directives System for the Vulnerable and Development of Its Responding Manual","author":"Lee J.","year":"2020"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.5977\/jkasne.2019.25.1.136"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare\u20102020\u2010002242"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apjon.2024.100635"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12904\u2010022\u201001086\u20100"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jagp.2016.01.135"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.13839"},{"key":"e_1_2_13_31_1","volume-title":"Life\u2010Sustaining Treatment Decision System","author":"Ministry of Health and Welfare","year":"2024"},{"key":"e_1_2_13_32_1","volume-title":"A Catholic Guide to End\u2010Of\u2010Life Decisions for Individuals and Families","author":"Missouri Catholic Conference","year":"2017"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12904\u2010022\u201001008\u20100"},{"key":"e_1_2_13_34_1","volume-title":"Registration Status of Advance Directives","author":"National Agency for Management of Life\u2010Sustaining Treatment","year":"2025"},{"key":"e_1_2_13_35_1","volume-title":"Dementia Today","author":"National Institute of Dementia","year":"2025"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/02692163251317856"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1080\/13576275.2025.2449893"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.20970\/kasw.2009.61.2.013013"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(21)02314\u2010X"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1089\/109662103768253687"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269216318809571"},{"key":"e_1_2_13_42_1","volume-title":"Knowledge and Attitudes Toward Advance Directives. Master's Thesis","author":"Seo S. Y.","year":"2019"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soncn.2022.151378"},{"key":"e_1_2_13_44_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010007\u20100693\u20100"},{"key":"e_1_2_13_45_1","doi-asserted-by":"publisher","DOI":"10.1177\/00302228211063297"},{"key":"e_1_2_13_46_1","doi-asserted-by":"publisher","DOI":"10.1177\/26323524241260425"},{"key":"e_1_2_13_47_1","volume-title":"Improve Support for Rising Numbers Living With Dementia, Urges","author":"United Nations","year":"2021"},{"key":"e_1_2_13_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13526"},{"key":"e_1_2_13_49_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269215519852987"},{"key":"e_1_2_13_50_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.1004552"},{"key":"e_1_2_13_51_1","volume-title":"Dementia","author":"World Health Organization","year":"2023"},{"key":"e_1_2_13_52_1","doi-asserted-by":"publisher","DOI":"10.22650\/JKCNR.2020.26.1.86"},{"key":"e_1_2_13_53_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12904\u2010023\u201001260\u2010y"},{"key":"e_1_2_13_54_1","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S395128"}],"container-title":["Nursing Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nop2.70922","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/nop2.70922","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nop2.70922","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T19:15:50Z","timestamp":1791573350000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/nop2.70922"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":53,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/nop2.70922"],"URL":"https:\/\/doi.org\/10.1002\/nop2.70922","archive":["Portico"],"relation":{},"ISSN":["2054-1058","2054-1058"],"issn-type":[{"value":"2054-1058","type":"print"},{"value":"2054-1058","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2025-04-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70922"}}