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Attitudes and Decisional Conflict in Family Caregivers of Persons With Dementia: A Mediating Role of Perceived Benefits of Advance Care Planning
KyungAh Cho, JUNGHEE KANG, Jung‐Ah Lee, Sang Yi Baek, Young Ko, JinShil Kim. Journal of Applied Gerontology, 2026-07-27
Topic: Risk, prevention and care in population studies
Background Family caregivers of people with dementia often experience decisional conflict—a state of uncertainty regarding end-of-life care choices—influenced by attitudes and perceived benefits of advance care planning. Objective To examine whether perceived benefits mediate the relationship between attitudes and decisional conflict among these caregivers. Methods A cross-sectional study was conducted with 92 family caregivers in South Korea. Mediation analysis was performed, controlling for age, education, and depressive symptoms. Results More positive attitudes were associated with lower decisional conflict directly and indirectly through perceived benefits. The indirect effect was significant ( B = −0.371, 95% CI [−0.867, −0.033]), indicating partial mediation. In addition, the total and direct effects of attitudes on decisional conflict were both statistically significant ( p < .05 for both). The model explained 28.2% of the variance in decisional conflict ( F = 6.75, R 2 = .282, p < .001). Perceived benefits may reduce decisional conflict among dementia caregivers.
Key findings
- Results More positive attitudes were associated with lower decisional conflict directly and indirectly through perceived benefits.
- The indirect effect was significant ( B = −0.371, 95% CI [−0.867, −0.033]), indicating partial mediation.
- In addition, the total and direct effects of attitudes on decisional conflict were both statistically significant ( p < .05 for both).
Why it matters
This cross-sectional study of 92 family caregivers of people with dementia in South Korea found that more positive attitudes were associated with lower decisional conflict, partly through perceived benefits of advance care planning. The model explained 28.2% of the variance in decisional conflict, suggesting perceived benefits may reduce it.
Study details
- Study designcross-sectional
- Effect size28.2%
- Evidence strengthLow
How this study scored 35/100
Published in a peer-reviewed journal, and it is a snapshot of people at one point in time. Scored zero for sample size, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of Applied Gerontology) |
| Journal's citation record | 1 / 4 | Journal of Applied Gerontology: journal h-index 92 (OpenAlex, 2026-10-29) |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | 0 / 6 | Cited 0.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author JinShil Kim: h-index 19 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Kentucky: institution h-index 824 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 42509205) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 35 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Cho, K., JUNGHEE, K. A. N. G., Lee, J., Baek, S. Y., Ko, Y., & Kim, J. (2026). Attitudes and Decisional Conflict in Family Caregivers of Persons With Dementia: A Mediating Role of Perceived Benefits of Advance Care Planning. Journal of Applied Gerontology. https://doi.org/10.1177/07334648261472262
Vancouver
Cho K, JUNGHEE KANG, Lee J, Baek SY, Ko Y, Kim J. Attitudes and Decisional Conflict in Family Caregivers of Persons With Dementia: A Mediating Role of Perceived Benefits of Advance Care Planning. Journal of Applied Gerontology. 2026. doi:10.1177/07334648261472262. PMID: 42509205.
BibTeX
@article{cho2026-42509205,
author = {Cho, KyungAh and JUNGHEE, K. A. N. G. and Lee, Jung‐Ah and Baek, Sang Yi and Ko, Young and Kim, JinShil},
title = {{Attitudes and Decisional Conflict in Family Caregivers of Persons With Dementia: A Mediating Role of Perceived Benefits of Advance Care Planning}},
journal = {Journal of Applied Gerontology},
year = {2026},
doi = {10.1177/07334648261472262},
pmid = {42509205},
url = {https://doi.org/10.1177/07334648261472262}
}
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