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This study aimed to analyze factors influencing completion of advance directives(ADs) and withdrawal of life-sustaining treatments(LSTs) among older adults in South Korea. Based on the PRISMA statement and NECA systematic literature review guideline, we identified studies published in journals between 2010 and 2019, and evaluated the quality of included studies using the Mixed Methods Appraisal Tool. Finally, 16 studies were included for analysis. Nine studies published in Korean, and seven published in English. Four studies were hospital-based research, and twelve studies were community-based research. Most older adults agreed to complete ADs, had intention to complete ADs, and disagreed to receive LSTs. However, most decisions related to ADs and LSTs were made near death. Experience and attitude toward ADs and LSTs were significant factors influencing decisions to complete ADs and withdrawal of LSTs. Family function and support were important to make older adults make decisions for themselves based on their preferences at the end-of-life. It is important to provide educational programs about ADs and LSTs for older adults and their family members. Also, training programs for health care providers(HCPs) should be developed to make HCPs support older adults and their family members in the process of decision-making.
