研究目的：在台灣推動預立醫療自主計畫（Advance Care Planning, ACP）的經驗中，由於傳統討論死亡話題的禁忌，常常使得民眾不願意清楚的表達自己的意願，因此有效運用適合的文化概念以改善民眾對預立醫療自主計畫的認識，是十分重要的議題。材料與方法：發展社區宣導教材及單張，於花蓮縣內11個社區，由資深安寧醫護人員擔任講師，進行宣導課程，課程結束後以問卷方式評估不同族群民眾對於「自覺身體健康狀況」、「生命末期時之代言人」、「心肺復甦術之過程及接受程度」、以及「是否願意簽屬安寧緩和意願書」等議題之看法及差異性。結果：共有235位社區民眾填答，願意簽屬預立安寧緩和意願書之比例為32%，有51.1%之民眾還需思考，沒辦法當場決定。閩南族群、身體自覺狀況較健康、對心肺復甦術較了解、及年紀較輕之民眾願意簽署之比例為較高（p<0.05），結論：文化、語言之差異及對心肺復甦術之了解程度，的確會影響民眾簽屬預立醫療自主計畫之意願，發展具備文化適應性之教材內容，應能協助建立適合我國國情且能順利推動之完整預立醫療自主計畫。

Purpose: In Taiwan, people do not want to talk about death in daily conversation. It is difficult to discuss with people about their advance care planning (ACP). We need to develop a culture sensitive strategy to promote advance care planning in Taiwan society. Material and Methods: We developed educating materials and conducted community programs to promote ACP in eastern Taiwan. After the program, we evaluated the concepts about self-reported health status, choosing of surrogate, the idea and understanding about Do Not Resuscitation and the acceptance of ACP of the participants. Results: There are 235 community dwelling residents included. The rate of agree of advance directives are 32%. About 51.1% participants expressed that they can't make decisions right away. The factors influencing higher agreement of ACP are race, healthy status, understanding about DNR and the younger age (p＜0.05). Conclusions: The ACP programs for local culture can provide culture-sensitive choices and reflections for elders in Taiwan. They are more likely to discuss their own end-of-life decisions through this program.