Patients' Attitudes Toward Advance Directives

Douglas, Rebecca; Brown, Hazel N.

doi:10.1111/j.1547-5069.2002.00061.x

Cited by 76 publications

(74 citation statements)

References 18 publications

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“…4 Our findings indicate that preparedness planning initiated during a palliative care consultation may be a necessary first step to the ultimate completion of an AD, but more importantly, to respecting patients' wishes and preferences the next time they are admitted to the hospital.…”

mentioning

confidence: 74%

Does Preparedness Planning Improve Attitudes and Completion of Advance Directives in Patients with Symptomatic Heart Failure?

Evangelista

Motie²,

Lombardo³

et al. 2012

Journal of Palliative Medicine

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Background and Objective: There is little evidence to support whether interventions that engage patients with symptomatic heart failure (HF) in preparedness planning impacts completion of advance directives (ADs). This study was conducted to assess the impact of a palliative care intervention on health perceptions, attitudes, receipt of information and knowledge of ADs, discussion of ADs with family and physicians, and completion of ADs in a cohort of patients with symptomatic HF. Methods: Thirty-six patients hospitalized for HF decompensation were recruited and referred for an outpatient consultation with a palliative care specialist in conjunction with their routine HF follow-up visit after discharge; telephone interviews to assess health status and attitudes toward ADs were conducted before and 3 months after the initial consultation using an adapted version of the Advance Directive Attitude Survey (ADAS). Information pertaining to medical history and ADs was verified through medical chart abstraction. Results and Conclusion: The current study found support for enhancing attitudes and completion of ADs following a palliative care consultation in patients with symptomatic HF. Despite a significant increase in attitudes toward completion of ADs following the intervention, only 47% of the participants completed ADs. This finding suggests that although education and understanding of ADs is important and can result in more positive attitudes, it does not translate to completion of ADs in all patients.

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mentioning

confidence: 74%

Does Preparedness Planning Improve Attitudes and Completion of Advance Directives in Patients with Symptomatic Heart Failure?

Evangelista

Motie²,

Lombardo³

et al. 2012

Journal of Palliative Medicine

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“…Studies have indicated that, in general, patients believe they should be given choices about the care they receive at the end-of-life. A study of attitudes about advance directives among a sample of 30 inpatients by Douglas and Brown (2002), reported that all thirty participants believed they would be given such choices, while 29 said that, if they were unable to make such choices, their family members would be given the opportunity. In a 2000 study of 1,016 randomly drawn patients from four tertiary hospitals, the most frequently cited reason respondents gave for having a directive was "wanting to make up your own mind" (92%) (Mezey et al, 2000).…”

Section: Review and Critique Of Related Studiesmentioning

confidence: 99%

“…Furthermore, the respondents reported that they felt more comfortable discussing advance directives with an attending physician (94%) or nurse (78%), versus other hospital personnel (39%). Douglas and Brown (2002) found that of their sample of thirty hospital patients, only 18% of the seventeen who didn't complete advance directives listed "discomfort with making decisions about life support" as a reason (p. 64). Although a study of 55 adults aged 50 years or older by Inman (2002) did find a degree of patient discomfort with discussing advance directives with statements such as "it's too morbid" and "I can't cope with the thought of death" (p. 44), these reasons fell behind less emotional ones such as "haven't gotten around to it" and "not ready" (p. 44) and were taken from a minority 22% who had not discussed end-of-life wishes with someone.…”

Section: Review and Critique Of Related Studiesmentioning

confidence: 99%

“…Despite the fact that the majority of people are familiar with the major elements related to advance directives and agree that advance directives are a good idea (Elpern, Yellen, & Burton, 1993;Nolan & Bruder, 1997), studies since the implementation of the PSDA have consistently demonstrated low rates of advance directive completion varying from 5%-49% (Center for Bioethics, 2001;Douglas & Brown, 2002;Elpern et al, 1993;Gordon & Shade, 1999;Mezey, Leitman, Mitty, Bottrell, & Ramsey, 2000). Even more disheartening, of the few individuals who do complete advance directives, only a small number discuss them with their providers or even tell them that the documents exist (Elpern et al, 1993;Gordon & Shade, 1999).…”

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confidence: 99%

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Perceptions of North Dakota registered nurses regarding advance directives

Fritel¹

2005

PsycEXTRA Dataset

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0704-0188Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. ABSTRACTOne of the functions of nurses is to assist individuals to achieve a peaceful death.In order to fulfill this role, patient end-of-life wishes must be communicated to family members and health care providers. Since passage of the Patient Self-Determination Act This was an exploratory descriptive study of nurses registered in and currently working within the state of North Dakota. The purpose of this study was to explore the current perceptions and experiences of North Dakota registered nurses with discussing advance directives with patients and assisting with their implementation.A self-reported questionnaire was mailed to a random sample of 600 registered nurses in the state of North Dakota who met the study criteria. The viii questionnaire elicited participant perceptions and experiences related to advance directives, with a focus on knowledge and comfort levels with discussing advance directives, agreement with the concept of patient autonomy, and barriers to advance directive discussions encountered in practice. Data were analyzed using descriptive and inferential statistics.More than half of all participants demonstrated actual as well as perceived knowledge on questions relating to the PSDA and possession of sufficient information to discuss advance directives with patients. However, the majority indicated that they would benefit from further education on the topic. Likewise, a little more than half of the participants indicated that they were comfortable with discussing advance directives with patients, and agreed that it was indeed a nursing responsibility to do so. However, social work was predominantly ranked number one over the patient's nurse as the person they would contact if a patient asked for advance directive information. Almost all participants agreed with the concept of patient autonomy in making end-of-life caredecisions, yet completion rates of advance directives for themselves reflected the low national averages. Finally, the majority of participants reported encountering multiple barriers to discussing advance directives in their practice, with time constraints ranked number one by a large margin. This was an exploratory descriptive study of nurses registered in and currently working within the state of North Dakota. The purpose of this study was to explore the current perceptions and experiences of North Dakota registered nurses with discussing advance directives with patients and assisting with their implementation.

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“…The Natural Death Act, first passed in California, USA, in 1976, initiated living wills, and some forms of the act have now been implemented in most of the United States and Canada [1,2,3]. By signing living wills, incurable and terminal patients record their last decisions, primarily to refuse or accept cardiopulmonary resuscitation (CPR).…”

Section: Introductionmentioning

confidence: 99%