Perceptions, Attitudes, and Knowledge toward Advance Directives: A Scoping Review

Abstract

(1) Background: Advance directives are an expression of a person’s autonomy regarding end-of-life care. Several studies have shown that the level of completion in countries where advance directives are legalised is low. To better understand this phenomenon, it is important to know the perceptions, attitudes, and knowledge that the population has about this instrument. The aim of this article was to explore a population’s perceptions and/or attitudes and/or knowledge toward advance directives. (2) Methods: A search was conducted in March 2023 in the ISI Web of Knowledge, Scopus, and PubMed databases using the following keywords: “advance care directives”, “advance care planning”, “perceptions”, “attitudes”, and “knowledge”. Two hundred and twenty-four (224) articles were identified, and thirteen (13) were included for analysis. (3) Results: The selected articles point to a low level of knowledge toward advance directives: they recognise a strong positive attitude of the population toward the implementation of advance directives but a low level of achievement. (4) Conclusions: Studies on perceptions/attitudes/knowledge toward advance directives are important to understand the real needs of the population regarding this issue and to implement more adequate and effective promotion and dissemination measures.

Advance Directives in Portugal: A Qualitative Survey

“…A systematic review of the literature published from 1994 to 2016, revealed a low level of knowledge about ADs [19]. More recently, another review of literature published from 2018 to 2022 confirmed this fact [50]. As mentioned in the data collection section, it was only after reading the documents provided beforehand that some of the participants became aware of ADs.…”