The Discussion About Advance Directives

Johnston, Sarah

doi:10.1001/archinte.1995.00430100047005

Cited by 157 publications

(15 citation statements)

References 14 publications

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“…Offering structured and repeated AD consultations to outpatients is more challenging than offering them to hospitalized patients as it requires an appropriate infrastructure and qualified and dedicated personnel. Furthermore, AD consulting often seems to be facilitated by a hospital admission as the reasons for hospitalization, such as upcoming intensive therapy, medical complications, or worsening health condition, can prompt AD discussions [25,32,33]. …”

Section: Discussionmentioning

confidence: 99%

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The Impact of a Tumor Diagnosis on Patients' Attitudes toward Advance Directives

et al. 2014

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Background: Although advance care planning and the completion of advance directives (ADs) are important tools to avoid unwanted aggressive care once patients have lost their decision-making capacity, only a minority of cancer patients are admitted with completed ADs, and little is known about patients' wishes regarding AD consultations. Methods: For 1 year, every new patient admitted to the hematology/oncology outpatient clinic of the University Hospital Regensburg received a self-administered questionnaire comprising a self-evaluation of AD knowledge and questions about preferences regarding consultation partners and the time of consultation. Disease-related data were collected from medical records. Statistics were calculated with SPSS. Results: Of the 500 questionnaires handed out, 394 (75%) were evaluable and analyzed. Twenty-eight percent of the participants had completed an AD (living will or health care proxy). Ninety-two percent of the participants without ADs had never received a consultation offer from any professional involved. Only 20% perceived a clear relation between cancer and AD consultations. More than 50% of the participants without ADs were in favor of consultations ‘now' or ‘in a few weeks', while more than 40% objected to AD consultations. Conclusions: Oncology patients have a large unmet demand for AD consultations. However, a relevant percentage of these patients object to AD consultations. Structured and early AD consultation offers should be made, and early discussions about indications for aggressive treatment should take place.

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Section: Discussionmentioning

confidence: 99%

“…Thus far, there have been no comparable surveys in an outpatient setting. Furthermore, little is known about cancer patients' preference [25] regarding when to address advance care planning issues.…”

Section: Introductionmentioning

confidence: 99%

The Impact of a Tumor Diagnosis on Patients' Attitudes toward Advance Directives

et al. 2014

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“…However, their impact has been surprisingly small. Despite legislation in the United States aimed at encouraging the completion of advance directives, less than 10% of healthy Americans have completed one 1. The question remains as to how advance directives can be developed and effectively implemented in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Assessment of competence to complete advance directives: validation of a patient centred approach

Fazel

Hope

Jacoby

1999

BMJ

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Results This patient centred approach for assessing competence to complete advance directives can discriminate between elderly persons living in the community and elderly patients with dementia. The procedure has good interrater (r = 0.95) and test-retest (r = 0.97) reliability. Validity was examined by relating this approach with a global assessment of competence to complete an advance directive made by two of us (both specialising in old age psychiatry). The data were also used to determine the best threshold score for discriminating between those competent and those incompetent to complete an advance directive. Conclusion A patient centred approach to assess competence to complete advance directives can be reliably and validly used in routine clinical practice.

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“…[1][2][3] In the United Kingdom overall drug resistance levels have been low. 4 A surveillance system, the UK Mycobacterial Resistance Network (MYCOBNET), was established in 1994 by the Public Health Laboratory Service to record drug resistance in laboratory isolates of tuberculosis.…”

Section: Discussionmentioning

confidence: 99%

Assessment of competence to complete advance directives: validation of a patient centred approach

1999

BMJ

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The Discussion About Advance Directives

Cited by 157 publications

References 14 publications

The Impact of a Tumor Diagnosis on Patients' Attitudes toward Advance Directives

The Impact of a Tumor Diagnosis on Patients' Attitudes toward Advance Directives

Assessment of competence to complete advance directives: validation of a patient centred approach

Assessment of competence to complete advance directives: validation of a patient centred approach

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