Factors that Influence Attitudes toward Advance Directives among Hemodialysis Patients
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SUBMITTER: Cho M
PROVIDER: S-EPMC10911983 | biostudies-literature | 2024 Mar
REPOSITORIES: biostudies-literature
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Project description:PurposeThis study aimed to identify attitudes toward advance directives (ADs) among female cancer patients and factors related to ADs.MethodsThe study was conducted at a university hospital in Seoul from September 19, 2020, to January 20, 2021. The participants were 153 patients diagnosed with gynecological cancer or breast cancer. Data were collected using questionnaires and included general characteristics, disease- and AD-related characteristics, knowledge and attitudes about ADs, and attitudes about dignified death. Data were analyzed using the t-test, analysis of variance, and multiple regression analysis.ResultsOnly 2% of the participants completed ADs. The mean score for attitudes toward ADs was 3.30, indicating a positive knowledge and attitude toward dignified death. The factors related to attitudes toward ADs were attitudes toward dignified death (β=0.25, P=0.001), experience discussing life-sustaining treatment (β=0.17, P=0.037), preferred time to have a consultation about ADs (β=0.19, P=0.046), intention to write ADs (β= 0.15, P=0.038), and Eastern Cooperative Oncology Group Performance Status (β=-0.37, P<0.001). The explanatory power of these variables for attitudes toward ADs was 38.5%.ConclusionOverall, patients preferred to have a consultation about ADs when they were still active, mentally healthy, and able to make decisions. Education about ADs should be provided to patients on the first day of hospitalization for chemotherapy or while awaiting treatment in an outpatient setting so patients can write ADs and discuss them with family and friends.
| S-EPMC10519724 | biostudies-literature
Project description:PurposeThis study investigated knowledge of and attitudes toward advance directives (ADs) among middle-aged women in South Korea, their willingness to write ADs in the future, and the factors related to knowledge of and attitudes toward ADs.MethodsData were collected using a self-administrated questionnaire completed by 154 middle-aged women aged 50 to 64 from February to March 2020. The questionnaire asked about participants' knowledge of and attitude toward ADs, willingness to write ADs in the future, experiences with life-sustaining treatment within their families, experience making decisions about life-sustaining treatment, and demographic characteristics.ResultsScores for both knowledge of and attitude toward ADs were relatively high. About 60% of participants gave wrong answers when asked if attorneys were required for writing ADs. A higher knowledge score was significantly associated with a higher attitude score (r=0.227, P<0.01). The women were more likely to be willing to write ADs in the future when they reported a middle income level rather than a lower income level (odds ratio [OR]=5.952, P<0.01), considered themselves unhealthy (OR=5.873, P<0.01), and graduated college or higher (OR=4.096, P<0.05). Furthermore, women who thought that ADs would have an impact on treatment (OR=1.869, P<0.05) and on their families (OR=1.447, P<0.05) were more likely to be willing to write an AD.ConclusionThis study shows that wrong information about ADs persists among middle-aged women, and significant factors associated with knowledge of and attitude toward ADs were identified. Targeted education programs about ADs need to be developed for middle-aged women.
| S-EPMC10180045 | biostudies-literature
Project description:PurposeThis study investigated awareness of dying well, as well as attitudes and preferences toward advance directives (ADs), among elderly individuals who lived alone.MethodsThe participants were 173 elderly people living alone. Data were collected from July 2019 to September 2019 using questionnaires on perceptions of dying well, awareness of advance directives, and general characteristics.ResultsThe majority of participants (68.2%) stated that they had never heard of advance directives. The information they requested to include in their advance directives mostly involved decisions on pain treatment, such as the use of analgesic drugs in the final stages of a terminal disease. Perceptions of dying well were statistically significantly different according to age and education.ConclusionThis study discussed the attitudes and preferences of elderly living alone regarding advance directives to provide basic resources for the systematic and active use of advance directives.
| S-EPMC10332727 | biostudies-literature
Project description:BackgroundAdvance directives (ADs) were implemented in Portugal in 2012. Although more than a decade has passed since Law 25/2012 came into force, Portuguese people have very low levels of adherence. In this context, this study aimed to identify and analyse the attitudes of people aged 18 or older living in Portugal towards ADs and to determine the relationships between sociodemographic variables (gender/marital status/religion/level of education/residence/whether they were a health professional/whether they had already drawn up a living will) and people's attitudes towards ADs.MethodsAn online cross-sectional analytical study was conducted using a convenience sample. For this purpose, a request (email) that publicized the link to a -form-which included sociodemographic data and the General Public Attitudes Toward Advance Care Directives (GPATACD) scale-was sent to 28 higher education institutions and 30 senior universities, covering all of mainland Portugal and the islands (Azores and Madeira). The data were collected between January and February 2023.ResultsA total of 950 adults from completed the online form. The lower scores (mean 1 and 2) obtained in most responses by applying the GPATACD scale show that the sample of the Portuguese population has a very positive attitude towards ADs. The data showed that women, agnostics/atheists, health professionals and those who had already made a living will had more positive attitudes (p < 0.001) towards ADs. There were no statistically significant differences in the attitudes of the Portuguese population sample towards ADs in relation to marital status, education level, and residence.ConclusionThe results obtained enable us to confirm that this sample of the Portuguese population has a positive attitude towards ADs. We verify that there are certain fringes of this sample with certain sociodemographic characteristics (women, agnostics/atheists, health professionals and those who had already made a living will) that have a more positive attitude towards ADs. This data could facilitate the implementation and adjustment of relevant measures, particularly in the field of health education and aimed at groups with less favourable attitudes, to increase the effectiveness of voluntary exercise of citizens' autonomy in end-of-life care planning.
| S-EPMC10988855 | biostudies-literature
Project description:BackgroundAlthough advance directives (AD) have been implemented for years in western countries, the concept of AD is not promoted extensively in eastern countries. In this study we evaluate a program to systematically conduct advance care planning (ACP) communication for hospitalized patients in Taiwan and identify the factors associated with AD completion.MethodsIn this retrospective evaluation of a clinical ACP program, we identified adult patients with chronic life-limiting illness admitted to Taipei City Hospital between April 2015 and January 2016. Trained healthcare providers held an ACP meeting to discuss patients' preference regarding end-of-life care and AD completion. A multiple logistic regression was performed to determine the factors associated with the AD completion.ResultsA total of 2878 patients were determined to be eligible for ACP during the study, among which 1798 (62.5%) completed ACP and data was available for 1411 patients (49.1%). Of the 1411 patients who received ACP communication with complete data, the rate of AD completion was 82.6%. The overall mean (SD) age was 78.2 (14.4) years. Adjusting for other variables, AD completion was associated with patients aged ≥ 85 years [adjusted odds ratio (AOR) = 1.80, 95% CI 1.21-2.67], critical illness (AOR = 1.17, 95% CI 1.06-1.30), and social workers participating in ACP meetings (AOR = 1.74, 95% CI 1.24-2.45).ConclusionThe majority of inpatients with chronic life-limiting illness had ACP communication as part of this ACP program and over 80% completed an AD. Our study demonstrates the feasibility of implementing ACP discussion in East Asia and suggests that social workers may be an important component of ACP communication with patients.
| S-EPMC6034783 | biostudies-literature
Project description:This study aimed to investigate physicians' and nurses' knowledge and attitudes toward advance directives (ADs) for cancer patients, which empower patients to take decisions on end-of-life needs if they lose their capacity to make medical decisions. A cross-sectional study was conducted using convenience sampling. The outcomes were responses to the knowledge and attitude questions, and the main outcome variables were the total scores for knowledge and attitudes toward ADs. This study included 281 physicians and nurses (60.5%). Most physicians were men (95, 80.5%), whereas most nurses were women (147, 86.5%). The mean (standard deviation; SD) total knowledge score was 6.8 (4.0) for physicians and 9.1 (3.0) for nurses (p < 0.001). There was a significant difference in the total knowledge score between nurses and physicians, with an adjusted mean difference of 1.54 (95% confidence interval [CI]; 0.08-2.97). Other significant independent predictors of knowledge of ADs were female sex (1.60, 95% CI; 0.27-3.13) and education level (master's versus bachelor's: 1.26, 95% CI; 0.30-2.33 and Ph.D. versus bachelor's: 2.22, 95% CI; 0.16-4.52). Nurses' attitudes appeared to be significantly more positive than those of physicians, and the mean total attitude score (SD) was 19.5 for nurses (6.2) and 15.1 (8.1) for physicians (p < 0.001). The adjusted mean difference (95% CI) for nurses versus physicians was 3.71 (0.57-6.98). All participants showed a high level of knowledge of ADs; however, nurses showed considerably more positive attitudes than physicians.
| S-EPMC6461283 | biostudies-literature
Project description:The purpose of this study was to examine the psychometric properties of the Advance Directive Attitude Survey in Korean (K-ADAS), a measure of attitudes toward advance directives (ADs). A total of 118 low-income, community-dwelling older adults (mean age, 75.09 years) participated. An exploratory factor analysis (EFA) was conducted to determine the factor structure of the K-ADAS. Validity was further assessed by known associations of the K-ADAS with perceived susceptibility and severity using part of the Advance Care Planning surveys. Its reliability was examined by calculating alpha coefficients. EFA determined a three-factor structure model with good model fit. Validity was further supported with significant correlations between the K-ADAS and susceptibility and severity. Reliability was supported by adequate level of Cronbach's alpha. The K-ADAS was a valid and reliable measure for assessment of AD attitudes with a sound model fit. Thus, the K-ADAS can be used to assess AD attitudes among community-dwelling elders.
| S-EPMC7151054 | biostudies-literature
Project description:PurposeThe purpose of this study was to promote awareness of the need for advance directives (ADs) and to provide baseline data for the development of a nurse training program about ADs.MethodsNurses at eight long-term care hospitals in Busan and South Gyeongsang Province (N=143) were recruited using the random sampling method from December 2018 to January 2019. Data were obtained using a structured self-reported questionnaire to assess their knowledge, experience, and attitudes regarding ADs. Data were analyzed in SPSS 22.0 using descriptive statistics, the t-test, analysis of variance, the Scheffé test, Pearson's correlation coefficient, and stepwise multiple regression analysis.ResultsThe mean scores were 7.79±1.39 points for knowledge, 1.92±2.00 points for experience, and 2.80±0.24 points for attitudes regarding ADs. Knowledge and experience (r=0.32, P<0.001) had a positive correlation with knowledge and attitudes (r=0.17, P=0.39).ConclusionAccording to the results, nurses generally had a high level of knowledge regarding ADs, which resulted in a positive attitude toward ADs. However, they had little experience with ADs. Therefore, nurses' must develop both direct and indirect experience with ADs using a practical training program to strengthen their clinical competency regarding ADs.
| S-EPMC10179997 | biostudies-literature
Project description: Not available
| S-EPMC1734217 | biostudies-literature
Project description:This study aimed to explore and compare knowledge levels about advance directives (ADs) and life-sustaining treatment (LST) plans in end-of-life patients between emergency nurses and emergency medical technicians (EMTs). Using a cross-sectional study design and convenience sampling, 96 nurses and 68 EMTs were recruited from 12 emergency medical centers. A survey on knowledge about and attitudes toward ADs was performed using both online and offline methods between November and December 2019. Emergency healthcare providers were conceptually knowledgeable regarding ADs and LST, although approximately half or fewer had knowledge about ADs (such as the legal process for preparation, family or healthcare providers' role, and the healthcare proxy). The knowledge levels of nurses and EMTs were moderate. Nurses had significantly greater knowledge relative to EMTs about ADs and LST. Positive attitudes of emergency healthcare providers were also moderately low, with nurses having less positive views than EMTs. Significant differences regarding ADs were found, with younger emergency healthcare providers having fewer career years, no personal end-of-life experiences, and less need for ADs having less knowledge. Emergency healthcare providers' knowledge about and attitudes toward ADs were moderately low, with EMTs demonstrating a greater knowledge deficit and nurses exhibiting lower positive attitudes. Younger and novice providers had lower knowledge, but younger providers had more positive attitudes, implying that professional education and training should begin early in their careers to enhance their confidence for emergency delivery of advanced care planning.
| S-EPMC7908551 | biostudies-literature