The attitude of Canadian nurses towards advance directives

This article seeks to shed light on the beliefs that influence nurses' intention of respecting or not respecting an advance directive document, namely a living will or a durable power of attorney. Nurses' beliefs were measured using a 44-statement questionnaire. The sample was made up of 306 nurses working either in a long-term care centre or in a hospital centre offering general and specialized care in the province of Québec. The results indicate that nurses have a strong intention of complying with advance directives written by patients. The analysis also shows that four variables determine the strength of this intention: respect for autonomy; the location of the workplace; justice; and the dimension of relationships and emotions. Although these documents favour the expression of patients' wishes, nurses should be aware that they do not systematically guarantee respect of a patient's autonomy, nor do they replace a relationship based on trust between patients and health care professionals.