Related Experiment Videos
Advance directives: ambulatory patients' knowledge and perspectives
Jack P Freer1, Michael Eubanks, Brandon Parker
1Division of General Internal Medicine, University at Buffalo, State University of New York, USA. jfreer@buffalo.edu
The American Journal of Medicine
|December 6, 2006
Summary
Many patients know about advance directives (ADs) and believe they have completed them, but providers often lack copies. Patient perceptions and knowledge gaps hinder effective advance care planning.
Area of Science:
- Health Services Research
- Patient Care
Background:
- Advance directives (ADs) completion rates are low in ambulatory settings.
- Understanding patient perceptions is crucial for improving advance care planning strategies.
Purpose of the Study:
- To clarify patient knowledge, perceptions, and completion rates of advance directives in an academic internal medicine practice.
Main Methods:
- Prospective study of 508 adult ambulatory patients across four academic internal medicine sites.
- Data collected via a standardized instrument on AD awareness, familiarity, completion, and attitudes.
- Multivariate logistic regression used to identify factors correlated with AD completion.
Main Results:
- 86.2% of patients were unfamiliar with the term "advance directives," yet 93.5% recognized specific types.
- 43.1% reported completing an AD, but only 25% believed their provider had a copy.
- AD completion correlated significantly with older age, higher reading ability, and greater educational level.
Conclusions:
- Patients in ambulatory settings demonstrate awareness of ADs and report completion, but documentation is often missing from charts.
- A significant portion of patients consider AD discussions inappropriate for their situation.
- Addressing patient-provider communication and understanding patient attitudes are key to promoting effective advance care planning.
Related Concept Videos
01:19Standards of Care II
Nurses bear specific legal responsibilities under several federal statutes, including:
01:27Ethical Issues
Nurses are essential in patient care, upholding the ethical principles of their profession and effectively navigating ethical dilemmas. Neglecting ethical issues can lead to inadequate patient care, compromised therapeutic relationships, and moral distress among healthcare workers.
Ethical Concerns in Healthcare:
Ethical Concerns in Healthcare:
01:29Documentation in Long-Term and Home Healthcare Setting
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
01:30Ethical Dilemmas II
Resolving an ethical dilemma in healthcare involves a systematic approach that considers every aspect of the issue, respecting both the patient's needs and values and the healthcare professional's ethical obligations. Here are potential steps to resolve an ethical dilemma:
01:27Nursing Ethical Principles II
Ethical principles are essential in guiding nurses to fulfill their responsibilities, focusing on the quality of nursing care and decision-making. These principles, including autonomy, beneficence, non-maleficence, justice, and fidelity, shape the ethical framework within healthcare settings.
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's cancer...
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's cancer...
01:13Patient-centered Care
Patient-centered care involves delivering care beyond inpatient hospitalization. Reflective practice can enhance a patient-centered approach. Reflective practice is a process of reasoning that considers all aspects of the present situation, including practicalities, learning from personal practice, and consideration of patient needs. Patients appreciate care decisions made while considering their input. Involving the patient in their care provides the patient with a sense of contribution rather...