Assessing a nurse-led advance directive and advance care planning seminar

Advance directives (AD) and advance care planning (ACP) are critical to making patient-centered end-of-life decisions. Despite their importance, completion rates for AD in the United States remain low at about 18-36%. Lack of education related to AD and not understanding AD have been cited as key reasons for not participating in ACP or completing AD.

The purpose of this quasi-experimental pilot study was to assess the effectiveness of a nurse led educational AD seminar that used the Five Wishes on attitudes related to AD, AD completion, and participation in ACP conversations.

A post-test repeated measures design was used.

Of the 86 participants who attended the seminar, most (n=71, 82.6%) found the seminar useful, and 97.7% (n=84) reported that they were likely to complete an AD and participate in ACP conversations with family or friends. Overall attitudes about ADs were high. Older females were more likely to complete AD than their younger male counterparts, and women were more likely than men to have ACP conversations.

The results of this study lend support to the role of nursing-driven community-based educational interventions to improve AD completion and participation in the ACP process.