Perceptions, Attitudes, and Knowledge toward Advance Directives: A Scoping Review.

Area of Science:

• Bioethics
• Public Health
• Healthcare Policy

Background:

• Advance directives affirm patient autonomy in end-of-life care decisions.
• Legalized advance directives show low completion rates globally.
• Understanding public perception, attitudes, and knowledge is crucial to address this gap.

Purpose of the Study:

• To explore population perceptions, attitudes, and knowledge regarding advance directives.
• To identify barriers and facilitators for advance directive completion.

Main Methods:

• Systematic literature search conducted in March 2023 across major databases (PubMed, Scopus, Web of Knowledge).
• Keywords included "advance care directives", "advance care planning", "perceptions", "attitudes", and "knowledge".
• Analysis of 13 selected articles from an initial 224 identified.

Main Results:

• A consistent finding across studies is a low level of public knowledge about advance directives.
• Populations generally express positive attitudes towards the concept and implementation of advance directives.
• Despite positive attitudes, the actual completion rates of advance directives remain low.

Conclusions:

• Understanding public perceptions, attitudes, and knowledge is vital for effective advance directive policies.
• Further research can inform targeted strategies to improve the promotion and dissemination of advance directives.
• Addressing the gap between positive attitudes and low completion rates is essential for enhancing end-of-life care autonomy.