Characteristics associated with the intention to complete advance directives and end-of-life preferences in...

Area of Science:

• Cardiology
• Palliative Care
• Health Psychology

Background:

• Advance directives (ADs) are crucial for patient autonomy in end-of-life care, particularly for those with chronic conditions like heart failure (HF).
• Understanding factors influencing AD completion and treatment preferences in HF patients is essential for personalized care planning.

Purpose of the Study:

• To identify characteristics associated with the intention to complete advance directives (ADs).
• To determine end-of-life treatment preferences among outpatients with heart failure (HF).

Main Methods:

• A cross-sectional analytical study involving 108 HF outpatients in Brazil.
• Data collected included sociodemographics, clinical status, quality of life (QoL) using the Minnesota Living with Heart Failure Questionnaire, and knowledge/intention regarding ADs.
• Statistical analyses (chi-square, Mann-Whitney) were used to assess variable relationships (p < 0.05).

Main Results:

• Intention to complete ADs correlated with medication adherence (99% vs 88.1%), worse QoL (29.7±18.2 vs 20.9±11.0), perceived HF knowledge (89.7% vs 63.6%), desire for self-determination in treatment (27.3% vs 2.15%), and perceived AD usefulness (91.8% vs 27.3%).
• Key end-of-life preferences included living as long as possible (50.5%), avoiding sedation (37.1%), and proximity to family/friends (32.0%).

Conclusions:

• Specific patient characteristics are linked to the intention to complete ADs and shape end-of-life preferences in HF patients.
• These insights can guide healthcare providers in facilitating AD completion and empowering patients to exercise autonomy in their care decisions.