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Advance directives: barriers to completion

K L Glick1, K M Mackay, S Balasingam

  • 1Rochester General Hospital, USA.

The Journal of the New York State Nurses' Association
|January 29, 1999
PubMed
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Advance directives, documents outlining end-of-life care wishes, are underutilized due to poor education, complex paperwork, and communication gaps between patients, families, and providers. Improving these areas is crucial for patient-centered care.

Area of Science:

  • Healthcare policy
  • Bioethics
  • Patient advocacy

Background:

  • Advance directives are intended to ensure patient autonomy in end-of-life care decisions.
  • Despite widespread endorsement, the completion and utilization rates of advance directives remain low.
  • Existing literature suggests significant challenges hinder the effectiveness of advance directives.

Purpose of the Study:

  • To identify key barriers preventing the effective completion and use of advance directives.
  • To synthesize findings from existing research on advance directive challenges.
  • To inform future strategies for improving advance directive implementation.

Main Methods:

  • Systematic review of 15 research articles on advance directives.
  • Qualitative synthesis of identified barriers to advance directive completion and use.

Related Experiment Videos

  • Analysis of factors influencing patient, family, and provider interactions.

    • Main Results:

    • Three primary barriers identified: lack of patient education, difficulties with paperwork, and discordance among stakeholders.
    • Lack of knowledge about advance directives impedes informed decision-making.
    • Communication breakdowns between patients, families, and healthcare providers create significant obstacles.

    Conclusions:

    • The current framework for advance directives is not adequately meeting patient needs.
    • Addressing educational deficits and simplifying documentation are essential.
    • Improving communication and concordance among patients, families, and providers is critical for effective advance care planning.