Advance Directives in Hospice Healthcare Providers: A Clinical Challenge

Abstract

The majority of hospice healthcare providers have not completed an advance directive. These results are very similar to those for other healthcare providers treating patients with terminal diseases, specifically oncologists. Because, at completion, 43% said that they would now complete an advance directive, such a survey of healthcare providers may help increase completion rates.

Professional characteristics and the prevalence of advance directives among palliative care professionals: A cross-sectional study

“…According to the scientific literature, hospice healthcare providers who reported being "very knowledgeable" about ADs were 3.9 times more likely to have an advance directive (Luck et al, 2017). However, it is worth mentioning that, in studies carried out with the general population, other factors were associated with the presence of ADs: ethnicity, health care utilization, age, religious affiliation, number of children, marital status, number of comorbidities, admission with a chronic disease, having made end-of-life decisions for someone else, and who asked the patient about ADs (Van Scoy et al, 2014;White et al, 2014;Luck et al, 2017).…”

“…The LimeSurvey platform was used to develop this online survey. For the data collection, which took place from January to May of 2018, a questionnaire was developed by the authors themselves based on a previous study that explored the prevalence and factors influencing AD completion rates in a survey of hospice healthcare providers (Luck et al, 2017). The questions were multiple choice, and the questionnaire took approximately 10 min to be completed.…”

“…Advance directives (ADs) are documents expressing an individual's wishes about future medical care, to ensure that these wishes are met in the event that they become unable to articulate these desires or unable to make important decisions for themselves (Dadalto, 2020). ADs related to the end-of-life can be understood as documents where people can specify their choices regarding the future healthcare treatment and options they would like to receive in the event that they become unable to communicate their choices (Luck et al, 2017). This document, therefore, helps to protect people's autonomy (Peicius et al, 2017).…”

“…Healthcare professionals working in palliative care (PC) have the opportunity to witness how ADs help assure that patients' wishes are carried out (Luck et al, 2017). These professionals also witness the damaging consequences suffered by patients, their families, and the healthcare team when those patients do not register their end-of-life wishes, especially those regarding medical treatments (Luck et al, 2017).…”

Exploring Quality of Life in End-of-Life Discussions

“…4 Other researchers have demonstrated similar knowledge deficits even with providers who specialize in the care of patients at EOL. 5 Several evaluative studies regarding ACP communication between patients, caregivers, and physicians emphasize that improving health-care professionals' education and knowledge about ADs is critical in promoting patient welfare and autonomy. 4,6,7 To improve barriers to AD completion and address QOL concerns, empathic communication between physicians and patients has shown promise.…”