Physician Attitudes Toward Advanced Directives

Coleman, A

doi:10.1177/1049909112464544

Cited by 25 publications

(9 citation statements)

References 32 publications

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“…In line with previous studies, the broad majority of the professionals asked found ADs helpful in knowing their patient’s will and ensuring the patients receive the care they really want [12, 13]. However, the enactment of the law did not have an effect on the physicians’ and nurses’ opinion, which could be seen as in accordance with the clarifying character of the legislation.…”

Section: Discussionsupporting

confidence: 77%

Survey on German Palliative Care Specialists’ Experiences with Advance Directives

Zenz

2016

Pain Ther

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IntroductionAdvance directives (AD) play a central role in end-of-life treatments, intensive care, and palliative care. However, little is known about the experiences of healthcare professionals with ADs. This study reports on palliative care professionals’ views on advance directives (AD).MethodsA questionnaire was handed out to attendants of a palliative care symposium.ResultsComplete answers were obtained from 126 physicians and 276 nurses. Almost all physicians and nurses had treated patients with an AD, and the majority more than 10 patients. The most frequent refusal by the patients was resuscitation (87.8%) followed by intensive care (79.1%), artificial ventilation, and nutrition. The most frequent wish was pain therapy (92.3%) followed by allowing the natural course of the illness (64.4%). The wish for hospice treatment (44.8%) or spiritual care (39.3%) was less frequent.DiscussionThe results hint at fears and deficits in the care of patients at the end of life. Often the quality of life and not the quantity of days remaining is in the center of a patient’s will and points to the growing importance of palliative care.ConclusionADs are well established among palliative care professionals and regarded as helpful for patients at the end of life.

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Section: Discussionsupporting

confidence: 77%

Survey on German Palliative Care Specialists’ Experiences with Advance Directives

Zenz

2016

Pain Ther

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“…7 , 8 Although most physicians demonstrate positive attitudes towards AD, the attending team does not always follow the plan of care established in the AD. 5 , 9 , 10…”

Section: Introductionmentioning

confidence: 99%

“…( 7 , 8 ) Apesar da maioria dos médicos demonstrar atitudes positivas em relação às DAV, nem sempre a equipe assistente segue o planejamento de cuidado determinado na DAV. ( 5 , 9 , 10 )…”

Section: Introductionunclassified

Variables that influence the medical decision regarding Advance Directives and their impact on end-of-life care

Arruda

Abreu

Santana

et al. 2019

Einstein (São Paulo)

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The objective of this study was to identify the variables that influence physicians to implement Advance Directives and assess their impact on end-of-life care. It is a narrative literature review of 25 articles published between 1997 and 2018, in the following databases: CAPES, EBSCOhost, BDTD, VHL, Google Scholar, MEDLINE®/PubMed. The keywords utilized were: “advance directives”, “living wills”, “physicians”, “attitude”, “decision making”, “advance care planning”. The main factors that influenced physicians to implemente the directives were patients prognosis, medical paternalism, and patients understanding of their medical condition. Respect for autonomy, lack of knowledge and experience with directives, legal concerns, family influence, cultural and religious factors also contributed to medical decision. Most studies (86%) showed that having a directive led to lower rates of invasive interventions in the last days of patient´s life. Physicians were interested in respecting their patients’ autonomy and agreed that having an advance directive helped in the decision-making process; however, they stated other factors were also taken into account, mainly prognosis and reversibility conditions. Having directives contributed to reducing the use of life support therapies and adoption of comfort measures.

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“…According to a cross-cultural survey study 12) of medical professionals and patients, the AD completion rates were 79% and 9% in the United States and Japan, respectively; when asked about the usefulness of AD in palliative care, 100% of the respondents in the United States indicated that AD were useful, compared to 71% of the respondents in Japan. In one study on the attitudes of medical professionals regarding AD, 13) the opinions of families were identified as important in the Asian countries of Japan, Thailand, and Singapore. This finding may be due to the cultural background of Asia in which family-centered decision-making has a large impact on the establishment of patient treatment plans.…”

Section: Discussionmentioning

confidence: 99%

Korean Medical Professionals’ Attitudes and Experiences on Advance Care Planning for Noncancerous Disease

Lee

Goo²,

Shin

et al. 2019

Ann Geriatr Med Res

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Background Advance care planning (ACP) allows patients to declare their preferences for life-sustaining and hospice palliative care. However, the perception of ACP remains low in Korea. The present study assessed the attitudes and status of medical professionals in relation to end-of-life care decisions in older and noncancerous patients. Methods This descriptive correlation study was performed to understand the attitudes regarding and status of ACP and advance directives (AD). For this purpose, we conducted a survey of members who attended the Spring Conference of the Korean Geriatrics Society in May 2015 using a questionnaire that included questions on experiences related to AD, opinions on disturbance factors and improvement measures, and questions about the status of their medical institutions. Results All of 181 respondents were doctors. Among the respondents, 21.7% had the experience of treating patients who had completed an AD. Medical professionals saw AD use as appropriate for terminal patients with less than 6 months of life expectancy, as well as those with degenerative neurological disorders such as amyotrophic lateral sclerosis, chronic diseases such as chronic renal disease, and early stages of Alzheimer’s disease. Conclusion The results showed that geriatrics medical professionals agreed with the necessity for AD in noncancerous terminal diseases and that consideration of a family-centered decision-making culture, legal protection for medical professionals, and education of the general public and medical professionals will be helpful for the popularization of AD.

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Physician Attitudes Toward Advanced Directives

Cited by 25 publications

References 32 publications

Survey on German Palliative Care Specialists’ Experiences with Advance Directives

Survey on German Palliative Care Specialists’ Experiences with Advance Directives

Variables that influence the medical decision regarding Advance Directives and their impact on end-of-life care

Korean Medical Professionals’ Attitudes and Experiences on Advance Care Planning for Noncancerous Disease

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