PMID: 8583031Jan 1, 1996Paper

Advance directive decision making among medical inpatients

Journal of Professional Nursing : Official Journal of the American Association of Colleges of Nursing
A J ReinM T Nolan

Abstract

Per the Patient Self-Determination Act of 1991, hospitals are required to ascertain whether patients have an advance directive (AD). At this point, factors prompting patients to issue ADs have not been studied. The purpose of this study was to describe patients' understanding of ADs as well as the process patients used to arrive at their decisions to implement an AD. A stratified random sample of 26 patients from two intensive care units, one general medical unit, one general cardiac unit, and one acquired immunodeficiency unit were selected for participation. Patients were asked a series of open-ended questions to determine their knowledge and understanding of ADs. The constant comparative method was used to review the transcripts. It was found that only 31 per cent of patients had issued an AD, and 20% had learned of ADs for the first time during their hospitalization. Response analysis showed four phases of AD decision making: evaluation of illness, establishment of priorities, consideration of implications of the directives, and selection or rejection of directives. In conclusion, patients continue to have limited understanding of ADs and their implications. Continued investigation will elucidate the best strategies to educ...Continue Reading

Citations

Oct 26, 1999·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·I LloveraL I Lesser
Oct 23, 1997·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·I LloveraA Sama
Feb 20, 2008·Palliative & Supportive Care·Catherine M HandyWayne A Ury
Feb 14, 1998·Journal of Gerontological Nursing·G L HustedD Stainbrook
May 14, 2004·Journal of Advanced Nursing·Amy Olivier Calvin
Oct 8, 2003·Western Journal of Nursing Research·Deborah Dillon McDonaldEnrico Del Signore
Jul 10, 2001·Journal of Advanced Nursing·S Nordgren, B Fridlund
Dec 23, 1999·International Journal of Geriatric Psychiatry·A J Treloar

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