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Advance Directives and Factors Associated with the Completion in Patients with Heart Failure

Author

Listed:
  • JinShil Kim

    (College of Nursing, Gachon University, 191 Hambakmeoro, Yeonsu-gu, Incheon 21936, Korea)

  • Mi-Seung Shin

    (Division of Cardiology, Gil Medical Center, Department of Internal Medicine, Gachon University College of Medicine, 21 Namdong-daero 774 beon-gil, Namdong-gu, Incheon 21565, Korea)

  • Albert Youngwoo Jang

    (Division of Cardiology, Gil Medical Center, Department of Internal Medicine, Gachon University College of Medicine, 21 Namdong-daero 774 beon-gil, Namdong-gu, Incheon 21565, Korea)

  • Shinmi Kim

    (Department of Nursing, Changwon National University, 20 Changwondaehakro, Euichanggu, Kyungsangnamdo, Changwon 51140, Korea)

  • Seongkum Heo

    (Georgia Baptist College of Nursing, Mercer University, 3001 Mercer University Drive, Atlanta, GA 30341, USA)

  • EunSeok Cha

    (College of Nursing, Chungnam National University, 266 MunWharo, Junggu, Daejeon 35015, Korea)

  • Minjeong An

    (College of Nursing, Interdisciplinary Program of Arts & Design Technology, Chonnam National University, 160 Baekseoro, Donggu, Gwangju 61469, Korea)

Abstract

Advance directive (AD) has been underutilized among patients with heart failure (HF). This study was performed to explore the ADs and examine factors associated with the completion of an AD survey in patients with HF. In a descriptive, correlational study, data on end-of-life values, treatment directives, and proxy (Korean-Advance Directive (K-AD) questionnaire) and factors associated with K-AD completion were collected among HF patients during outpatient visits. Of 67 patients (age, 67 years; male, 61.2%), 52.2% completed all or part of the K-AD. Among values, comfortable death was the most preferred ( n = 15) followed by avoiding family burden ( n = 6). In those completers, preferences for hospice care, cardiopulmonary resuscitation, ventilation support, and hemodialysis were 68.6%, 42.9%, 28.6%, and 28.6%, respectively. Female sex (odds ratio (OR) = 0.167), poorer HF prognosis (OR = 0.156), and better functional status (OR = 0.905) were associated with less likelihood of completing the AD survey. The findings suggest that in-depth AD discussion needs to be started earlier in patients with HF to facilitate completion of AD, especially in female patients. Future research should investigate if early discussion of ADs as part of advance care planning with integration into standard care of HF facilitates the documentation of ADs.

Suggested Citation

  • JinShil Kim & Mi-Seung Shin & Albert Youngwoo Jang & Shinmi Kim & Seongkum Heo & EunSeok Cha & Minjeong An, 2021. "Advance Directives and Factors Associated with the Completion in Patients with Heart Failure," IJERPH, MDPI, vol. 18(4), pages 1-12, February.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:4:p:1780-:d:498138
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    References listed on IDEAS

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    1. Qiu Zhang & Chuanbo Xie & Shanghang Xie & Qing Liu, 2016. "The Attitudes of Chinese Cancer Patients and Family Caregivers toward Advance Directives," IJERPH, MDPI, vol. 13(8), pages 1-11, August.
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