Advance Directives and Proxies' Predictions About Patients' Treatment Preferences

The accuracy of proxies when they interpret advance directives or apply substituted decision-making criteria has been called into question. It therefore became important to know if the Andalusian Advance Directive Form (AADF) can help to increase the accuracy of proxies' predictions. The aim of...

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Published inNursing ethics Vol. 16; no. 1; pp. 93 - 109
Main Authors Barrio-Cantalejo, Ines Maria, Molina-Ruiz, Adoracion, Simon-Lorda, Pablo, Camara-Medina, Carmen, Lopez, Isabel Toral, del Aguila, Maria del Mar Rodriguez, Bailon-Gomez, Rosa Maria
Format Journal Article
LanguageEnglish
Published London, England SAGE Publications 01.01.2009
SAGE PUBLICATIONS, INC
Subjects
Accuracy
Advance Directives
Aged
Decision Making
Female
Humans
Life Support Care
Linear Models
Male
Middle Aged
Multivariate Analysis
Nurse-Patient communication
Nursing
Patient Satisfaction
Proxies
Proxy
Spain
Treatment preferences
Spain
proxy
advance directives
advance care planning
nursing ethics
randomized trial
Andalusia
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Summary:The accuracy of proxies when they interpret advance directives or apply substituted decision-making criteria has been called into question. It therefore became important to know if the Andalusian Advance Directive Form (AADF) can help to increase the accuracy of proxies' predictions. The aim of this research was to compare the effect of the AADF on the accuracy of proxies' predictions about patients' preferences with that gained from informative and deliberative sessions about end-of-life decision making. A total of 171 pairs of patients and their proxies were randomized to three groups. The control group's answers to the Life Sustaining Preferences Questionnaire (LSPQ) were compared with their proxies' answers to the same questionnaire. In one intervention group, the patients had already completed the AADF and given it to their proxies, who used it to guide their own answers to the LSPQ. In the second intervention (discussion) group, both patients and proxies attended two educative sessions guided by trained nurses and later filled in the LSPQ. Comparisons of accuracy and other variables showed a strong association with the discussion group. The findings show that promoting communication between patients and their proxies improves the accuracy of proxies' predictions much more than isolated use of the AADF form.
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ISSN:0969-7330
1477-0989
DOI:10.1177/0969733008097995