Abstract:
Surveys of both patients and health care providers have indicated strong interest, up to 95%, in favor of advance directives, which are legal documents that express patients' healthcare treatment decisions. Despite the widespread support for advance directives, actual completion rates are very low, ranging from 4% to 20% for the general population.
The purpose of this study is to explore how both demographics and attitudes about death predict advance directive completion in a community wide sample, using quantitative methods. Existing survey data from a sample of 259 persons in a Pacific Northwest community will be examined. The nine-page survey used in this study consisted of questions about demographics, advance care planning, spiritual beliefs, attitudes of, and experiences with death and dying, preferred medical practices, and pain management. Questions that dealt with attitudes about death used a modified version of Bugen's Coping with Death Scale. Validity and reliability were established for the modified scale.
Logistic regression analyses found that increasing age was positively and significantly associated with advance directive completion, statistically controlling for gender, race, income, education, and coping with death. Results also showed that higher scores on the Coping with Death scale were positively and significantly associated with advance directive completion, statistically controlling for age gender, race, income, and education. Ability to cope with death gives insight to the discrepancy between the strong
support for advance directives and the low completion rates.
