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  1. The discussion about advance directives : patient and physician opinions regarding when and how it should be conducted.

    Article - En anglais


    Widely publicized court cases have focused national attention on the importance of advance directives.

    In spite of initiatives such as the Patient SelfDetermination Act of 1991, fewer than 10% of Americans have prepared advance directives.

    One way to increase the preparation of advance directives may be to increase the frequency and quality of discussions about them between individual patients and their physicians.

    We performed a multicenter observational study to assess the opinions of primary care patients and physicians regarding these discussions.


    This was a cross-sectional descriptive survey of randomly selected primary care patients and physicians in eight primary care internal medicine clinics in the eastern and midwestern United States.


    The 883 subjects included 329 adult outpatients, 282 resident physicians, and 272 practicing Physicians.

    Physician and patient response rates were 75% and 76%, respectively.

    Patients felt that the discussion should occur earlier than did the physicians : at an earlier age, earlier in the natural history of disease, and earlier in the patient-physician relationship.

    Most subjects agreed it was the physician's responsibility to initiate the discussion.


    We defined a discrepancy between the preferences of primary care patients and physicians regarding the timing of the discussion about advance directives.

    Mots-clés Pascal : Soin santé primaire, Patient Request Form, Consentement éclairé, Thérapie, Relation médecin malade, Etude comparative, Désir, Réalité, Homme

    Mots-clés Pascal anglais : Primary health care, Patient Request Form, Informed consent, Therapy, Physician patient relation, Comparative study, Desire, Reality, Human

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 95-0339113

    Code Inist : 002B30A01B. Création : 01/03/1996.