Factors influencing dialysis patients'completion of advance directives.
- Although chronic dialysis patients support the use of advance directives, they rarely complete them.
We asked 80 chronic dialysis patients (60 receiving in-center hemodialysis and 20 receiving peritoneal dialysis) why they had not completed an advance directive, and gave them the opportunity to complete a dialysis-specific living will and to designate a health care proxy.
Questionnaires containing the dialysis-specific living will, patient demographic information, and questions about advance directives were distributed during a routine hemodialysis session or peritoneal dialysis clinic visit by a nurse working in the unit.
Forty-one hemodialysis patients and 14 peritoneal dialysis patients completed the questionnaires (69% response rate).
The mean age was 53 ± 15 years and the mean time on dialysis was 5 ± 5 years.
Fifty-eight percent of the patients were women, 57% were white, 67% were hospitalized in the past year, 23% were employed, 70% had children, and 21% lived alone (43% lived with a partner and 11% lived with parents).
All patients thought advance directives were a good idea, but only 35% had completed one and only seven (14%) had discussed wishes for life-sustaining therapy with their nephrologist ; 34 patients (67%) had discussed their wishes with their family.
Most said they had not completed an advance directive because their family knew what they would want (12 of 32 patients [38% ]). (...)
Mots-clés Pascal : Ethique, Relation médecin malade, Milieu familial, Insuffisance rénale, Stade terminal, Refus, Hémodialyse, Influence, Décision, Appareil urinaire pathologie, Rein pathologie, Epuration extrarénale
Mots-clés Pascal anglais : Ethics, Physician patient relation, Family environment, Renal failure, Terminal stage, Denial, Hemodialysis, Influence, Decision, Urinary system disease, Kidney disease, Extrarenal dialysis
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0012214
Code Inist : 002B27B03. Création : 17/04/1998.