PURPOSE: To develop a theory-based model to assist nurses in promoting self-determination for completion of an advance directive (AD). DESIGN AND METHODS: This descriptive study included data from a convenience sample of 118 community-dwelling older adults in Tennessee, USA. Multinomial logistic regression was used to estimate the influence of 15 factors and covariates on completion of an AD. FINDINGS: The parsimonious model had three significant factors: receiving AD information; attitude index; and health literacy score. Participants were highly likely to complete ADs if they had positive attitudes toward ADs and had received information on ADs. As health literacy increased, the likelihood that participants completed ADs was reduced. This model explained 25% of the variation in AD completion. Chi-square fit for the parsimonious model was highly significant. CONCLUSIONS: Of 15 factors and covariates that could influence completion of an AD, only receiving information about ADs, having positive attitudes toward ADs, and health literacy significantly affected the likelihood of participants completing ADs. More study is needed on this model and how nurses can assist patients with end-of-life decisions.
PURPOSE: To develop a theory-based model to assist nurses in promoting self-determination for completion of an advance directive (AD). DESIGN AND METHODS: This descriptive study included data from a convenience sample of 118 community-dwelling older adults in Tennessee, USA. Multinomial logistic regression was used to estimate the influence of 15 factors and covariates on completion of an AD. FINDINGS: The parsimonious model had three significant factors: receiving AD information; attitude index; and health literacy score. Participants were highly likely to complete ADs if they had positive attitudes toward ADs and had received information on ADs. As health literacy increased, the likelihood that participants completed ADs was reduced. This model explained 25% of the variation in AD completion. Chi-square fit for the parsimonious model was highly significant. CONCLUSIONS: Of 15 factors and covariates that could influence completion of an AD, only receiving information about ADs, having positive attitudes toward ADs, and health literacy significantly affected the likelihood of participants completing ADs. More study is needed on this model and how nurses can assist patients with end-of-life decisions.
Authors: Carmen W H Chan; Martin M H Wong; Kai Chow Choi; Helen Y L Chan; Amy Y M Chow; Raymond S K Lo; Michael M K Sham Journal: Int J Environ Res Public Health Date: 2019-01-28 Impact factor: 3.390
Authors: Billingsley Kaambwa; Julie Ratcliffe; Sandra L Bradley; Stacey Masters; Owen Davies; Craig Whitehead; Catherine Milte; Ian D Cameron; Tracey Young; Jason Gordon; Maria Crotty Journal: BMC Health Serv Res Date: 2015-12-09 Impact factor: 2.655
Authors: Carmen W H Chan; Martin M H Wong; Kai Chow Choi; Helen Y L Chan; Amy Y M Chow; Raymond S K Lo; Michael M K Sham Journal: Asia Pac J Oncol Nurs Date: 2019 Jan-Mar