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Western Journal of Nursing Research, Vol. 26, No. 7, 784-796 (2004)
DOI: 10.1177/0193945904266528
© 2004 SAGE Publications

Knowledge, Attitudes, and Predictors of Advance Directive Discussions of Registered Nurses

Amy R. Lipson

Frances Payne Bolton School of Nursing, Case Western Reserve University

Alice J. Hausman

Department of Public Health, Temple University

Patricia A. Higgins

Frances Payne Bolton School of Nursing, Case Western Reserve University

Christopher J. Burant

Department of Bioethics, Case Western Reserve University School of Medicine

The purpose of this study was to describe nurses’ knowledge, attitudes, and experiences regarding advance directives. A secondary purpose was to examine predictors of advance directive discussions between nurses and patients. Seven-hundred and nineteen respondents, randomly selected from a list of registered nurses in the state of Ohio, completed mailed questionnaires. Descriptive t test, chi-square, and logistic regression statistics were used in the data analyses. The respondents were knowledgeable and possessed positive attitudes about advance directives. Higher self-perceived confidence in advance directive discussion skills and the experience of caring for at least one patient with a current advance directive were found to be significant predictors of advance directive discussions. These findings suggest that experience with advance directives documents is critical for nurses’ comfort and that developing interventions to further nurses’ confidence in their discussion skills may increase advance directive discussions.

Key Words: advance directives • predictors • discussions • attitudes • knowledge


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