Patients' Attitudes Toward Advance Directives


  • The opinions and assertions contained in this article are the private views of the authors and are not to be construed as official or as reflecting the views of the U.S. Army or the Department of Defense.

Maj. Douglas, 559 Graham Rd., Ft. Sam Houston, TX 78234. E-mail:


Purpose: To explore hospitalized patients' attitudes toward advance directives, their reasons for completing or not completing advance directive forms, and demographic differences between patients who did and did not complete advance directive forms.

Design and Method: The convenience sample comprised 30 hospitalized patients in North Carolina. Participants were interviewed using an adapted advance directive attitude survey (ADAS), and were asked five general questions about advance directives. Validity and reliability were established on the adapted tool.

Findings: The overwhelming majority of participants had received information on advance directives and they were moderately positive about them. The majority who had completed advance directives were Caucasian, female, over age 65, had less than a high school education, and perceived their health as poor. Most believed that an advance directive would ensure they received the treatment they desired at the end of life.

Conclusions: Patients' attitudes alone did not determine who will and will not complete advance directives. Most participants who completed advance directives had specific reasons for doing so. Nurses have responsibility for discussing advance directives with patients, families, and physicians to ensure adequate education about the completion of advance directives.