The Impact of Advance Directive Perspectives on the Completion of Life-Sustaining Treatment Decisions in Patients with Heart Failure: A Prospective Study
Evidence for non-modifiable and modifiable factors associated with the utilization of advance directives (ADs) in heart failure (HF) is lacking. The purpose of this study was to examine baseline-to-3-month changes in knowledge, attitudes, and benefits/barriers regarding ADs and their impact on the c...
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| Format: | Article |
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MDPI AG
2021-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/24/5962 |
| _version_ | 1797503441050796032 |
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| author | JinShil Kim Seongkum Heo Bong Roung Kim Soon Yong Suh Jae Lan Shim Minjeong An Mi-Seung Shin |
| author_facet | JinShil Kim Seongkum Heo Bong Roung Kim Soon Yong Suh Jae Lan Shim Minjeong An Mi-Seung Shin |
| author_sort | JinShil Kim |
| collection | DOAJ |
| description | Evidence for non-modifiable and modifiable factors associated with the utilization of advance directives (ADs) in heart failure (HF) is lacking. The purpose of this study was to examine baseline-to-3-month changes in knowledge, attitudes, and benefits/barriers regarding ADs and their impact on the completion of life-sustaining treatment (LST) decisions at 3-month follow-up among patients with HF. Prospective, descriptive data on AD knowledge, attitudes, and benefits/barriers and LSTs were obtained at baseline and 3-month follow-up after outpatient visits. Of 64 patients (age, 68.6 years; male, 60.9%; New York Heart Association (NYHA) classes I/II, 70.3%), 53.1% at baseline and 43.8% at 3-month follow-up completed LST decisions. Advanced age (odds ratio (OR) = 0.91, <i>p</i> = 0.012) was associated with less likelihood of the completion of LST decisions at 3-month follow-up, while higher education (OR = 1.19, <i>p</i> = 0.025) and NYHA class III/IV (OR = 4.81, <i>p</i> = 0.049) were associated with more likelihood. In conclusion, advanced age predicted less likelihood of LST decisions at 3 months, while higher education and more functional impairment predicted more likelihood. These results imply that early AD discussion seems feasible in mild symptomatic HF patients with poor knowledge about ADs, considering the non-modifiable and modifiable factors. |
| first_indexed | 2024-03-10T03:50:42Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T03:50:42Z |
| publishDate | 2021-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-521a4e0959a94ca98a1c1907451fb8002023-11-23T08:58:41ZengMDPI AGJournal of Clinical Medicine2077-03832021-12-011024596210.3390/jcm10245962The Impact of Advance Directive Perspectives on the Completion of Life-Sustaining Treatment Decisions in Patients with Heart Failure: A Prospective StudyJinShil Kim0Seongkum Heo1Bong Roung Kim2Soon Yong Suh3Jae Lan Shim4Minjeong An5Mi-Seung Shin6College of Nursing, Gachon University, Incheon 21936, KoreaGeorgia Baptist College of Nursing, Mercer University, Atlanta, GA 30341, USADepartment of Internal Medicine, Seoul Medical Center, Seoul 02053, KoreaDivision of Cardiology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon 21565, KoreaCollege of Nursing, Dongguk University, Gyeongju 38066, KoreaCollege of Nursing, Chonnam National University, Gwangju 61469, KoreaDivision of Cardiology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon 21565, KoreaEvidence for non-modifiable and modifiable factors associated with the utilization of advance directives (ADs) in heart failure (HF) is lacking. The purpose of this study was to examine baseline-to-3-month changes in knowledge, attitudes, and benefits/barriers regarding ADs and their impact on the completion of life-sustaining treatment (LST) decisions at 3-month follow-up among patients with HF. Prospective, descriptive data on AD knowledge, attitudes, and benefits/barriers and LSTs were obtained at baseline and 3-month follow-up after outpatient visits. Of 64 patients (age, 68.6 years; male, 60.9%; New York Heart Association (NYHA) classes I/II, 70.3%), 53.1% at baseline and 43.8% at 3-month follow-up completed LST decisions. Advanced age (odds ratio (OR) = 0.91, <i>p</i> = 0.012) was associated with less likelihood of the completion of LST decisions at 3-month follow-up, while higher education (OR = 1.19, <i>p</i> = 0.025) and NYHA class III/IV (OR = 4.81, <i>p</i> = 0.049) were associated with more likelihood. In conclusion, advanced age predicted less likelihood of LST decisions at 3 months, while higher education and more functional impairment predicted more likelihood. These results imply that early AD discussion seems feasible in mild symptomatic HF patients with poor knowledge about ADs, considering the non-modifiable and modifiable factors.https://www.mdpi.com/2077-0383/10/24/5962heart failureadvance directiveslife-sustaining treatmentknowledgeattitudes |
| spellingShingle | JinShil Kim Seongkum Heo Bong Roung Kim Soon Yong Suh Jae Lan Shim Minjeong An Mi-Seung Shin The Impact of Advance Directive Perspectives on the Completion of Life-Sustaining Treatment Decisions in Patients with Heart Failure: A Prospective Study Journal of Clinical Medicine heart failure advance directives life-sustaining treatment knowledge attitudes |
| title | The Impact of Advance Directive Perspectives on the Completion of Life-Sustaining Treatment Decisions in Patients with Heart Failure: A Prospective Study |
| title_full | The Impact of Advance Directive Perspectives on the Completion of Life-Sustaining Treatment Decisions in Patients with Heart Failure: A Prospective Study |
| title_fullStr | The Impact of Advance Directive Perspectives on the Completion of Life-Sustaining Treatment Decisions in Patients with Heart Failure: A Prospective Study |
| title_full_unstemmed | The Impact of Advance Directive Perspectives on the Completion of Life-Sustaining Treatment Decisions in Patients with Heart Failure: A Prospective Study |
| title_short | The Impact of Advance Directive Perspectives on the Completion of Life-Sustaining Treatment Decisions in Patients with Heart Failure: A Prospective Study |
| title_sort | impact of advance directive perspectives on the completion of life sustaining treatment decisions in patients with heart failure a prospective study |
| topic | heart failure advance directives life-sustaining treatment knowledge attitudes |
| url | https://www.mdpi.com/2077-0383/10/24/5962 |
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