[Changes in knowledge and carrying out the advance directives of patients admitted to internal medicine]

Abstract

Backgrounds: Advance directives (ADs), are documents in which patients express in advance that their wishes are fulfilled when they are unable to communicate them. It is unknown whether patients admitted to internal medicine are more aware of and make ADs.

Objective: To study the changes in the level of knowledge and implementation of AD among patients admitted to an internal medicine department of a hospital in Madrid since a specific regulation to implement them was introduced.

Patients and methods: A survey was conducted among patients admitted to internal medicine in two periods: 2008 and 2010.

Results: A total of 206 surveys were analysed (84 in 2008 and 122 in 2010). The mean age of the patients was 76.8 years, and 51.5% were women. More than two-thirds (69.4%) had a co-morbidity. and 4.4% had a terminal illness, with no statistical differences between the periods. Only 5.3% knew what ADs are, 1 had implemented ADs, and 46.1%, once informed, would like to implement them. There were no differences between 2008 and 2010 as regards knowledge and implementation of AD. In 2010 there was a greater interest to implement them (would like to implement them: 52.5 vs 36.9%), although in 2010 less respondents believe that AD would change the attitude of the doctor (not change the attitude: 92.6 vs. 69%, P<.001).

Conclusions: Knowledge and implementation of AD did not change significantly in the years following the regulation (from 2008-2010). In both periods, their knowledge and implementation are scarce.

Keywords: Advance directives; Anticipated wills; Bioethics; Bioética; Instrucciones previas; Living will; Testamento vital; Voluntades anticipadas.