[Knowledge level and professional attitudes to the Living Will: Differences between different professionals and provinces in the same autonomous community]

Abstract

Objectives: Primary: To determine the differences, by occupational category and province, in the knowledge and attitudes of health professionals on the Living Wills Document (LWD) in 4 Andalusian provinces: Cordoba, Jaen, Cadiz, and Granada. Secondary: To determine the number of documents prepared in these areas and the number consulted in terminal situations.

Material and methods: Descriptive observational multicenter study, with 17 health areas in 4 Andalusian provinces.

Target population: Family doctors, nurses and social workers of the areas studied (n=340). Interventions Validated self-administered questionnaire about advance directives. Descriptive and bivariate (×2) analysis of data was performed.

Results: Mean age 46±8.8 years, 53.2% women. Physicians 56.1%, nurses 41.1%, social workers 2.6%. The mean score (0-10) of their knowledge was 5.42±2.41, with 78.4% believing that LWD are regulated in Andalusia (provinces differences, P=.001). More than one-third (36.7%) had read the document (differences by occupation, P=.001). The mean score on the advantage of preparing a LWD for the patient was 8.27±2.16 (significant differences between provinces P=.02). Mean score about the practitioner would respect the wishes of a patient in a LWD was 9.14±1.64 (significant difference between provinces P=.03). The mean score of the question about expressing the desires of the professional on preparing their LWD in the following year was 4.85±3.74 (P=.02).

Conclusions: There are different behaviors between professions on reading the LWD. There are differences between provinces in the following aspects: whether the documents are regulated, whether the professionals prepare the LWD, and whether the professionals respects the provisions of the LWD.

Keywords: Actitud del personal de salud; Advance directives; Atención Primaria de Salud; Directivas anticipadas; Health personnel attitude; Instrucciones previas; Living wills; Primary Care.