[Patient advanced directives from the perspective of surgery patients-new aspects and aims : Living wills of patients before planned surgery]

Chirurg. 2019 Apr;90(4):299-306. doi: 10.1007/s00104-018-0772-5.
[Article in German]

Abstract

Background: Patient advance directives and other forms of precautionary medical provisions have arisen from patients' determination to influence and decide about medical treatment even in extreme situations. Although this topic is very present in the media, clinical experience indicates that the majority of patients are not yet aware of this subject. This current investigation aimed to collect data about the familiarity and degree of distribution of patient medical advance directives. Furthermore, it was examined how a routine question concerning patient's provisions in a preoperative setting is perceived by the patients and from which source information about this topic should be provided.

Methods: Between April 2017 and October 2017 a total of 200 patients were randomly selected prior to planned surgery and interviewed anonymously using a standardized questionnaire.

Results: Of the patients surveyed 78.8% stated that they knew about the possibility of patient advance directives. Of the patients interviewed 26.3% stated they had drawn up an advance directive, 20.7% had a precautionary power of attorney and 12.3% had signed a care directive. Among the influencing factors in drawing up an advance directive, age, as well as familial and disease-related causes, were identified as significant factors. The overwhelming majority of respondents (77.6%) wished to be approached on the subject of precautionary medical provisions before a planned operation.

Conclusion: Despite an increasing proportion of patients who have drawn up an advance directive, there is still a great need for information on the subject. Doctors should address patients on the topic before planned interventions.

Keywords: Advance directives; Care directive; Precautionary medical provisions.

MeSH terms

  • Advance Directives*
  • Humans
  • Living Wills*
  • Surgical Procedures, Operative
  • Surveys and Questionnaires