Table 1 Studies on patients with ADs by type of care
Field | Year | Author and type of study | Results |
|---|---|---|---|
Primary care | 2000 | Flordelís, Fernando Qualitative study | 70 participants: ADs would be helpful in communications about end-of-life care between doctors and patients |
2003 | Santos de Unamuno, Carmen Observational | 107 participants. 97% of patients expressed interest in ADs, 39.3% stated that they would complete such a document, 88.8% that they would discuss it with their relatives and 73.8% with their family doctor | |
2008 | Ángel- López Rey, Esther Observational | 395 participants. 88.8% were unfamiliar with ADs. After informing them about the document, 67.8% would fill it out if terminally ill, while 56.3% would sign it immediately. 34.4% would assign a relative to be a representative. 76.9% would keep the document once signed, while 49.3% would modify it at request of their relatives and 46.6% at request of their doctor. 85.4% would feel reassured to know that their wishes would be honored if they were to become incapacitated | |
2008 | Angora, Francisco Intervention study | 51 participants. 47% were already familiar with ADs, and 39% knew that such a document could be completed in their region. 69% would prefer to submit the document to a public register, 12% to witnesses and 6% to the notary public. 82% would notify their family doctor. 78% believed that ADs are only taken into consideration in extreme cases | |
2011 | Navarro, Beatriz Qualitative study | 15 participants. Positive attitude towards ADs, but great ignorance about the document itself and its purpose. Any information was mainly obtained from the media. What they had heard about ADs, they related to euthanasia and organ donation. They pointed out the need to include the document in the patient’s medical record and that the initiative to increase awareness about ADs should come from doctors themselves | |
2012 | Andrés-Pretel, Fernando Observational | 464 participants. 86.2% of the patients were unfamiliar with them, while 3.4% had registered ADs. 76.7% showed a favorable attitude, stating that it would be advisable to register ADs. 88.2% pointed out the need to raise awareness among the entire population about the possibility of registering ADs, especially the elderly. 70.2% believed that it facilitates decision-making for the doctor and family | |
2014 | Llordés, Montserrat Observational | 579 participants. 38% were familiar with them, while 2% had registered ADs, mostly before a notary public (62%). 74% expressed interest in receiving information, preferably in writing | |
2015 | Serrano, Reyes Observational | 192 participants. 51% were familiar with ADs. Of them, up to 15.3% had been informed by health care professionals (16.3% by relatives and 43.9% through the media). 90.6% believed that ADs were useful, with 65.6% willing to make use of them. 60.4% believed that family doctors should offer all of their patients the chance to register ADs. 75.5% would recommend their relatives to prepare ADs | |
2018 | Ortiz-Gonçalves, Belén Observational | 425 participants. 50% were familiar with ADs and 4% had drafted them. 63% were willing to prepare them, 45% would inform their family, and 70% would tell their doctor. 91% would like to decide about the care they receive at the end of life | |
Nursing home | 2002 | Martínez, Esther Intervention study | 20 participants. 35% had their will prepared, and 60% would choose a relative as their representative. 80% had some written statement about future care, most preferring to die in the nursing home. 60% expressed the desire to receive information in the event of terminal illness or a degenerative disease |
Intensive care | 2003 | Solsona, José F Observational | 80 participants. 12.5% had verbally designated a representative. None had done so in writing. None had knowledge of living wills, nor had any formalized one |
Emergencies Emergencies | 2007 | Antolín, Albert Observational | 160 participants. 19% were familiar with ADs, and 3% had been informed about them by their doctor. 85% would designate a relative to be their representative. 50% were in favor of completing ADs after being properly informed, and 91% were in favor of distributing informative brochures |
2010 | Antolín, Albert Observational | 190 participants: 16% were familiar with ADs, and 5% had been informed about them by their doctor. 81% would designate a relative to be their representative. 46% were in favor of completing ADs after being properly informed, and 97% were in favor of distributing informative brochures | |
Internal medicine | 2011 | Molina, Julia Observational | 155 participants. 4.5% knew what ADs were, but only 1 patient had completed ADs (before a notary public). After learning about their existence, up to 31.6% would like to prepare ADs. 80.6% were in favor of having the document in the patient’s medical record, while 72.9% did not believe that having ADs would change the doctor’s decisions. None remembered that there was a section about ADs in the hospital’s intake handbook |
2013 | Pérez, María Observational | 206 participants. 5.3% knew what ADs were, but only 1 patient had completed ADs. After being informed about them, up to 46.1% would like to do so. Patients remarked that having ADs would not change the doctor’s mind. Of the patients who were familiar with ADs, most knew about them through the media. 80.1% wanted the information to be included in the patient’s medical record | |
Palliative care | 2011 | Domínguez, Carmen Observational | 267 participants. 11.2% knew of their existence, while 40% wished to be given further information, 62% of them being non-cancer patients. 2.25% had completed ADs. Among these, ADs had been executed before witnesses, and private documents were used; none had done so using the official form from their Autonomous Community. A legal representative was not assigned either. 100% of ADs were recorded in the patient’s medical record |