Oncology nurses' perceptions of advance directives for patients with cancer

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HOBDEN, Breanne | BRYANT, Jamie | WALLER, Amy | SHEPHERD, Jan | SANSON-FISHER, Rob

This study examined oncology nurses' perceptions of the impact of advance directives on oncology patients' end-of-life care. Nurses (n=104) who were members of an oncology nursing society or worked in a large metropolitan cancer centre completed a cross-sectional survey assessing perceptions of advance directives. There was high agreement that advance directives: make decisions easier for family (87%) and providers (82%); are doctors' responsibility to implement (80%); reduce unwanted aggressive treatment in the last weeks of life (80%); protect patient autonomy (77%); and increase likelihood of dying in preferred location (76%). There was moderate or low agreement that advance directives: are accessible when needed (60%); are oncology nurses' responsibility to implement (46%); are always followed (41%); reduce the likelihood of pain in the last weeks of life (31%); contain difficult to follow statements (30%); and have no impact on comfort in the last weeks of life (15%). Most nurses perceive benefits for advance directives, however, there remains uncertainty around accessibility and implementation. Guidelines and education on AD processes in oncology could improve person-centered end-of-life care.

http://dx.doi.org/10.1111/nhs.12826

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