Study of the factors influencing the preparation of advance directives

Abstract

The aim of the study is to analyze the factors influencing the decision to prepare advance directives (AD) related to socio-demographic situation, health status, degree of dependence, healthcare characteristics and psychosocial aspects. This is a case-control study conducted using a personal interview. We compared 123 subjects who had completed AD with 123 subjects who had not and who belonged to two health centers in the Albacete Health District. Study variables included self-perceived health, functional status, morbidity, socio-demographic characteristics, use of health services, attitudes toward AD and psychosocial aspects. We found a predominance of women (64.2%) among those who prepared AD, with a mean age of 53.3 years. Preparing AD was associated with secondary or higher education (OR=2.5), a lifestyle other than living with a partner and with children (OR=2.5), chronic medication use (OR=3.2), higher than average number of specialist visits (OR=4.0), a longer-term relationship with the family physician (OR=3.5), a family history of having AD (OR=17.3) and with lower levels of social interaction (OR=3.0). The results suggest that several factors, resulting from both the socio-demographic situation and health or functional status, can affect the decision to formalize AD.

Keywords: Advance directives; Living will; Medical ethics.