PMID- 34945258
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20211229
IS  - 2077-0383 (Print)
IS  - 2077-0383 (Electronic)
IS  - 2077-0383 (Linking)
VI  - 10
IP  - 24
DP  - 2021 Dec 19
TI  - The Impact of Advance Directive Perspectives on the Completion of Life-Sustaining 
      Treatment Decisions in Patients with Heart Failure: A Prospective Study.
LID - 10.3390/jcm10245962 [doi]
LID - 5962
AB  - Evidence for non-modifiable and modifiable factors associated with the 
      utilization of advance directives (ADs) in heart failure (HF) is lacking. The 
      purpose of this study was to examine baseline-to-3-month changes in knowledge, 
      attitudes, and benefits/barriers regarding ADs and their impact on the completion 
      of life-sustaining treatment (LST) decisions at 3-month follow-up among patients 
      with HF. Prospective, descriptive data on AD knowledge, attitudes, and 
      benefits/barriers and LSTs were obtained at baseline and 3-month follow-up after 
      outpatient visits. Of 64 patients (age, 68.6 years; male, 60.9%; New York Heart 
      Association (NYHA) classes I/II, 70.3%), 53.1% at baseline and 43.8% at 3-month 
      follow-up completed LST decisions. Advanced age (odds ratio (OR) = 0.91, p = 
      0.012) was associated with less likelihood of the completion of LST decisions at 
      3-month follow-up, while higher education (OR = 1.19, p = 0.025) and NYHA class 
      III/IV (OR = 4.81, p = 0.049) were associated with more likelihood. In 
      conclusion, advanced age predicted less likelihood of LST decisions at 3 months, 
      while higher education and more functional impairment predicted more likelihood. 
      These results imply that early AD discussion seems feasible in mild symptomatic 
      HF patients with poor knowledge about ADs, considering the non-modifiable and 
      modifiable factors.
FAU - Kim, JinShil
AU  - Kim J
AD  - College of Nursing, Gachon University, Incheon 21936, Korea.
FAU - Heo, Seongkum
AU  - Heo S
AD  - Georgia Baptist College of Nursing, Mercer University, Atlanta, GA 30341, USA.
FAU - Kim, Bong Roung
AU  - Kim BR
AD  - Department of Internal Medicine, Seoul Medical Center, Seoul 02053, Korea.
FAU - Suh, Soon Yong
AU  - Suh SY
AD  - Division of Cardiology, Department of Internal Medicine, Gil Medical Center, 
      Gachon University College of Medicine, Incheon 21565, Korea.
FAU - Shim, Jae Lan
AU  - Shim JL
AUID- ORCID: 0000-0002-7795-0149
AD  - College of Nursing, Dongguk University, Gyeongju 38066, Korea.
FAU - An, Minjeong
AU  - An M
AUID- ORCID: 0000-0003-4318-8755
AD  - College of Nursing, Chonnam National University, Gwangju 61469, Korea.
FAU - Shin, Mi-Seung
AU  - Shin MS
AUID- ORCID: 0000-0002-0273-0109
AD  - Division of Cardiology, Department of Internal Medicine, Gil Medical Center, 
      Gachon University College of Medicine, Incheon 21565, Korea.
LA  - eng
GR  - 2016-17/Gachon University Gil Medical Center/
GR  - 201703-06/Korean Society of Cardiology/
PT  - Journal Article
DEP - 20211219
PL  - Switzerland
TA  - J Clin Med
JT  - Journal of clinical medicine
JID - 101606588
PMC - PMC8703517
OTO - NOTNLM
OT  - advance directives
OT  - attitudes
OT  - heart failure
OT  - knowledge
OT  - life-sustaining treatment
COIS- The authors declare no conflict of interest.
EDAT- 2021/12/25 06:00
MHDA- 2021/12/25 06:01
PMCR- 2021/12/19
CRDT- 2021/12/24 01:08
PHST- 2021/11/14 00:00 [received]
PHST- 2021/12/15 00:00 [revised]
PHST- 2021/12/16 00:00 [accepted]
PHST- 2021/12/24 01:08 [entrez]
PHST- 2021/12/25 06:00 [pubmed]
PHST- 2021/12/25 06:01 [medline]
PHST- 2021/12/19 00:00 [pmc-release]
AID - jcm10245962 [pii]
AID - jcm-10-05962 [pii]
AID - 10.3390/jcm10245962 [doi]
PST - epublish
SO  - J Clin Med. 2021 Dec 19;10(24):5962. doi: 10.3390/jcm10245962.