COMPARISON OF PATIENTS AND HEALTH-CARE PROFESSIONALS ATTITUDES TOWARDS ADVANCE DIRECTIVES

Objectives-This study, was designed to identify and compare the attitu des of patients and health care professionals towards advance directiv es. Advance directives promote recognition of the patient's autonomy, letting the individual exercise a certain measure of central over life -sustaining care and treatments in the eventuality of becoming incompe tent. Design-Attitudes to advance directives were evaluated using a 44 -item self-reported questionnaire. It yeilds an overall score as well as five factor scores: autonomy, beneficence, justice, external norms, and the affective dimension. Setting-Health care institutions in the province of Quebec, Canada. Survey sample-The sampling consisted of 92 1 subjects: 123 patients, 167 physicians, 340 nurses and 291 administr ators of health care institutions. Results-Although the general attitu de of each population was favourable to the expression of autonomy, mu ltivariate analysis of variance (MANOVA) indicated that physicians att ached less importance to this subscale than did other populations (p < .001). Above all, they favoured legal external norms and beneficence. Physicians and administrators also attached less importance to the aff ective dimension than did patientsd and nurses. Specifically, physicia ns' attitudes towards advance directives were shown to be less positiv e than patients' attitudes. Conclusion-More attention should be given to the importance of adequately informing patients about advance direc tives because they may not represent an adequate means for patients to assert their autonomy.