Advance directives: The experience of health care professionals across thecontinuum of care

This study explored the perceptions of health care providers across the con tinuum of care as to how effective advance directive arrangements were in a ssuring compliance with the patients' wishes, as well as their overall sati sfaction levels with the process. The health care providers who responded t o the survey indicated high levels of overall satisfaction with advance dir ectives, despite low patient completion rates and, most significantly, low confidence levels that surrogate decision making accurately reflected the p atient's wishes. A secondary analysis compared the perceptions of health ca re providers with consumers' reasons for failing to complete advance direct ives. The need for further education was perceived as a primary need by the health care professionals but not by the consumers. Recommendations for po licy initiatives and further research are then presented.