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Laranjeira C, Dixe MDA, Gueifão L, Caetano L, Passadouro R, Querido A. Awareness and Attitudes towards Advance Care Directives (ACDs): An Online Survey of Portuguese Adults. Healthcare (Basel) 2021; 9:healthcare9060648. [PMID: 34072558 PMCID: PMC8227883 DOI: 10.3390/healthcare9060648] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/17/2021] [Accepted: 05/25/2021] [Indexed: 12/28/2022] Open
Abstract
(1) Background: Evidence shows that facilitated advance decisions can increase the number of meaningful and valid Advance Care Directives (ACDs) and improve the quality of care when End-Of-Life (EOL) is near. Little is known about the awareness and attitudes of Portuguese adults towards ACDs. The present study aims to assess the knowledge, attitudes, and preferences of a sample of Portuguese adults regarding EOL care decisions and ACDs. (2) Methods: A total of 1024 adults were assessed with an online cross-sectional survey collecting information on sociodemographic factors, knowledge, attitudes and preferences regarding advance decisions and EOL care. (3) Results: Participants had a mean age of 40.28 ± 11.41 years. Most were female and had a professional background related to healthcare. While 76.37% of participants had heard of ACDs, only a small percentage (2.34%) had actually ever made an ACD. Knowledge levels were weakly correlated with attitudes regarding ACDs (r = -0.344; p < 0.01). (4) Conclusions: Participants lacked a comprehensive understanding about ACDs, but revealed positive attitudes towards their use and usefulness. Further research can inform efforts to improve ACD engagement in this population. The discussion about ACDs should be part of health promotion education with a focus on planning for a comfortable and peaceful death.
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Affiliation(s)
- Carlos Laranjeira
- School of Health Sciences of Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal;
- Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo André—66–68, Campus 5, Polytechnic of Leiria, 2410-541 Leiria, Portugal;
- Research in Education and Community Intervention (RECI I & D), Piaget Institute, 3515-776 Viseu, Portugal
- Correspondence: (C.L.); (A.Q.)
| | - Maria dos Anjos Dixe
- School of Health Sciences of Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal;
- Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo André—66–68, Campus 5, Polytechnic of Leiria, 2410-541 Leiria, Portugal;
| | - Luís Gueifão
- Intensive Care Unit, Leiria Hospital Center, R. de Santo André, 2410-197 Leiria, Portugal; (L.G.); (L.C.)
| | - Lina Caetano
- Intensive Care Unit, Leiria Hospital Center, R. de Santo André, 2410-197 Leiria, Portugal; (L.G.); (L.C.)
| | - Rui Passadouro
- Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo André—66–68, Campus 5, Polytechnic of Leiria, 2410-541 Leiria, Portugal;
| | - Ana Querido
- School of Health Sciences of Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal;
- Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo André—66–68, Campus 5, Polytechnic of Leiria, 2410-541 Leiria, Portugal;
- Center for Research in Health and Information Systems (CINTESIS), NursID, University of Porto, 4200-450 Porto, Portugal
- Correspondence: (C.L.); (A.Q.)
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Laranjeira C, Dixe MDA, Gueifão L, Caetano L, Passadouro R, Gabriel T, Querido A. Development and psychometric properties of the general public's attitudes toward advance care directives scale in Portugal. J Public Health Res 2021; 10:1881. [PMID: 33681087 PMCID: PMC7922370 DOI: 10.4081/jphr.2021.1881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 01/13/2021] [Indexed: 11/22/2022] Open
Abstract
Background: To date, no instrument in Portugal has evaluated the attitudes of the population about advance care directives. This paper describes the development and testing of the General Public's Attitudes Toward Advance Care Directives (GPATACD) Scale. Design and Methods: Methodological study. The development of the instrument was based on a literature review, updated in 2018. Face and content validity were verified by an expert panel and piloted among six participants. Data were collected in an online survey of 1024 Portuguese adults. The obtained data were analyzed using Varimax rotation, while the reliability was evaluated by calculating Cronbach's alpha. Results: The scale achieves good Item-Content Validity Index (I-CVI) values, between 0.89 and 1.00, and scale-CVI values of 0.91. A principal component analysis generated four dimensions with 26 items as a final scale, with overall Cronbach's alpha of 0.848. Conclusions: The findings demonstrate that the scale is valid and reliable as a vehicle for assessment of the general public's attitudes toward advance care directives.
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Affiliation(s)
- Carlos Laranjeira
- School of Health Sciences of Polytechnic Institute of Leiria; Research in Education and Community Intervention (RECI), Piaget Institute; Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria
| | - Maria Dos Anjos Dixe
- School of Health Sciences of Polytechnic of Leiria; Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria
| | - Luís Gueifão
- Intensive Care Unit, Leiria Hospital Center, Leiria
| | | | - Rui Passadouro
- ACES do Pinhal Litoral, Leiria; Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria
| | | | - Ana Querido
- School of Health Sciences of Polytechnic of Leiria; Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Center for Research in Health and Information Systems (CINTESIS), NursID, University of Porto, Portugal
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