Factors Affecting Intention of Signing an Advanced Directives in Cancer Patients

Abstract

Purpose: The purpose of this study was to identify factors affecting intention to sign an Advanced Directives (AD) in cancer patients.Methods: A descriptive correlational study design was used. Participants were 173 adult cancer patients in outpatient and inpatient departments at the cancer center of G University Hospital located in J city. Data were collected from February 25 to August 30, 2019. Data were analyzed using x<sup>2</sup> test, independent t-test, and multivariate logistic regression with SPSS/WIN 24.0.Results: Factors influencing an intention to sign an AD in cancer patients were job status (OR 2.81, 95% CI=1.20~6.56), whether or not any acquaintances had signed an AD (OR 51.48, 95% CI=3.76~704.71), proper time to sign an AD (when diagnosed with end-stage: OR 0.28, 95% CI=0.10~0.80; when near death: OR 0.09, 95% CI=0.02~0.46; reference: when healthy), discussion with family members about signing an AD (OR 15.87, 95% CI=2.28~110.54) and attitude towards AD (OR 6.50, 95% CI=1.23~34.38).Conclusion: In order to increase the intention to sign an AD in cancer patients, the development and implementation of nursing interventions to promote a positive attitude towards AD is highly recommended. Further, encouraging discussion with family members about signing an AD is recommended, and helping cancer patients to recognize that signing an AD is appropriate at a time when it is possible to make a treatment decision rather than when the patients has been diagnosed with end stage cancer.