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Do Spanish Hospital Professionals Educate Their Patients About Advance Directives?

A Descriptive Study in a University Hospital in Madrid, Spain

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It is unknown whether hospital-based medical professionals in Spain educate patients about advance directives (ADs). The objective of this research was to determine the frequency of hospital-based physicians’ and nurses’ engagement in AD discussions in the hospital and which patient populations merit such efforts. A short question-and-answer-based survey of physicians and nurses taking care of inpatients was conducted at a university hospital in Madrid, Spain. In total, 283 surveys were collected from medical professionals, of whom 71 per cent were female, with an average age of thirty-four years. Eighty-four per cent had never educated patients about ADs because of lack of perceived responsibility, time, or general knowledge of ADs. Patient populations that warranted AD discussions included those with terminal illnesses (77 per cent), chronic diseases (61 per cent), and elderly patients (43 per cent). Regarding degree of AD understanding in medical professionals: 57 per cent of medical professionals claimed sufficient general knowledge of ADs, 19 per cent understood particulars regarding AD document creation, and 16 per cent were aware of AD regulatory policies. Engagement in AD discussions was considered important by 83 per cent of medical professionals, with 79 per cent interested in participating in such discussions themselves. The majority of hospital physicians and nurses do not educate their patients about ADs, despite acknowledging their importance. Patient populations of highest priority included those with terminal diseases or chronic illness or who are of advanced age.

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  1. Law 3/2005, May 23, which regulates the exercise of the right to formulate advance directives in health and creates the appropriate registry. BOCM 140, June 2005.

  2. Law 41/2002, November 14, regulating patient autonomy and rights and obligations of information and clinical documentation. BOE. 274, November 2002.

  3. Law 3/2005, May 23, which regulates the exercise of the right to formulate advance directives in health and creates the appropriate registry. BOCM 140, June 2005.


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The research team would like to thank Venktesh Ramnath for his work revising and editing this article.

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Correspondence to Benjamín Herreros.

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Pérez, M., Herreros, B., Martín, M.D. et al. Do Spanish Hospital Professionals Educate Their Patients About Advance Directives?. Bioethical Inquiry 13, 295–303 (2016).

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