title: Effectiveness of advance directives for the care of terminally ill patients in Chiang Mai University Hospital, Thailand.
abstract: The key hypothesis behind advance directives (ADs) proposes that, if an intervention enhances a person's right to choose, a dying person will not opt for expensive, life-prolonging medical care and an ethically acceptable saving of resources will result. In order to assess the acceptability and effectiveness of ADs in reducing cardiopulmonary resuscitation (CPR) attempts and in-hospital death among terminally ill patients in a tertiary care hospital in northern Thailand, a non-randomized, controlled intervention study using an after-only unequivalent control group design was conducted. The majority of the subjects and the surrogates preferred to employ ADs in expressing their preferences on CPR and there was a high level of agreement between the subjects and surrogates on the decision. The use of ADs appeared to be effective in reducing futile CPR attempts and the in-hospital mortality rate among subjects during the index hospitalization. Advance directives were accepted well in this study setting.
authors.affiliation: Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand. sudarat@mail.nurse.cmu.ac.th
authors.forename: Sudarat
authors.initials: S
authors.lastname: Sittisombut
authors.forename: Colleen
authors.initials: C
authors.lastname: Maxwell
authors.forename: Edgar J
authors.initials: EJ
authors.lastname: Love
authors.forename: Chitr
authors.initials: C
authors.lastname: Sitthi-Amorn
mesh_terms: D000328:Adult; D016223:Advance Directives; D016887:Cardiopulmonary Resuscitation; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D013727:Terminal Care; D019452:Terminally Ill; D013785:Thailand