title: Advance directive use and psychosocial characteristics: an analysis of patients enrolled in a psychosocial cancer registry.
abstract: Advance directives (ADs) refer to a category of documents that enable individuals to state their preferences for future healthcare decisions in the event of incapacitation. The purpose of the study was to examine differences in psychosocial characteristics and AD completion rates in persons newly diagnosed with cancer. This sample comes from data collected for a psychosocial registry for patients with cancer. The following psychosocial data were collected: Functional Assessment of Cancer Therapy-General, Profile of Mood States-short form, and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale. The sample included 312 persons who had been diagnosed with cancer within the previous 5 months. There were no statistically significant differences between completion of an AD and the measured psychosocial characteristics at baseline (mean, 4.2 months); however, at 3 months, patients who reported higher quality of life (Functional Assessment of Cancer Therapy-General) were associated with lower AD completion rates and persons with greater mood disturbances had higher rates of AD completion. Our data suggest the need to develop strategies that would facilitate discussion of ADs for patients entering the cancer care continuum.
authors.affiliation: Case Western Reserve University, Frances Payne Bolton School of Nursing, 10900 Euclid Ave, Cleveland, OH 44106-4904, USA. carol.kelley@case.edu
authors.forename: Carol G
authors.initials: CG
authors.lastname: Kelley
authors.forename: Amy R
authors.initials: AR
authors.lastname: Lipson
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Daly
authors.forename: Sara L
authors.initials: SL
authors.lastname: Douglas
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D016223:Advance Directives / Q000523:psychology / Q000706:statistics & numerical data; D000368:Aged; D015897:Comorbidity; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States; D015999:Multivariate Analysis; D009369:Neoplasms / Q000175:diagnosis / Q000523:psychology*; D015404:Nursing Methodology Research; D010358:Patient Participation / Q000523:psychology / Q000706:statistics & numerical data; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology; D012042:Registries; D011795:Surveys and Questionnaires; D015599:Trauma Severity Indices