title: [Knowledge about disease course and living wills among patients with heart failure].
abstract: OBJECTIVE
  To determine the level of knowledge about possible disease outcomes and living wills among patients with heart failure (HF) treated in an emergency department and to evaluate their willingness to draw up a living will.
  
  
  METHODS
  This cross-sectional, multicenter, noninterventional, prospective study included a consecutive series of patients. Patients' demographic and clinical characteristics were recorded. Once their symptoms were under control, patients were interviewed about their knowledge of and opinions about HF. The dependent variables were a good objective understanding of the disease and a willingness to draw up a living will, and factors associated with these variables were investigated.
  
  
  RESULTS
  The study included 309 patients: 79% considered themselves well-informed, 51.5% really were well-informed, 39.8% wanted more information, and 54.7% wanted to participate more in decision-making. In addition, 13.3% knew what living wills involved, 4.9% had received information about them from their doctor, and 28.8% agreed to draw one up. There was an independent association between being objectively well-informed and willingness to draw up a living will. Moreover, the former was associated with admission to intensive care, feeling well-informed, and having participated sufficiently in decision-making; the latter with age <75 years, wanting more information, understanding what a living will involved, and the referral center.
  
  
  CONCLUSIONS
  The knowledge possessed by HF patients about the natural history of their disease was suboptimal, as was their knowledge about living wills and their willingness to draw one up. Providing better information about these issues is an essential part of the doctor-patient relationship.
authors.affiliation: Área de Urgencias, Hospital Clínic, Grupo de Investigación Urgencias, Procesos y Patologías, Fundació Clínic, Barcelona, España. ANTOLIN@clinic.ub.es
authors.forename: Albert
authors.initials: A
authors.lastname: Antolín
authors.forename: Miquel
authors.initials: M
authors.lastname: Sánchez
authors.forename: Pere
authors.initials: P
authors.lastname: Llorens
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Martín Sánchez
authors.forename: Juan Jorge
authors.initials: JJ
authors.lastname: González-Armengol
authors.forename: Juan P
authors.initials: JP
authors.lastname: Ituño
authors.forename: José F
authors.initials: JF
authors.lastname: Carbajosa
authors.forename: José M
authors.initials: JM
authors.lastname: Fernández-Cañadas
authors.forename: Juan
authors.initials: J
authors.lastname: González del Castillo
authors.forename: Òscar
authors.initials: Ò
authors.lastname: Miró
mesh_terms: D000368:Aged; D003376:Counseling; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006333:Heart Failure / Q000523:psychology*; D006801:Humans; D016224:Living Wills / Q000523:psychology*; D008297:Male; D010342:Patient Acceptance of Health Care; D011446:Prospective Studies; D012959:Socioeconomic Factors; D013030:Spain