title: Does preparedness planning improve attitudes and completion of advance directives in patients with symptomatic heart failure?
abstract: OBJECTIVE
  There is little evidence to support whether interventions that engage patients with symptomatic heart failure (HF) in preparedness planning impacts completion of advance directives (ADs). This study was conducted to assess the impact of a palliative care intervention on health perceptions, attitudes, receipt of information and knowledge of ADs, discussion of ADs with family and physicians, and completion of ADs in a cohort of patients with symptomatic HF.
  
  
  METHODS
  Thirty-six patients hospitalized for HF decompensation were recruited and referred for an outpatient consultation with a palliative care specialist in conjunction with their routine HF follow-up visit after discharge; telephone interviews to assess health status and attitudes toward ADs were conducted before and 3 months after the initial consultation using an adapted version of the Advance Directive Attitude Survey (ADAS). Information pertaining to medical history and ADs was verified through medical chart abstraction.
  
  
  CONCLUSIONS
  The current study found support for enhancing attitudes and completion of ADs following a palliative care consultation in patients with symptomatic HF. Despite a significant increase in attitudes toward completion of ADs following the intervention, only 47% of the participants completed ADs. This finding suggests that although education and understanding of ADs is important and can result in more positive attitudes, it does not translate to completion of ADs in all patients.
authors.affiliation: 1Program of Nursing Science, University of California Irvine, Irvine, California 92697, USA. l.evangelista@uci.edu
authors.forename: Lorraine S
authors.initials: LS
authors.lastname: Evangelista
authors.forename: Marjan
authors.initials: M
authors.lastname: Motie
authors.forename: Dawn
authors.initials: D
authors.lastname: Lombardo
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ballard-Hernandez
authors.forename: Shaista
authors.initials: S
authors.lastname: Malik
authors.forename: Solomon
authors.initials: S
authors.lastname: Liao
mesh_terms: D016223:Advance Directives / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006333:Heart Failure / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010166:Palliative Care; D010817:Physician-Patient Relations; D036301:Qualitative Research