Cancer patients and advance directives: a survey of patients in a hematology and oncology outpatient clinic.
BACKGROUND
In 2009, Germany enacted a new law supporting advance directives that led to heated discussions in the media and the public. 3 years after the law passed, we surveyed patients with malignant diseases with regards to their views on advance directives.


METHODS
Between September 2011 and July 2012 an anonymous survey on advance directives was conducted among 617 patients at the hematology and oncology outpatient department of the University Hospital Mannheim, using a standardized questionnaire developed for this investigation.


RESULTS
Of the 503 patients who returned the questionnaire, 31% (n = 157) indicated having an advance directive. Of these 157, 54% (n = 85) completed the advance directive after 2009. 56% (282 out of 503) desired more information on advance directives. Of these, 71% (201 out of 282) wanted their general physician and 45% (128 out of 282) their specialist, to provide more information about this issue. Of the 339 patients without an advance directive, 47% (n = 158) stated that they had 'not worried about that yet'.


CONCLUSIONS
Although the percentage of patients with advance directives has increased since the legislative amendment, more information is still required by patients. It is recommended that physicians should discuss advance directives more frequently with their patients.
III. Medizinische Klinik, Universitätsmedizin Mannheim, Universität Heidelberg, Germany.
Elisabeth
E
Hubert
Nadine
N
Schulte
Sebastian
S
Belle
Axel
A
Gerhardt
Kirsten
K
Merx
Wolf-Karsten
WK
Hofmann
Alexander
A
Stein
Iris
I
Burkholder
Ralf-Dieter
RD
Hofheinz
Melanie
M
Kripp
D000293:Adolescent; D000328:Adult; D016223:Advance Directives / Q000706:statistics & numerical data*; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D005858:Germany / Q000453:epidemiology; D057220:Health Literacy / Q000706:statistics & numerical data*; D006405:Hematology / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000706:statistics & numerical data*; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000628:therapy; D010358:Patient Participation / Q000706:statistics & numerical data*; D015995:Prevalence; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D055815:Young Adult