title: Relevance of specialized nutritional support in the statements of advance directives. A specialty hospital experience
abstract: Introduction: The Statement of Advance Directives (SAD) is a written document that contains the preferences for health care and treatments desired to receive when the capacity to express is lost.
  Objective: To study the content of SAD registered in the office of Register of Advance Directives of the Hospital Universitario Puerta del Mar regarding Specialized Nutritional Support (SNS) and hydration in the period from November 2013 to December 2015.
  Method:Cross-sectional study on the content of the SAD written in the form of Decree 59/2012. Nine relevant variables related with SNS-H are studied in the DVA.
  Results: 414 SAD are analysed, 60% of which belong to women. The average age is 55.2 years. 41.7% of the SAD was registered by self-motivation. 84.78% do not wish to receive parenteral nutrition, 91.06% reject feeding through gastrostomy intubation, and 89.37% do not want to receive the nasogastric intubation. Hydration is rejected by 71.25%. The three possible options of SNS depend on the age of the declarant with statistical significance (p < 0.001), but not so for hydration. Both SNE and hydration are significantly associated with the reasons for the registration of Advance Directives (p < 0.001).
  Conclusions: Age is the main factor that determines the choice of accepting or rejecting SNS. By contrast, the choice of hydration is not conditioned by age. The reasons that drive respondents to register DVA is another determinant in the choice of whether to receive or not SNE and hydration.
authors.affiliation: Hospital Universitario Puerta del Mar. Cádiz. mariaj.cabezavaca.sspa@juntadeandalucia.es.
authors.forename: María José
authors.initials: MJ
authors.lastname: Cabeza de Vaca Pedrosa
authors.forename: Manuel
authors.initials: M
authors.lastname: Aguilar Diosdado
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Vizcaya Rojas
authors.forename: José Pedro
authors.initials: JP
authors.lastname: Novalbos Ruiz
authors.forename: Antonio
authors.initials: A
authors.lastname: Lorenzo Peñuelas
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Valero Cabeza de Vaca
mesh_terms: D000293:Adolescent; D000328:Adult; D016223:Advance Directives; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D018529:Nutritional Support; D013030:Spain; D055815:Young Adult