Association Between Knowledge and Attitudes Towards Advance Directives in Emergency Services

Aim: To assess the levels and relationship of knowledge and attitudes of nursing and medical professionals towards advance directives in hospital emergency departments and emergency medical services, and determine the correlated and predictor variables of favourable attitudes towards advance directives. Design: Observational, descriptive and cross-sectional study. Methods: : The study was conducted in the emergency department of a second-level hospital and in the emergency medical service. Data collection was performed from January 2019 to February 2020. The guidelines STROBE were followed for the preparation of the study. Results: : A total of 173 responses were obtained. Among them, 91.3% considered that they were not sufficiently informed about advance directives, and 74% acknowledged not having incorporated them into their usual practice. The multinomial analysis indicated a statistically significant relationship between (a) the variables age and emergency service and (b) having more favourable attitudes on the part of the professionals by consulting their patients (OR 1.07 [95% CI: 1.02-1.12]; p = 0.003) and compliance with patient advance directives (OR 3.53 [95% CI: 1.64-7.61]; p = 0.001). The fact of working the afternoon shift was a predictor variable for obtaining a higher score with respect to attitudes in complex scenarios. Conclusion: Implementing the consultation of patient advance directives in practice makes it possible to adjust decision-making to the wishes and preferences of the patients served, probably reducing the ethical and legal conflicts generated in the context of emergency services.