Physicians and nurses' knowledge and attitudes towards advance directives for cancer patients in Saudi Arabia

This study aimed to investigate physicians' and nurses' knowledge and attitudes toward advance directives (ADs) for cancer patients, which empower patients to take decisions on end-of-life needs if they lose their capacity to make medical decisions. A cross-sectional study was conducted us...

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Bibliographic Details
Published in:	PloS one Vol. 14; no. 4; p. e0213938
Main Authors:	AlFayyad, Isamme N, Al-Tannir, Mohamad A, AlEssa, Waleed A, Heena, Humariya M, Abu-Shaheen, Amani K
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 12-04-2019 Public Library of Science (PLoS)
Subjects:	Adult Advance directives Advance Directives - psychology Advertising executives Attitude of Health Personnel Attitudes Beliefs, opinions and attitudes Biology and Life Sciences Cancer Cancer patients Care and treatment Clinical Competence Confidence intervals Cross-Sectional Studies Decision making Decisions Education Family physicians Female Health care Humans Islam - psychology Knowledge Male Management Medical care quality Medical law Medical personnel Medicine and Health Sciences Men Neoplasms - therapy Nurses Nurses - psychology Nursing research Older people Palliative care Patient care Patients People and Places Physicians Physicians - psychology Planning Practice Preferences Research and Analysis Methods Response rates Saudi Arabia Social Sciences Studies Young Adult Saudi Arabia Riyadh Saudi Arabia
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Summary:	This study aimed to investigate physicians' and nurses' knowledge and attitudes toward advance directives (ADs) for cancer patients, which empower patients to take decisions on end-of-life needs if they lose their capacity to make medical decisions. A cross-sectional study was conducted using convenience sampling. The outcomes were responses to the knowledge and attitude questions, and the main outcome variables were the total scores for knowledge and attitudes toward ADs. This study included 281 physicians and nurses (60.5%). Most physicians were men (95, 80.5%), whereas most nurses were women (147, 86.5%). The mean (standard deviation; SD) total knowledge score was 6.8 (4.0) for physicians and 9.1 (3.0) for nurses (p < 0.001). There was a significant difference in the total knowledge score between nurses and physicians, with an adjusted mean difference of 1.54 (95% confidence interval [CI]; 0.08-2.97). Other significant independent predictors of knowledge of ADs were female sex (1.60, 95% CI; 0.27-3.13) and education level (master's versus bachelor's: 1.26, 95% CI; 0.30-2.33 and Ph.D. versus bachelor's: 2.22, 95% CI; 0.16-4.52). Nurses' attitudes appeared to be significantly more positive than those of physicians, and the mean total attitude score (SD) was 19.5 for nurses (6.2) and 15.1 (8.1) for physicians (p < 0.001). The adjusted mean difference (95% CI) for nurses versus physicians was 3.71 (0.57-6.98). All participants showed a high level of knowledge of ADs; however, nurses showed considerably more positive attitudes than physicians.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Competing Interests: The authors have declared that no competing interests exist.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0213938