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Effectiveness of advance directives for the care of terminally ill patients in Chiang Mai University Hospital, Thailand
Author(s) -
Sittisombut Sudarat,
Maxwell Colleen,
Love Edgar J.,
SitthiAmorn Chitr
Publication year - 2008
Publication title -
nursing and health sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.563
H-Index - 47
eISSN - 1442-2018
pISSN - 1441-0745
DOI - 10.1111/j.1442-2018.2007.00371.x
Subject(s) - cardiopulmonary resuscitation , terminally ill , medicine , intervention (counseling) , chiang mai , advance care planning , medical emergency , nursing , family medicine , emergency medicine , resuscitation , palliative care , history , ethnology
The key hypothesis behind advance directives (ADs) proposes that, if an intervention enhances a person's right to choose, a dying person will not opt for expensive, life‐prolonging medical care and an ethically acceptable saving of resources will result. In order to assess the acceptability and effectiveness of ADs in reducing cardiopulmonary resuscitation (CPR) attempts and in‐hospital death among terminally ill patients in a tertiary care hospital in northern Thailand, a non‐randomized, controlled intervention study using an after‐only unequivalent control group design was conducted. The majority of the subjects and the surrogates preferred to employ ADs in expressing their preferences on CPR and there was a high level of agreement between the subjects and surrogates on the decision. The use of ADs appeared to be effective in reducing futile CPR attempts and the in‐hospital mortality rate among subjects during the index hospitalization. Advance directives were accepted well in this study setting.