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Developing a Parsimonious Model for Predicting Completion of Advance Directives
Author(s) -
Judy Campbell Mary,
Jo Edwards M.,
Ward Karen S.,
Weatherby Norman
Publication year - 2007
Publication title -
journal of nursing scholarship
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.009
H-Index - 80
eISSN - 1547-5069
pISSN - 1527-6546
DOI - 10.1111/j.1547-5069.2007.00162.x
Subject(s) - multinomial logistic regression , covariate , logistic regression , health literacy , literacy , descriptive statistics , psychology , regression analysis , medicine , gerontology , statistics , health care , mathematics , pedagogy , economics , economic growth
Purpose: To develop a theory‐based model to assist nurses in promoting self‐determination for completion of an advance directive (AD).Design and Methods: This descriptive study included data from a convenience sample of 118 community‐dwelling older adults in Tennessee, USA. Multinomial logistic regression was used to estimate the influence of 15 factors and covariates on completion of an AD.Findings: The parsimonious model had three significant factors: receiving AD information; attitude index; and health literacy score. Participants were highly likely to complete ADs if they had positive attitudes toward ADs and had received information on ADs. As health literacy increased, the likelihood that participants completed ADs was reduced. This model explained 25% of the variation in AD completion. Chi‐square fit for the parsimonious model was highly significant.Conclusions: Of 15 factors and covariates that could influence completion of an AD, only receiving information about ADs, having positive attitudes toward ADs, and health literacy significantly affected the likelihood of participants completing ADs. More study is needed on this model and how nurses can assist patients with end‐of‐life decisions.