Knowledge and attitudes of nursing staff toward advance directives in 2 health areas in Andalusia (Spain)

To identify the knowledge and attitudes of nursing staff toward advance directives (AD) in 2 health areas, and to compare the results in both areas. We performed a cross-sectional, descriptive study by means of a self-administered, validated, 12-item questionnaire carried out in 2 Andalusian health areas. Sampling was not carried out as the aim was to contact the whole population. A total of 298 (75.25%) questionnaires were completed. The nursing staff surveyed scored their knowledge with a mean of 4.47 points. Only 63.1% (188) knew about the legislation on AD, and only 32.3% (n= 96) had read the document. The nurses believed that planning and writing down one's wishes about the care to be received was advisable (mean: 8.36). The nursing professionals considered ADs to be a useful tool for health professionals (mean: 8.37) and for relatives (mean: 8.21). The nurses surveyed would register their own AD at some point in their lives (mean: 8.33). However, when the nurses were asked if they would do so in the next year the mean score dropped to 5.13. The nurses surveyed revealed a positive attitude toward the usefulness of ADs for patients' relatives and for health professionals, as well as a positive attitude toward the use of and respect for ADs. Among these nurses, willingness to register their own AD was high, but few intended to do so in the short term. Efforts should be made to improve nurses' knowledge of ADs and of the organizational process that allows these health professionals to introduce advance care planning as a specific task within nursing care.