Understanding of life-sustaining treatment in patients with chronic illness and their willingness to complete advance directives

We investigated the level of understanding of life-sustaining treatment in Korean patients with chronic illness and examined the influence of understanding of life-sustaining treatment on their willingness to complete advance directives. Data were collected by a survey of 187 outpatients recruited by the proportionate quota sampling method at 2 general hospitals in South Korea, using structured questionnaires. Data were analyzed with hierarchical multivariate logistic regression analysis. According to the results, only 9% of the respondents have an adequate understanding of the percentage of survival to actual hospital discharge after in-hospital cardiopulmonary resuscitation, and 59% understood the possibility of permanent use of a mechanical ventilator when breathing is not restored. Although most respondents showed a preference for advance directives, only 57% wanted to complete advance directives. Understanding of life-sustaining treatment significantly increased the odds of being willing to complete advance directives, controlling for covariates. In conclusion, proactive publicity and proper education regarding life-sustaining treatments by health care providers are critical to encouraging completion of advance directives.