Willingness to provide advance care planning in hospital setting: A cross-sectional survey

Introduction: To assess the willingness to provide advance directives (AD) and evaluate the association of sociodemographic and cultural factors in hospitalized patients in a general ward. Patients and methods: A cross-sectional study was conducted at Clínica Santa Isabel and Dr César Milstein Hospital between September 2021 and August 2024. Patients over 18 years old, hospitalized for more than 24 hours due to medical or surgical causes, were included. The primary outcome was the willingness to provide AD during hospitalization. Sociodemographic, cultural, religious, and medical data were collected. Two models were constructed to assess the independent effect of predictors: one for sociodemographic and cultural variables, and another for comorbidities and medical information. Results: A total of 358 participants were included, with a median age of 64 years [interquartile range (IQR) 45–74], 51.7% of whom were women. Among all patients, 9 (2.5%) had an AD document already signed. During hospitalization, 51.4% agreed to provide AD, while 66.4% were willing to do so in the outpatient setting. The main reasons for not providing AD were thinking that AD is not needed (39.7%) and insufficient information (23.4%). The likelihood of completing AD was significantly lower among older age groups: 41–69 years old, [odds ratio (OR) 0.31, confidence interval (CI) 95% 0.15–0.62, p < 0.001] and 60 years old or more (OR 0.28, CI 95% 0.13–0.6, p < 0.001). Conclusions: This study reveals that patients have limited awareness of AD. Nonetheless, over half were open to completing them after receiving further information. Clear communication about AD can encourage greater patient engagement in their healthcare decisions.