Factors influencing long-term care visiting nurses’ attitudes toward advance directives

Purpose: To examine the relationships among hospice perception, knowledge of advance directives, and attitudes toward advance directives (attitudes) in long-term care (LTC) visiting nurses. The factors influencing their attitudes were also identified.Methods: Data were collected from 164 LTC visiting nurses across South Korea using a structured online questionnaire. Descriptive statistics, independent t-test, one-way ANOVA, Pearson’s correlation coefficients, and multiple regression analysis were performed using IBM SPSS version 26.0.Results: The mean scores were 71.75±6.39, 8.37±0.85, and 50.21±4.85 for hospice perception, knowledge of advance directives, and attitudes, respectively. Attitudes differed significantly based on age (F=2.84, <i>p</i>=.040). Attitudes were positively correlated with hospice perception (r=.59, <i>p</i><.001) and knowledge of advance directives (r=.17, <i>p</i>=.027). However, hospice perception and knowledge of advance directives were not correlated (r=.11, <i>p</i>=.150). Furthermore, hospice perception (β=.58, <i>p</i><.001) was the only factor that significantly influenced attitudes, explaining 34.6% of the variance. Age and knowledge of advance directives were not significant predictors.Conclusion: Hospice perception is the most significant factor influencing visiting nurses’ attitudes toward advance directives. Accordingly, developing awareness-enhancing programs that incorporate professional knowledge and enable the internalization of the philosophy and values of hospice and palliative care is essential. Such initiatives will ultimately improve the quality of community-based end-of-life care provided by visiting nurses.