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Learning Objective 1: The learner will be able to verbalize the main barrier that prevents primary care providers from assessing and educating their patients about advance directives.
Learning Objective 2: The learner will be able to verbalize one reason primary care providers should include advance directive assessment into their routine practice.
Background: Many people do not have advance directives (AD) prepared and have never discussed their wishes for end-of-life care. Patients’ lack of knowledge about AD is complicated by primary care providers (PCP) who have limited knowledge of AD.
Aim:To determine if primary care provider advance directive education influences attitudes and practice.
Methods: A convenience sample of 76 primary care providers were asked to participate in a pre-survey, educational intervention, and post-survey descriptive design. The study was based on the Transtheoretical Model.
Results: The majority of PCPs responded in the precontemplation stage. PCPs believed it is their role to assess patients’ AD planning with 62.2% pre-survey and 82.9% post-survey. However, advance directive education did not influence practice in this project and the majority of PCPs had not added AD to their practice. . In addition, there was not a significant correlation between the nominal measure of PCPs level of formal training on AD and the interval measure of their belief about the role of PCPs in education of patients on AD, χ² (4, N = 35) = .385, p =.108. There was an inversely, significant correlation between years of experience and stated knowledge of the AD state laws (rho (24) = -.309, p = .039). Barriers to implementing ADs in practice were identified.
Discussion and Implications: AD education did not influence practice in this primary practice improvement project. PCPs believed it was their responsibility to educate and assess their patient’s AD plans, but indicated time, knowledge of the laws, and access to the appropriate forms as barriers. Future education should focus on how to overcome these barriers.