Medical Residents' Knowledge on Advance Directives of Will at a University Hospital

Matheus Veras Guterres Mendes; Marcelly Amanda Lucena Ericeira; Vanise Barros Rodrigues da Motta; João Batista Santos Garcia

Authors

Matheus Veras Guterres Mendes Universidade Federal do Maranhão, University Hospital - São Luís, MA, Brazil https://orcid.org/0000-0001-5195-2245
Marcelly Amanda Lucena Ericeira Universidade Federal do Maranhão, University Hospital - São Luís, MA, Brazil https://orcid.org/0000-0002-2179-4052
Vanise Barros Rodrigues da Motta Universidade Federal do Maranhão, University Hospital - São Luís, MA, Brazil https://orcid.org/0000-0002-9540-3616
João Batista Santos Garcia Universidade Federal do Maranhão - São Luís, MA, Brazil https://orcid.org/0000-0002-3597-6471

Keywords:

Palliative Care, Terminal Care, Living Wills

Abstract

Objectives: To analyze the profile of knowledge of medical residents on the topic of Advance Directives of Will.

Methods: This was a cross-sectional study, based on the availability of a specific questionnaire to medical residents of a University Hospital, addressing the knowledge on the concepts about Advance Directives of Will. Those who answered "yes" to prior knowledge on AD received a second questionnaire containing specific questions on regulation of AD in Brazil, the correct mode of application and personal questions on willingness to fill out an AD for themselves.

Results: A total of 190 medical residents participated in the survey, 95.95% of the total number of residents enrolled in the period. It was observed that 41% reported knowing of AD, but only 34.6% of them knew how to write it. In the association of demographic and educational characteristics with knowledge on the definition of AD, it was observed that there was no statistically significant difference between the variables. However, it was found that the older the resident, the lower the ability to write an AD (p=0.03).

Conclusion: Knowledge on AD was satisfactory among the residents evaluated in this study, and a negative correlation was observed between the increase in age of residents and the ability to write an AD.

References

Silva JAC da, Souza LEA de, Costa JLF, Miranda H da C. Conhecimento de estudantes de medicina sobre o testamento vital. Revista Bioética. 2015;23(3). doi: 10.1590/1983-80422015233093

Melo HP, Nunes R. Testamento Vital. (Almedina, ed.).; 2012.

Pereira CSA, Faria EO, Silva I, Bianco MM, Sides PM, Camargo VF. O fim da vida. São Paulo: Curso de Graduação em Enfermagem da Universidade Paulista. Published online 2009.

Brinkman-Stoppelenburg A, Rietjens JAC, van der Heide A. The effects of advance care planning on end-of-life care: A systematic review. Palliative Medicine. 2014;28(8):1000-1025. doi: 10.1177/0269216314526272

Rietjens JAC, van der Heide A, Onwuteaka-Philipsen BD, van der Maas PJ, van der Wal G. Preferences of the Dutch general public for a good death and associations with attitudes towards end-of-life decision-making. Palliative Medicine. 2006;20(7):685-692. doi: 10.1177/0269216306070241

Singer PA, Martin DK, Kelner M. Quality end-of-life care. Patients’ perspectives. Journal of the American Medical Association. 1999;281(2):163-168. doi: 10.1001/jama.281.2.163

Patrick DL, Engelberg RA, Curtis JR. Evaluating the quality of dying and death. Journal of Pain and Symptom Management. 2001;22(3):717-726. doi: 10.1016/S0885-3924(01)00333-5

Teno JM, Casey VA, Welch LC, Edgman-Levitan S. Patient-focused, family-centered end-of-life medical care: Views of the guidelines and bereaved family members. Journal of Pain and Symptom Management. 2001;22(3):738-751. doi: 10.1016/S0885-3924(01)00335-9

Singer PA, Martin DK, Lavery J v., Thiel EC, Kelner M, Mendelssohn DC. Reconceptualizing advance care planning from the patient’s perspective. Archives of Internal Medicine. 1998;158(8):879-884. doi: 10.1001/archinte.158.8.879

Chan CWH, Ng NHY, Chan HYL, Wong MMH, Chow KM. A systematic review of the effects of advance care planning facilitators training programs. BMC Health Services Research. 2019;19(1). doi: 10.1186/s12913-019-4192-0

Brasil. Decreto 44045/58 | Decreto No 44.045, de 19 de Julho de 1958, Presidência Da Republica.; 1958. Accessed May 19, 2021. https://presrepublica.jusbrasil.com.br/legislacao/116456/decreto-44045-58

Brasil. Lei 11000/04 | Lei No 11.000, de 15 de Dezembro de 2004, Presidência Da Republica.; 2004. Accessed May 19, 2021. https://presrepublica.jusbrasil.com.br/legislacao/97107/lei-11000-04

Conselho Federal de Medicina. RESOLUÇÃO CFM No 1.995/2012.; 2012. Accessed May 19, 2021. https://sistemas.cfm.org.br/normas/visualizar/resolucoes/BR/2012/1995

Frechman E, Dietrich MS, Walden RL, Maxwell CA. Exploring the Uptake of Advance Care Planning in Older Adults: An Integrative Review. Journal of Pain and Symptom Management. 2020;60(6):1208-1222.e59. doi: 10.1016/j.jpainsymman.2020.06.043

Moreira MADM, Costa SFG da, Cunha MLDM da, Zaccara AAL, Negro-Dellacqua M, Dutra F. Testamento vital na prática médica: compreensão dos profissionais. Revista Bioética. 2017;25(1):168-178.

Detering KM, Hancock AD, Reade MC, Silvester W. The impact of advance care planning on end of life care in elderly patients: Randomised controlled trial. BMJ (Online). 2010;340(7751):847. doi: 10.1136/bmj.c1345

Silva SR, Silva-Felipe AB. Diretivas antecipadas de vontade no ordenamento jurídico brasileiro. Ratio juris: revista eletrônica da graduação da faculdade de direito do sul de minas. 2020;3(1):73-92.

Figueroa JF, Maddox KEJ, Beaulieu N, Wild RC, Jha AK. Concentration of potentially preventable spending among high-cost medicare subpopulations. Annals of Internal Medicine. 2017;167(10):706-713. doi: 10.7326/M17-0767

Morrison RS. Research priorities in geriatric palliative care: An introduction to a new series. Journal of Palliative Medicine. 2013;16(7):726-729. doi: 10.1089/jpm.2013.9499

Mendes MVG, Silva JC de O, Ericeira MAL, Pinheiro AN. Testamento Vital: Conhecimentos e Atitudes de Alunos Internos de um Curso de Medicina. Revista Brasileira de Educação Médica. 2019;43(2). doi: 10.1590/1981-52712015v43n2rb20180117

Kulicz MJ, Amarante DF, Nakatani HTI, Arai Filho C, Okamoto CT. Terminalidade e testamento vital: o conhecimento de estudantes de medicina. Revista Bioética. 2018;26(3). doi: 10.1590/1983-80422018263262

Conceição MV da, Vasconcelos MC de C, Telino CJCL, Guedes EVB, Pimentel DMM. Conhecimento sobre cuidados paliativos entre médicos residentes de hospital universitário. Revista Bioética. 2019;27(1). doi: 10.1590/1983-80422019271296

Colbert CY, Mirkes C, Ogden PE, et al. Enhancing Competency in Professionalism: Targeting Resident Advance Directive Education. Journal of Graduate Medical Education. 2010;2(2). doi: 10.4300/JGME-D-10-00003.1

Dadalto L. Reflexos jurídicos da Resolução CFM 1.995/12. Revista Bioética. 2013;21(1):106-112. doi: 10.1590/s1983-80422013000100012

Brasil. Conselho Federal de Medicina.Diário Oficial da União. Resolução CFM 1995/2012 Diretivas Antecipadas de Vontade Dos Pacientes.; 2012.

Rocha AR, Buonicore GP, Silva AC, Pithan LH, Feijó AG dos S. Declaração prévia de vontade do paciente terminal: reflexão bioética. Revista Bioética. 2013;21(1):84-95. doi: 10.1590/s1983-80422013000100010

Schmitten JI, Lex K, Mellert C, RothÄrmel S, Wegscheider K, Marckmann G. Patientenverfügungsprogramm: Implementierung in Senioreneinrichtungen. Deutsches Arzteblatt International. 2014;111(4):50-57. doi: 10.3238/arztebl.2014.0050

Hammes BJ, Rooney BL, Gundrum JD. A comparative, retrospective, observational study of the prevalence, availability, and specificity of advance care plans in a county that implemented an advance care planning microsystem. Journal of the American Geriatrics Society. 2010;58(7):1249-1255. doi: 10.1111/j.1532-5415.2010.02956.x

Sullivan AM, Lakoma MD, Block SD. The status of medical education in end-of-life care. Journal of General Internal Medicine. 2003;18(9). doi: 10.1046/j.1525-1497.2003.21215.x

Alexander SC, Keitz SA, Sloane R, Tulsky JA. A Controlled Trial of a Short Course to Improve Residents?? Communication With Patients at the End of Life. Academic Medicine. 2006;81(11). doi: 10.1097/01.ACM.0000242580.83851.ad

Mullan PB, Weissman DE, Ambuel B, von Gunten C. End-of-Life Care Education in Internal Medicine Residency Programs: An Interinstitutional Study. Journal of Palliative Medicine. 2002;5(4). doi: 10.1089/109662102760269724

Weissman DE, Block SD. ACGME Requirements for End-of-life Training in Selected Residency and Fellowship Programs. Academic Medicine. 2002;77(4). doi: 10.1097/00001888-200204000-00008

Buss MK, Alexander GC, Switzer GE, Arnold RM. Assessing Competence of Residents to Discuss End-of-Life Issues. Journal of Palliative Medicine. 2005;8(2). doi: 10.1089/jpm.2005.8.363

Medical Residents' Knowledge on Advance Directives of Will at a University Hospital

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