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Research on Social Work Practice
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Advance Directives: A Social Work Initiative to Increase Participation

Jane Gockel

St. Louis Veterans Affairs Medical Center

Nancy Morrow-Howell

St. Louis Veterans Affairs Medical Center

Edith Thompson

St. Louis Veterans Affairs Medical Center

Mark Pousson

St. Louis Veterans Affairs Medical Center

Marva Johnson

St. Louis Veterans Affairs Medical Center

This article compared data on 200 patients at a large urban hospital on a number of demographic variables to distinguish clients who initiated an advance directive from those who declined. To better understand why some respondents refused, a telephone survey was conducted. As a result of the survey, an educational intervention was initiated in the walk-in clinic area. A social work student provided informatton and assisted with the completion of the forms. An ambulatory care setting was chosen assuming that, when patients are less ill, they may be better able to absorb the information on advance directives. As a result of the educational intervention, 66% of the respondents approached initiated an advance directive. Those that declined were called 2 weeks later, and 80% gave responses indicating they were making an informed decision. The findings clearly demonstrate that an educational intervention increases the percentage of individuals who initiate an advance directive.

Research on Social Work Practice, Vol. 8, No. 5, 520-528 (1998)
DOI: 10.1177/104973159800800502


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AM J HOSP PALLIAT CAREHome page
K. Black
Advance directive communication: nurses' and social workers' perceptions of roles.
American Journal of Hospice and Palliative Medicine, May 1, 2006; 23(3): 175 - 184.
[Abstract] [PDF]