Perspective on advanced directives among older adults in Shanghai: A qualitative study.
Rong-Rong Zhang, Yan Xu, Yue-Ping Zhao
PMID 36860709WHAT IT FOUND
Only one older adult had heard of advanced directives, but after seeing the Five Wishes form all said they would sign.
They wanted family involved and saw directives as a guide, not a command.
Key findings
01Only one participant had heard of advanced directives, but after the concept and form were explained, all participants said they were willing to sign.
02Participants preferred natural, peaceful end-of-life care over major operations or equipment-supported life.
03They saw advanced directives as a reference, while family opinions often took priority, and many said they could not discuss directives with their parents.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study included only community-dwelling older adults from one city, so it may not represent older adults in hospitals, nursing homes, or other regions. Participants were purposively selected for being open and willing to discuss hospice topics, so less open older adults may be missing. People with severe disease or cognitive disease were excluded, so the findings may not apply to patients already seriously ill or unable to participate. The study reported perceptions and themes, not outcomes, so it cannot show that advanced directives improve care or reduce conflict. The sample was small, and the findings are specific to the interview context and the Five Wishes form shown to participants.
Declared interests
The study was funded by Sanda University. The authors declared no conflict of interest.
The easy way to misread this
Do not read this as evidence that advanced directives work or that older adults will accept them in practice. The study reported perceptions from a small purposive sample, not outcomes from an implemented programme.