A cross-sectional study assessing concordance with advance care directives in a rural health district

Journal article


Curley, Dan, Kinsman, Leigh, Mooney, Graeme, Whiteford, Gail, Lower, Tony, Hobbs, Megan, Morris, Beverley, Bartlett, Kerry and Jacob, Alycia. (2024). A cross-sectional study assessing concordance with advance care directives in a rural health district. Australian Journal of Rural Health. 32(5), pp. 969-975. https://doi.org/10.1111/ajr.13166
AuthorsCurley, Dan, Kinsman, Leigh, Mooney, Graeme, Whiteford, Gail, Lower, Tony, Hobbs, Megan, Morris, Beverley, Bartlett, Kerry and Jacob, Alycia
Abstract

Objective
To measure compliance with Advance Care Directives (ACDs) for decedents in a rural setting.

Design
Observational, cross-sectional medical records audit comparing requests in ACDs with actual outcomes.

Setting
Rural Australian coastal district.

Participants
People who had an ACD, died during the study period (30 May 2020 to 15 December 2021) and participated in a local research project.

Main Outcome Measure(s)
Compliance was measured by comparing stated requests in the ACD with outcomes recorded in medical records. This included the place of death and a list of ‘unacceptable interventions’.

Results
Sixty-eight people met the inclusion criteria (age range of 46–92 [mean 67 years; median 74 years]; 42 [62%] male). The main cause of death was cancer (n = 48; 71%). Preferred place of death was not stated in 16 ACDs. Compliance with documented preferred place of death was 63% (33/52): 48% (16/33) when the preferred place of death was home; 78% (7/9) when sub-acute was preferred; and 100% (10/10) when hospital was preferred. Compliance was 100% with ‘unacceptable interventions’.

Conclusion
These results demonstrate strong compliance with rural patients' requests in ACDs, particularly ‘unacceptable interventions’. Home was the most common preferred place of death, but the compliance measure (48%) was the lowest in this study. This requires further exploration.

Keywordsadvance care directive; end-of-life; palliative care; rural
Year2024
JournalAustralian Journal of Rural Health
Journal citation32 (5), pp. 969-975
PublisherJohn Wiley & Sons Australia, Ltd
ISSN1440-1584
Digital Object Identifier (DOI)https://doi.org/10.1111/ajr.13166
PubMed ID39126142
Scopus EID2-s2.0-85200950891
Open accessPublished as ‘gold’ (paid) open access
Page range969-975
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online09 Aug 2024
Publication process dates
Accepted04 Jul 2024
Deposited06 May 2025
Additional information

© 2024 The Author(s). Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd.

This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Permalink -

https://acuresearchbank.acu.edu.au/item/91v6w/a-cross-sectional-study-assessing-concordance-with-advance-care-directives-in-a-rural-health-district

Download files


Publisher's version
  • 1
    total views
  • 0
    total downloads
  • 1
    views this month
  • 0
    downloads this month
These values are for the period from 19th October 2020, when this repository was created.

Export as

Related outputs

Increasing the uptake of advance care directives through staff education and one-on-one support for people facing end-of-life
Kinsman, Leigh David, Mooney, Graeme, Whiteford, Gail, Lower, Tony, Hobbs, Megan, Morris, Bev, Bartlett, Kerry, Jacob, Alycia and Curley, Dan. (2024). Increasing the uptake of advance care directives through staff education and one-on-one support for people facing end-of-life. BMJ Open Quality. 13(4), p. Article e002727. https://doi.org/10.1136/bmjoq-2023-002727
Analysis of violent incidents at five regional and remote Australian emergency departments : A retrospective descriptive study
Thomas, Brodie, Jacob, Alycia, McCann, Damhnat, Buykx, Penny, Schultz, Rebecca, Kinsman, Leigh, O'Meara, Peter, Edvardsson, Kristina and Spelten, Evelien. (2024). Analysis of violent incidents at five regional and remote Australian emergency departments : A retrospective descriptive study. SAGE Open Nursing. 10, pp. 1-12. https://doi.org/10.1177/23779608241261597
Everyone should have their own midwife : Women's and staff experiences during the implementation of two midwifery continuity of care models in regional Australia
Prussing, Elysse, Kinsman, Leigh, Jacob, Alycia, Doust, Jenni, Guy, Frances and Tierney, Olivia. (2024). Everyone should have their own midwife : Women's and staff experiences during the implementation of two midwifery continuity of care models in regional Australia. Women and Birth. 37(6), p. Article 101807. https://doi.org/10.1016/j.wombi.2024.101807
Drawing blood from a peripheral intravenous cannula and its effect on cannula dwell time, phlebitis, and bloodstream infection : A randomised controlled study
Davies, Hugh, Jacob, Alycia M., Aboo, Lea, Coventry, Linda L. and Jacob, Elisabeth. (2024). Drawing blood from a peripheral intravenous cannula and its effect on cannula dwell time, phlebitis, and bloodstream infection : A randomised controlled study. Collegian: The Australian Journal of Nursing Practice, Scholarship and Research. 31(4), pp. 181-187. https://doi.org/10.1016/j.colegn.2024.04.001
What are the facilitators and barriers experienced by sessional academics during the process of onboarding : A scoping review
Brouwer, Hendrika Jacoba, Griffiths, Semra, Jacob, Alycia, Ricks, Thomas Aaron, Schulz, Paula, Lavell, Sharni, Lam, Louisa and Jacob, Elisabeth. (2024). What are the facilitators and barriers experienced by sessional academics during the process of onboarding : A scoping review. Journal of Higher Education Policy and Management. pp. 1-18. https://doi.org/10.1080/1360080X.2024.2340987
A Massive Open Online Course Delivered Just-in-Time : A Cohort Study
Leathwick, Sandra Marie, El Ali, Mandy, Jacob, Alycia M. and Jacob, Elisabeth. (2023). A Massive Open Online Course Delivered Just-in-Time : A Cohort Study. Journal of Continuing Education in Nursing. 54(10), pp. 472-479. https://doi.org/10.3928/00220124-20230829-01