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Q What are the similarities and differences among patients and their primary care providers in their understanding of life sustaining treatment?
Qualitative study using indepth semistructured interviews.
Outpatient primary care clinic in the Veterans Affairs (VA) Pittsburgh Healthcare System.
30 primary care providers at the clinic (19 physicians, 10 nurse practitioners, and 1 physician assistant) (mean age 41 y, 63% women) and 30 patients who were scheduled to meet with the provider during the next 2 months. Patient inclusion criteria were age ⩾60 years (mean age 71 y, 93% men), ambulatory, fluent in English, residence in the community, receiving outpatient care from the VA, no acute illness, and scores ⩾27 out of 30 on the Folstein mini-mental state examination.
Individual, 1 hour, semistructured interviews were conducted with primary care providers and patients immediately after their clinic appointment. Participants were initially asked if they had an advance directive. Then, using open ended questions, patients were asked about 4 terms commonly found in advance directives: life sustaining treatment, terminal condition, state of permanent unconsciousness, and decision making capacity. The interviews …
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