Advance Directives for End-of-Life Care and the Role of Health Education Specialists: Applying the Theory of Reasoned Action

Advance Directives for End-of-Life Care and the Role of Health Education Specialists: Applying the Theory of Reasoned Action The need to address end-of-life issues has been recognized internationally. A 2005 meeting of the International Work Group in Death, Dying and Bereavement with experts from Australia, Canada, Germany, Japan, the Netherlands, Norway, the United States and the United Kingdom proposed that end-of-life care ought to considered a public health priority. (1) (p384) This recommendation was based on many international changes such as an increase in the older adult population, gaps between the rich and poor in many nations, and changes in health care including the ability to extend life. Recommendations from the meeting also included that all persons, not just professionals involved with the dying, be educated to be culturally, spiritually, socially, and emotionally sensitive to the needs of the dying and bereaved. (1) order to be sensitive to the needs of the dying it is critical to understand their end-of-life wishes. Advance directives provide this understanding by guiding care decisions that are consistent with the values and beliefs of the dying. Yet, many individuals world-wide die without an advance directive in place. (2,3) some countries, dying without an advance directive is related to a lack of legislation legalizing an advance directive4 and in others, dying without an advance directive has been attributed to individual predisposing conditions such as cultural beliefs, knowledge, and skills (5,6,7) as well as a lack of public awareness. (8) This article will discuss educational efforts to address these predisposing conditions and to increase public awareness in countries with legislation in place. an international overview of systematic reviews, authors reported that the completion rate of advance directives was not increased through the use of passive educational methods such as providing posters or videos; however, information shared in interactive sessions was an effective means of increasing the completion rate of advance directives. (9) While pertinent for all age categories, older adults are a very important target audience for this information. Internationally, the number of adults 60 years of age and older is increasing, In absolute terms, the number of older persons has more than tripled since 1950 and will almost triple again by 2050. (10) (p47) More deaths occur in the older adult group than in any other group. For instance, it is projected that in England in the year 2030, 86.7% of all deaths will occur in those 65 years of age and older. (11) These statistics demonstrate the importance of targeting older adults with advance directives education. Resnick and Andrews (12) suggest that education concerning advance directives ought to begin in the community setting prior to older adults becoming critically ill or mentally incompetent. Intuitively, the need to address advance directives prior to a health crisis makes sense. A decision about advance directives takes a good deal of thought and discussion among health care professionals, significant others, family members, and friends and is best done when all parties are calm and composed rather than in a stressful, emergency situation. Health education specialists' expertise and employment settings provide ample opportunities for health education specialists to play an important role in beginning this discussion. While the role of health education specialists may differ by country, the areas of assessment, planning, implementation, and evaluation are reported as common domains for health education specialists from various countries world-wide. (13) These programming skills are the basis for providing topical educational programming that is relevant to a target audience in a particular culture. the United States, hospitals are the largest employers of health education specialists (14) and hospitals receiving Medicare funding are mandated by 42 C. …

Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.