[Perception of advance directives by oncohematology caregivers].

INTRODUCTION

Advance directives (AD) are rarely used although they have been enshrined in law since 2005. Health establishments have a duty to inform patients regarding AD. However, studies have shown little awareness of this law in the healthcare environment. Our study analyzes the perception of AD by oncohematology caregivers.

METHODS

This is an observational, descriptive and prospective study conducted with a 12-item questionnaire distributed to oncohematology nurses and nursing assistants. Statistical analyses were carried out using a significance threshold of 0.05 and using the Chi2, Fisher or Kruskal-Wallis tests.

RESULTS

The questionnaire was completed by 138 caregivers. Among them, 63.8% felt they had "very weak" or "weak" knowledge of ADs. The level of training was considered insufficient by 83.8% of respondents. Those with a good level of knowledge of ADs approached them more often (P=0.003) and felt more comfortable doing so (P<0.001). More than 90% of caregivers were "convinced" or "very convinced" by ADs but less than half understood their impact in clinical practice.

DISCUSSION: ADs remain little known among caregivers who do not feel comfortable approaching them. Training in ADs is an improvement clue because it allows you to approach them more often and to feel more comfortable. ADs are well-received by caregivers but their impact is little perceived in practice. The involvement of caregivers in end-of-life decisions through multidisciplinarity should be strengthened in oncohematology based on the palliative care model.