The Prevalence of Advance Directives and Its Moderators Among Community People, Acutely and Chronically Ill Patients: A Systematic Review and Meta-Analysis.
Advance Directives (ADs) are essential in end-of-life care, enabling individuals to retain autonomy when they can no longer make decisions. However, data on ADs prevalence and influencing factors in different populations (acutely ill, chronically ill, and general) remain limited globally. This revie...
| Publicado en: | Inquiry (00469580) Vol. 62; pp. 1 - 14 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
8/10/2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=187280803&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 187280803 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00469580 INQ jtl: Inquiry (00469580) issn: 00469580 maglogo: Y pubinfo: dt: 8/10/2025 vid: 62 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 187280803 187280803 187280803 10.1177/00469580251344161 187280803 ppf: 1 ppct: 13 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: The Prevalence of Advance Directives and Its Moderators Among Community People, Acutely and Chronically Ill Patients: A Systematic Review and Meta-Analysis. aug: au: Valenti, Danila Bortolotti, Giulia Moro, Federico Cardini, Silvia Cavagna, Silvia Tartaglione, Marco Allegri, Davide Moggia, Fabrizio Semeraro, Federico Gamberini, Lorenzo affil: Palliative Care Network, Bologna Local Healthcare Authority, Bologna, Italy sug: subj: Advance Directives Psychosocial Factors Acute Disease Chronic Disease Community Living Community Health Services Terminal Care Human Male Female Systematic Review Meta Analysis PubMed Cochrane Library Multivariate Analysis North America Europe Confidence Intervals Age Factors Educational Status Race Factors Neoplasms Relational Autonomy Income Checklists Spearman's Rank Correlation Coefficient Descriptive Statistics Male Female ab: Advance Directives (ADs) are essential in end-of-life care, enabling individuals to retain autonomy when they can no longer make decisions. However, data on ADs prevalence and influencing factors in different populations (acutely ill, chronically ill, and general) remain limited globally. This review aims to assess the prevalence of ADs in acute and chronic care settings and the general population and identify factors influencing their completion. A systematic review was conducted using PubMed, Scopus and Cochrane Library databases for English-language studies on ADs prevalence up to December 2023. The Joanna Briggs Institute Critical Appraisal Tool was adopted for bias assessment, and information on potential moderating factors—such as age, gender, income, education, marital status, capacity for self-determination and cancer diagnosis—was collected. Analysis involved a random-effects meta-analysis, subgroup evaluations and meta-regressions, with multimodel inference for multivariate assessment. Out of 239 studies covering 8.9 million people, 73.6% were from North America and 18% from Europe. The estimated global ADs prevalence was 0.26 [95% CI: 0.23-0.30], with higher rates among chronically ill individuals and the general population. Positive associations with ADs completion were found for age, education level and white ethnicity, while male gender showed a negative association. Key influencing factors were white ethnicity, education and cancer diagnosis. These findings suggest that ADs completion remains low, relatively unchanged over time, and potentially unequal, especially among non-white, less-educated and non-cancer patients. Increased efforts to raise ADs prevalence are needed, particularly in underrepresented groups. pubtype: Academic Journal doctype: meta analysis research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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