Advance Directives Should Be Part of the Admission Process for Adults with Cancer: An Integrative Literature Review

Advance Directives Should Be Part of the Admission Process for Adults with Cancer:

An Integrative Literature Review

Jennifer Leonard

Larry Maturin MSN, APN, ACNS-BC, CEN, CCRN

Abstract

Background: Approximately 40 percent of individuals will be diagnosed with cancer in their lifetime and less than half of those patients have an advance directive when admitted to an oncology service.

Objective: The purpose of the integrative literature review was to determine the current standards for advance directives; determine why patients do not have advance directives after being diagnosed with cancer.

Methods: The integrative literature review was conducted using keywords “advance directives, adult, terminal oncology, and cancer” to search the literature between 1998 and 2017.

Results: According to research, patients agree that advance directives are necessary; however, they prefer to discuss advance directives with their primary care provider, admitting physician, or surgeon rather than their oncologist.

Conclusion: This integrative literature review provided evidence for the need to standardize the usage of advance directives for cancer patients. Although the use of advance directives has increased since the Patient Self-Determination Act, there are still too few individuals with completed advanced directives. By facilitating the conversation regarding advance directives, patients can reduce end of life cost and maintain quality of care and life for patients from admission to an oncology unit.

Keywords: advance directives, adult, terminal oncology, cancer