• Gloria Duke, Sue Thompson, and Mariane Hastie.
• Office of Nursing Research and Scholarship, The University of Texas at Tyler, College of Nursing and Health Sciences, 3900 University Blvd, Tyler, Texas, USA. gduke@uttyler.edu
• Int J Palliat Nurs. 2007 Jan 1; 13 (1): 39-43.

AimA cross-sectional, descriptive study to describe characteristics and other factors that influenced the decision by hospitalized patients in the East Texas area to formulate an advanced directive (AD).FindingsSpouses, family members and sense of spirituality were the strongest influential factors for completion of an AD. Most learned about ADs from family, friends, personal attorneys, and others, while less than a quarter of the sample learned about ADs from health care providers. Not wanting to be a burden on their family was the major reason cited for completing an AD.ConclusionsHealth care provider roles are vague in terms of responsibility for AD discussion and education. Further exploration of the attitudes, knowledge and practices concerning ADs of nurses and primary health care providers is recommended to provide focal points for future research in order to facilitate peace of mind for patients and families at end-of-life.

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