• T R Velasco-Sanz and E Rayón-Valpuesta.
• Servicio de Medicina Intensiva, Hospital Clínico San Carlos , Madrid, España; Universidad Complutense de Madrid, Madrid, España. Electronic address: tavela01@ucm.es.
• Med Intensiva. 2016 Apr 1; 40 (3): 154-62.

ObjectiveTo identify knowledge, skills and attitudes among physicians and nurses of adults' intensive care units (ICUs), referred to advance directives or living wills.DesignA cross-sectional descriptive study was carried out.SettingNine hospitals in the Community of Madrid (Spain).ParticipantsPhysicians and nurses of adults' intensive care.InterventionsA qualitative Likert-type scale and multiple response survey were made.VariablesKnowledge, skills and attitudes about the advance directives. A descriptive statistical analysis based on percentages was made, with application of the chi-squared test for comparisons, accepting p < 0.05 as representing statistical significance.ResultsA total of 331 surveys were collected (51%). It was seen that 90.3% did not know all the measures envisaged by the advance directives. In turn, 50.2% claimed that the living wills are not respected, and 82.8% believed advance directives to be a useful tool for health professionals in the decision making process. A total of 85.3% the physicians stated that they would respect a living will, in cases of emergencies, compared to 66.2% of the nursing staff (p = 0.007). Lastly, only 19.1% of the physicians and 2.3% of the nursing staff knew whether their patients had advance directives (p < 0.001).ConclusionsAlthough health professionals displayed poor knowledge of advance directives, they had a favorable attitude toward their usefulness. However, most did not know whether their patients had a living will, and some professionals even failed to respect such instructions despite knowledge of the existence of advance directives. Improvements in health professional education in this field are needed.Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

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