Predictors of Advance Directive Intentions Among Older Adults With End-Stage Renal Disease

PURPOSE: To evaluate the current status of advance directives (ADs) among older adults with end-stage renal disease (ESRD) and identify potential contributing factors. METHOD: A quantitative, comparative, and correlational design was used. Older adults with ESRD were recruited from a teaching hospital in Taiwan between October 2023 and October 2024. Structured questionnaires were used to assess quality of life, knowledge, attitudes, subjective norms, and behavioral intention to complete ADs. Data were analyzed to identify factors associated with the intention to complete ADs. RESULTS: A notable proportion of older adults with ESRD expressed an intention to complete an AD. Participants with one or two comorbidities were more likely to report this intention. Positive attitudes toward ADs and supportive subjective norms were also associated with greater intention to complete ADs. In contrast, knowledge and quality of life did not appear to significantly influence intention. CONCLUSION: Comorbidities, attitudes, and subjective norms are key influencers of intention to complete ADs.