This study sought to address the significant paucity in the medical decision making literature regarding the knowledge and attitudes of emerging adults toward advance care planning. Using a mostly qualitative approach, we attempted to document several dimensions of preferences and perspectives within a population well known for risk-taking behaviors, which may result in death, serious injury, and states of decisional incapacitation. Fifty-six undergraduates from two Pittsburgh universities took part in six focus group interviews between February-April 2007. Using a semi-structured focus group guide, participants were led through discussions on hypothetical end-of-life care scenarios, eliciting their views on Living Wills, Health Care Proxies, preferences for surrogates and their behaviors, and for life-sustaining treatment. Content analysis revealed inter-subject variability and intra-subject inconsistency among participants within all domains analyzed. Fifty-six percent of our sample had correct knowledge of advance directives, while only 10% understood that they offer proxy designation. Themes related to age-mediated invincibility, decreased risk perception, and an inexperience with morbidity and mortality relative to their elders emerged from the data. The findings of our study underscore the need for a through, quantitative effort to examine this volatile populations familiarity and attitudes regarding decisional incapacitation and the legal provisions in place to ensure autonomous and/or shared decision making. Additionally, we review the psychosocial literature related to advance care planning and apply it to this population, suggesting that current legal statutes are inappropriate for this age group, given their ongoing individuation and identity development.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-04152008-122211 |
| Date | 06 October 2008 |
| Creators | Kavalieratos, Dionysios |
| Contributors | David Barnard, William Klein, Rhonda Gay Hartman, Howard Degenholtz |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-04152008-122211/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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