Advance directive communication: nurses' and social workers' perceptions of roles

Am J Hosp Palliat Care. 2006 Jun-Jul;23(3):175-84. doi: 10.1177/1049909106289080.


As a facet of advance care planning for future health care, advance directive communication represents an important aspect of professional health care practice with older patients. Nurses and social workers routinely discuss advance directives in acute care settings; however, communication practices by discipline are not well understood. This qualitative study explored differences in advance directive communication practices by comparing and contrasting nurses' and social workers' perceptions of their roles. Focus group interviews were conducted with nurses (n = 6) and social workers (n = 5). Five key themes emerged from the data. Findings suggest that both professions perceive primary educational roles, though their informational practices differed in content. The professionals reported differential pathways that led to their practices with patients. Both disciplines identified advocacy roles with families and providers. The practitioners reported distinct roles with families. There was mutual recognition of interdisciplinary roles. The findings suggest that nurses and social workers engage in both parallel and complementary advance care planning practices with their patients.

MeSH terms

  • Adult
  • Advance Directives*
  • Cooperative Behavior
  • Female
  • Focus Groups
  • Humans
  • Male
  • Middle Aged
  • Nurse's Role*
  • Nurse-Patient Relations
  • Nursing Staff, Hospital
  • Patient Advocacy*
  • Professional-Patient Relations*
  • Social Work*
  • Surveys and Questionnaires
  • United States