Date of Award

Spring 5-23-2015

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor

Mary Jo Clark, PhD, RN


Background: Hispanics utilize more aggressive medical treatment at the end of life and are less likely to receive end-of-life care consistent with their wishes than nonHispanic Whites. Hispanics are less likely than nonHispanic Whites to have an advance directive (AD). Increasing AD completion among Hispanics can promote end-of-life care consistent with their wishes, diminish healthcare disparities, and eliminate unnecessary healthcare spending. Objectives: To promote completion of advance directives by increasing knowledge, positive attitudes, and comfort with advance care planning (ACP) among Hispanics through culturally sensitive interventions. Intervention: The project was conducted in Spanish and implemented among a Hispanic religious congregation. Two group sessions were held at their meetinghouse. Informational handouts and exercises were provided along with an initial knowledge and attitudes questionnaire. Individual reflections and group exercises were used to explore personal views. At the conclusion of the second group session, the same questionnaire was completed. Participants then scheduled a one-on-one session to complete an AD. Results: Of the 21 eligible participants, 13 attended both group sessions and scheduled a one-on-one visit. Mean scores for knowledge increased from 71% to 91%; mean attitude and comfort scores increased from 61% to 80%; and 100% of participants who attended both group sessions completed an AD. Conclusion: Increasing AD completion among Hispanics can be achieved through culturally appropriate interventions that increase knowledge about, attitudes toward, and comfort with end-of-life decisions. More studies are needed among Hispanics that focus on effective interventions to complete advance directives, rather than Hispanic end-of-life cultural preferences alone.