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Young Adult Knowledge and Readiness to Engage in Advance Care Planning Behaviors

Schnur, Kaylee, BSN; Radhakrishnan, Kavita, PhD, RN, MSEE

Journal of Hospice & Palliative Nursing: February 2019 - Volume 21 - Issue 1 - p 54–60
doi: 10.1097/NJH.0000000000000487
Feature Articles

Although advance care planning (ACP) has increased in importance and discussion, little is known about young adults' engagement in ACP. The purpose of this study was to identify associations among college-age students' characteristics, knowledge of ACP, and readiness to engage in ACP-related behaviors. One hundred forty-seven students at the University of Texas at Austin (aged 18–26 years) participated in an online survey regarding ACP knowledge, perceptions, and behavior engagement. Although 98% of the students had no advance directive, 85% rated themselves as “pro” ACP. Regarding ACP behaviors, at least 83% of participants had never considered completing a living will or health care proxy, but 33% and 45% of participants had talked with loved ones about being kept alive on machines or about quality of life, respectively. Greater knowledge of ACP correlated weakly with a favorable view of ACP (P = .002). Young adults should be made aware of their ability to dictate the care they want to receive in situations in which they are incapacitated, as well as advocate for their family members to engage in ACP. Discovering characteristics associated with readiness to engage in ACP can enable hospice and palliative care nurses to tailor discussions with young adults regarding ACP.

Kaylee Schnur, BSN, is undergraduate honors student, University of Texas at Austin School of Nursing.

Kavita Radhakrishnan, PhD, RN, MSEE, is assistant professor, School of Nursing, University of Texas at Austin.

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Editorial support with manuscript development was provided by John Bellquist from the Cain Center for Nursing Research and the Center for Transdisciplinary Collaborative Research in Self-management Science (P30, NR015335) at the University of Texas at Austin School of Nursing.

The authors have no conflicts of interest to disclose.

Address correspondence to Kaylee Schnur, BSN, Undergraduate Honors Student, University of Texas at Austin School of Nursing, 1710 Red River St, Austin, TX 78701 (

© 2019 by The Hospice and Palliative Nurses Association.