{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:03:15Z","timestamp":1760234595508,"version":"build-2065373602"},"reference-count":48,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,5,29]],"date-time":"2021-05-29T00:00:00Z","timestamp":1622246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia (FCT)","award":["(UIDB\/05704\/2020 and UIDP\/05704\/2020)."],"award-info":[{"award-number":["(UIDB\/05704\/2020 and UIDP\/05704\/2020)."]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Healthcare"],"abstract":"<jats:p>(1) Background: Evidence shows that facilitated advance decisions can increase the number of meaningful and valid Advance Care Directives (ACDs) and improve the quality of care when End-Of-Life (EOL) is near. Little is known about the awareness and attitudes of Portuguese adults towards ACDs. The present study aims to assess the knowledge, attitudes, and preferences of a sample of Portuguese adults regarding EOL care decisions and ACDs. (2) Methods: A total of 1024 adults were assessed with an online cross-sectional survey collecting information on sociodemographic factors, knowledge, attitudes and preferences regarding advance decisions and EOL care. (3) Results: Participants had a mean age of 40.28 \u00b1 11.41 years. Most were female and had a professional background related to healthcare. While 76.37% of participants had heard of ACDs, only a small percentage (2.34%) had actually ever made an ACD. Knowledge levels were weakly correlated with attitudes regarding ACDs (r = \u22120.344; p &lt; 0.01). (4) Conclusions: Participants lacked a comprehensive understanding about ACDs, but revealed positive attitudes towards their use and usefulness. Further research can inform efforts to improve ACD engagement in this population. The discussion about ACDs should be part of health promotion education with a focus on planning for a comfortable and peaceful death.<\/jats:p>","DOI":"10.3390\/healthcare9060648","type":"journal-article","created":{"date-parts":[[2021,5,31]],"date-time":"2021-05-31T00:22:15Z","timestamp":1622420535000},"page":"648","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Awareness and Attitudes towards Advance Care Directives (ACDs): An Online Survey of Portuguese Adults"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1080-9535","authenticated-orcid":false,"given":"Carlos","family":"Laranjeira","sequence":"first","affiliation":[{"name":"School of Health Sciences of Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal"},{"name":"Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo Andr\u00e9\u201466\u201368, Campus 5, Polytechnic of Leiria, 2410-541 Leiria, Portugal"},{"name":"Research in Education and Community Intervention (RECI I & D), Piaget Institute, 3515-776 Viseu, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9035-8548","authenticated-orcid":false,"given":"Maria dos Anjos","family":"Dixe","sequence":"additional","affiliation":[{"name":"School of Health Sciences of Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal"},{"name":"Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo Andr\u00e9\u201466\u201368, Campus 5, Polytechnic of Leiria, 2410-541 Leiria, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5615-3012","authenticated-orcid":false,"given":"Lu\u00eds","family":"Gueif\u00e3o","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Leiria Hospital Center, R. de Santo Andr\u00e9, 2410-197 Leiria, Portugal"}]},{"given":"Lina","family":"Caetano","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Leiria Hospital Center, R. de Santo Andr\u00e9, 2410-197 Leiria, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7766-576X","authenticated-orcid":false,"given":"Rui","family":"Passadouro","sequence":"additional","affiliation":[{"name":"Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo Andr\u00e9\u201466\u201368, Campus 5, Polytechnic of Leiria, 2410-541 Leiria, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5021-773X","authenticated-orcid":false,"given":"Ana","family":"Querido","sequence":"additional","affiliation":[{"name":"School of Health Sciences of Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal"},{"name":"Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo Andr\u00e9\u201466\u201368, Campus 5, Polytechnic of Leiria, 2410-541 Leiria, Portugal"},{"name":"Center for Research in Health and Information Systems (CINTESIS), NursID, University of Porto, 4200-450 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,29]]},"reference":[{"key":"ref_1","first-page":"627","article-title":"Anticipated directives of will, advance health care directive, health care attorney: An issue of self-determination","volume":"34","author":"Goncalves","year":"2015","journal-title":"Med. 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