Objectives Advance Directives (AD) have not been widely discussed or used in Thailand. The objectives of the study were to assess knowledge, attitude and factors impact intention to prepare of AD among Thai gynecologic cancer patients.

Methods Gynecologic cancer patients were approached for recruitment at a tertiary-care hospital in the city area of Bangkok, Thailand. We conducted papar-and-pencil survey on self-perceived and objective knowledge, decision for oneself, intention to prepare the AD, influential person, past experiences of illness and loss. Multiple regression analysis was used to identify the indicators that were associated with the intention to prepare the AD.

Results One hundred and one participants were enrolled. Six participants (5.9%) had completed their AD. Twenty-two (21.8%) planned to prepare later, 18 (17.8%) did not have an intention to prepare and fifty-five (54.5%) were unsure. Sixty-two participants (61.4%) never heard about AD, 36 (35.7%) knew at some level and 3 (3.0%) reported that they knew AD. There were misunderstandings about AD in several aspects, such as 69% of participants understood that AD has not been legally effective in Thailand. Perceived knowledge was significantly related to the intention to prepare AD (B=0.346, p<0.001), whereas the objective knowledge, past experiences of illness and loss, perceived health, and age did not.

Conclusions Low level of knowledge and completion rates of advance directives among Thai gynecologic cancer patients highlights the importance of giving more information and education on the advance directives in the country, especially to the cancer patients and their families.