Seriously ill hospitalized patients’ perspectives on the benefits and harms of two models of hospital CPR discussions.

Link to article at PubMed

Related Articles

Seriously ill hospitalized patients' perspectives on the benefits and harms of two models of hospital CPR discussions.

Patient Educ Couns. 2013 Dec;93(3):633-40

Authors: Anderson WG, Cimino JW, Lo B

OBJECTIVE: To describe seriously ill patients' perspectives on expert-endorsed approaches for hospital cardiopulmonary resuscitation (CPR) discussions.
METHODS: We created two videos depicting a hospital doctor discussing CPR with a seriously ill patient. One depicted a values-based approach with a doctor's recommendation, and one an information-focused approach without a recommendation. During semi-structured interviews, 20 seriously ill hospitalized patients viewed and commented on both videos. We conducted a thematic analysis to describe benefits and harms of specific discussion components.
RESULTS: Half of participants reported no preference between the videos; 35% preferred the information-focused, and 15% the values-based. Participants' reactions to the discussion components varied. They identified both benefits and harms with components in both videos, though most felt comfortable with all components (range, 60-65%) except for the doctor's recommendation in the values-based video. Only 40% would feel comfortable receiving a recommendation, while 65% would feel comfortable with the doctor eliciting their CPR preference as in the information-focused video, p=0.03.
CONCLUSION: Participants' reactions to expert-endorsed discussion components varied. Most would feel uncomfortable receiving a doctor's recommendation about CPR.
PRACTICE IMPLICATIONS: Participants' varied reactions suggest the need to tailor CPR discussions to individual patients. Many patients may find doctor's recommendations to be problematic.

PMID: 24005002 [PubMed - indexed for MEDLINE]

Leave a Reply

Your email address will not be published.