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QUALITY OF DISCUSSIONS ON RESUSCITATION BETWEEN ICU PHYSICIANS AND CRITICALLY ILL PATIENTS' SURROGATE DECISION MAKERS

by ALMOOSA, KHALID FAEQ

Abstract (Summary)
Background. Critically ill patients are often unable to participate in discussions about resuscitation in the event of a cardiopulmonary arrest, leaving their surrogates to make these decisions on their behalf. The ability of surrogates to make these decisions, however, depends on the quality of communication with physicians regarding the resuscitation process and its outcomes. There are few data on the frequency and quality of these discussions about resuscitation and how they are perceived by the surrogates. Methods. Surrogates of critically ill patients who were not able to make decisions about resuscitation at the University Hospital, Cincinnati, and the Cincinnati Veterans Affairs Medical Center were offered the opportunity to participate in a questionnaire designed to elicit information about the quality of communications with the physicians. Enrolled subjects were interviewed using a structured questionnaire in person or over the phone. Additional data regarding the patients’ ICU course and outcomes were collected from their medical records. Results. Of 38 surrogates who participated in the survey, 21 (55%) recalled participating in a discussion on resuscitation with the ICU physicians. Surrogates were usually spouses (33%) or children (41%) of the patients, 52 + 12 years of age, and mostly (89%) high school educated. Discussions lasted an average of 18 + 15 minutes, and were often multiple, with other family and friends also present. Most discussions included the topics of chest compressions, electrical cardioversion, and endotracheal intubation, and these topics were well understood by most surrogates. Surrogates were generally (80%) satisfied with these discussions, and most believed they facilitated making a decision about resuscitation. Conclusion. A large proportion of hospitalized patients’ surrogates had not participated in a discussion on resuscitation within the first several days of the patient’s stay in the ICU. For those who had participated, most understood the contents of the discussions and were generally satisfied with them.
Bibliographical Information:

Advisor:

School:University of Cincinnati

School Location:USA - Ohio

Source Type:Master's Thesis

Keywords:resuscitation discussion critical illness

ISBN:

Date of Publication:01/01/2007

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