Understanding Cardiopulmonary Resuscitation Decision Making
CHEST JournalPublished 1 August 2006
Daren K. Heyland, Chris Frank, Dianne Groll, Deb Pichora, Peter Dodek, Graeme Rocker
Citations173
SJR quartileQ1
SJR score1.83
SNIP1.83
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TL;DR
Strategies that improve understanding of CPR and foster discussions that involve patients, family members, and physicians in the decision-making process may improve the quantity and quality of communication and decision making about CPR.
Abstract
Seriously ill hospitalized patients have poor knowledge about CPR, and variable preferences for deliberation and their role in the decision-making process regarding their treatment. Strategies that improve understanding of CPR and foster discussions that involve patients, family members, and physicians in the decision-making process may improve the quantity and quality of communication and decision making about CPR.
Keywords
MedicineHealth Professions
The GerontologistProgress in Development of the Index of ADL
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New England Journal of MedicineUnderstanding the Treatment Preferences of Seriously Ill Patients
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Journal of Clinical EpidemiologyDecision making during serious illness: What role do patients really want to play?
1,009 Citations1992Lesley F. Degner, Jeffrey A. Sloan
It is suggested that the impact of being diagnosed with a life-threatening illness may influence preferences to participate, and the majority of patients and members of the public wanted their physician and family to share responsibility for decision making if they were too ill to participate.
New England Journal of MedicineThe Influence of the Probability of Survival on Patients' Preferences Regarding Cardiopulmonary Resuscitation
576 Citations1994Donald J. Murphy, David Burrows +5 more
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Journal of the American Geriatrics SocietyWhat Is Wrong With End‐of‐Life Care? Opinions of Bereaved Family Members
503 Citations1997Laura C. Hanson, Marion Danis +1 more
Perceptions of care at the end of life are described to describe family perceptions of care in the care of a loved one with terminal illness.
New England Journal of MedicineA Prospective Study of Advance Directives for Life-Sustaining Care
493 Citations1991Marion Danis, Leslie I. Southerland +6 more
The effectiveness of written advance directives is limited by inattention to them and by decisions to place priority on considerations other than the patient's autonomy.
Annals of Internal MedicinePatient Preferences for Communication with Physicians about End-of-Life Decisions
445 Citations1997Jan Hofmann, Neil S. Wenger +6 more
Communication and preferences about cardiopulmonary resuscitation and prolonged mechanical ventilation among patients enrolled in the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment (SUPPORT), a prospective multicenter study of the preferences, treatments, and outcomes of seriously ill hospitalized patients, are examined.
Journal of Pain and Symptom ManagementA Measure of the Quality of Dying and Death
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American Journal of Respiratory and Critical Care MedicineImpact of a Family Information Leaflet on Effectiveness of Information Provided to Family Members of Intensive Care Unit Patients: A Multicenter, Prospective, Randomized, Controlled Trial
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Results indicate that ICU caregivers should consider using an FIL to improve the effectiveness of the information they impart to families in intensive care unit (ICU) patients.
Intensive Care MedicineDecision-making in the ICU: perspectives of the substitute decision-maker
298 Citations2003Daren K. Heyland, Deborah J. Cook +6 more
In this multicenter observational study, it was found that most substitute decision-makers for ICU patients wanted to share decision-making responsibility with physicians and that, overall, they were satisfied with their decision- making experience.
Annals of Internal MedicineA Bedside Decision Instrument To Elicit a Patient's Preference Concerning Adjuvant Chemotherapy for Breast Cancer
281 Citations1992Mark N. Levine, Amiram Gafni +2 more
The instrument has been used to elicit treatment preferences in 37 newly presenting patients with high-risk, node-negative breast cancer and has been found to be acceptable and helpful to the patient.
CHEST JournalBarriers and Facilitators to End-of-Life Care Communication for Patients with COPD
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Journal of Pain and Symptom ManagementMeasuring the Symptom Experience of Seriously Ill Cancer and Noncancer Hospitalized Patients Near the End of Life with the Memorial Symptom Assessment Scale
262 Citations2003Joan Tranmer, Daren K. Heyland +4 more
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Annals of Internal MedicineEffects of Offering Advance Directives on Medical Treatments and Costs
262 Citations1992Lawrence J. Schneiderman, Richard Kronick +3 more
Executing the California Durable Power of Attorney for Health Care and having a summary copy placed in the patient's medical record had no significant positive or negative effect on a patient's well-being, health status, medical treatments, or medical treatment charges.
Journal of the American Geriatrics SocietyMedical Care Inconsistent with Patients' Treatment Goals: Association with 1‐Year Medicare Resource Use and Survival
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To describe how frequently seriously ill persons perceive that the care they receive is inconsistent with treatment preferences and the effect on 1‐year resource utilization.
CHEST JournalDying in the ICU
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Overall satisfaction with end-of-life care was significantly associated with completeness of information received by the family member, respect and compassion shown to patient and family members, and satisfaction with amount or level of health care received.
PubMedUnderstanding cultural difference in caring for dying patients.
152 Citations1995Barbara A. Koenig, J Gates-Williams
A way to assess cultural variation in end-of-life care is suggested, arguing that culture is only meaningful when interpreted in the context of a patient's unique history, family constellation, and socioeconomic status.
Journal of General Internal MedicinePreferences for cardiopulmonary resuscitation
138 Citations1995the SUPPORT Investigators, Joan M. Teno +9 more
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Journal of General Internal MedicineResuscitation decision making in the elderly
132 Citations1993Ronald S. Schonwetter, R. M. Walker +2 more
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Journal of Critical CareThe seriously ill hospitalized patient: Preferred role in end-of-life decision making?
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Critical Care MedicineA prospective study of the impact of patient preferences on life-sustaining treatment and hospital cost
123 Citations1996Marion Danis, Elizabeth J. Mutran +6 more
In a university teaching hospital setting, there is no systematic evidence that patient preferences determine life-sustaining treatment use or hospital costs.
Journal of Palliative CareDying in Canada: Is It an Institutionalized, Technologically Supported Experience?
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The majority of deaths in Canada occur in hospitals and a substantial proportion occur in special care units, raising questions about the appropriateness and quality of current end-of-life care practices in Canada.
Journal of Medical EthicsIncreasing use of DNR orders in the elderly worldwide: whose choice is it?
104 Citations2002E. Paul Cherniack
The process ought to include education for patients about the process and efficacy of CPR, and for physicians on how to consider the values and levels of knowledge of their patients, whose preferences may differ from their own.
Critical Care MedicineA comparison of patient, family, and physician assessments of the value of medical intensive care
93 Citations1988Marion Danis, Martha Gerrity +2 more
Journal of Palliative CareEnd-of-Life Care in Acute Care Hospitals in Canada: A Quality Finish?
77 Citations2005Daren K. Heyland, Dianne Groll +10 more
In conclusion, most patients and their family members in the survey were not completely satisfied with EOL care and improvement initiatives to target key elements identified by patients and FCGs have the potential to improve satisfaction with E OL care across care settings.
CHEST JournalCommunication of Prognostic Information for Critically Ill Patients
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Families of critically ill patients were generally satisfied with communication in the ICU; however, 19% were unable to recall receiving any prognostic information from physicians, suggesting that the capacity of physicians and other ICU personnel to manage families' communication expectations may positively influence caregiver satisfaction.
Journal of Palliative CareEnd-of-Life Decision Making in the Seriously Ill Hospitalized Patient: An Organizing Framework and Results of a Preliminary Study
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An organizing framework that describes the decision making process and breaks it into three analytic steps: information exchange, deliberation, and making the decision is presented and hopes to better understand the complex interaction and processes between dying patients, caregivers, and physicians.
MetamedicineSurrogate decision-making: The elderly's familial expectations
50 Citations1987Dallas M. High, Howard B. Turner
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49 Citations2003George E. Hardart, Robert D. Truog
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Journal of Internal MedicineShould cardiopulmonary resuscitation be performed on patients with heart failure? The role of the patient in the decision‐making process
45 Citations2000Anders Ågård, Göran Hermerén +1 more
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American Journal of Hospice and Palliative Medicine®Cardiopulmonary resuscitation is not addressed in the admitting medical records for the majority of patients who undergo CPR in the hospital
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Results showed that CPR is infrequently addressed in the hospital orders or medical records in patients who undergo CPR during their hospital stay, and the severity of illness at the time of admission does not appear to influence whether physicians discuss CPR with patients and their families.
PubMedHow do doctors discuss do-not-resuscitate orders?
19 Citations1985Alison Miller, Bernard Lo
A striking variation was found in whether physicians explicitly asked for patient preferences, how they described cardiopulmonary resuscitation (CPR) and its possible outcomes and whether they made a recommendation to the patient about DNR orders.