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Discussing preferences for cardiopulmonary resuscitation: what do resident physicians and their hospitalized patients think was decided?
Patient Educ Couns 2008; 72(1):20-5PE

Abstract

OBJECTIVE

To explore the ways in which seriously ill hospitalized patients, their family members and physicians interpret the discussion of the patient's preferences for cardiopulmonary resuscitation (CPR).

METHODS

Resident physicians, their patients, and family members were interviewed following a discussion regarding preferences for CPR. We sought the participants' perceptions of the resulting decision, examined how often these interpretations differed, and explored the communicative factors underlying discrepancies when they occurred.

RESULTS

Fifty-six interviews with 28 matched dyads were completed. In six dyads (21%), the participants reported differing results of the discussion. Two patients had orders to limit their care based on the physician's interpretation of their discussion. Another two patients who did not want resuscitation lacked a DNR order. Two patients did not recall having the conversation. These discrepancies could be attributed to the physician misconstruing the patient's wishes, interference of a family member, and fluctuating preferences.

CONCLUSIONS

Discrepant interpretations of a DNR discussion occur with a concerning frequency between resident physicians and their hospitalized patients.

PRACTICE IMPLICATIONS

Educational efforts should focus on training physicians to clarify the language used in these discussions, remain vigilant about discerning the patient's preferences, and be aware that these preferences may be contextually fluid.

Authors+Show Affiliations

University of Kentucky College of Medicine, K504 KY Clinic, Lexington, KY 40536, United States. Klshef0@email.uky.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18337051

Citation

Deep, Kristy S., et al. "Discussing Preferences for Cardiopulmonary Resuscitation: what Do Resident Physicians and Their Hospitalized Patients Think Was Decided?" Patient Education and Counseling, vol. 72, no. 1, 2008, pp. 20-5.
Deep KS, Griffith CH, Wilson JF. Discussing preferences for cardiopulmonary resuscitation: what do resident physicians and their hospitalized patients think was decided? Patient Educ Couns. 2008;72(1):20-5.
Deep, K. S., Griffith, C. H., & Wilson, J. F. (2008). Discussing preferences for cardiopulmonary resuscitation: what do resident physicians and their hospitalized patients think was decided? Patient Education and Counseling, 72(1), pp. 20-5. doi:10.1016/j.pec.2008.01.017.
Deep KS, Griffith CH, Wilson JF. Discussing Preferences for Cardiopulmonary Resuscitation: what Do Resident Physicians and Their Hospitalized Patients Think Was Decided. Patient Educ Couns. 2008;72(1):20-5. PubMed PMID: 18337051.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Discussing preferences for cardiopulmonary resuscitation: what do resident physicians and their hospitalized patients think was decided? AU - Deep,Kristy S, AU - Griffith,Charles H, AU - Wilson,John F, Y1 - 2008/03/11/ PY - 2007/08/24/received PY - 2007/12/19/revised PY - 2008/01/19/accepted PY - 2008/3/14/pubmed PY - 2008/10/1/medline PY - 2008/3/14/entrez SP - 20 EP - 5 JF - Patient education and counseling JO - Patient Educ Couns VL - 72 IS - 1 N2 - OBJECTIVE: To explore the ways in which seriously ill hospitalized patients, their family members and physicians interpret the discussion of the patient's preferences for cardiopulmonary resuscitation (CPR). METHODS: Resident physicians, their patients, and family members were interviewed following a discussion regarding preferences for CPR. We sought the participants' perceptions of the resulting decision, examined how often these interpretations differed, and explored the communicative factors underlying discrepancies when they occurred. RESULTS: Fifty-six interviews with 28 matched dyads were completed. In six dyads (21%), the participants reported differing results of the discussion. Two patients had orders to limit their care based on the physician's interpretation of their discussion. Another two patients who did not want resuscitation lacked a DNR order. Two patients did not recall having the conversation. These discrepancies could be attributed to the physician misconstruing the patient's wishes, interference of a family member, and fluctuating preferences. CONCLUSIONS: Discrepant interpretations of a DNR discussion occur with a concerning frequency between resident physicians and their hospitalized patients. PRACTICE IMPLICATIONS: Educational efforts should focus on training physicians to clarify the language used in these discussions, remain vigilant about discerning the patient's preferences, and be aware that these preferences may be contextually fluid. SN - 0738-3991 UR - https://www.unboundmedicine.com/medline/citation/18337051/Discussing_preferences_for_cardiopulmonary_resuscitation:_what_do_resident_physicians_and_their_hospitalized_patients_think_was_decided L2 - https://linkinghub.elsevier.com/retrieve/pii/S0738-3991(08)00067-0 DB - PRIME DP - Unbound Medicine ER -