Abstract
We compared the understanding by family physicians and nurses of their elderly outpatients' preferences for cardiopulmonary resuscitation and mechanical ventilation under 3 scenarios reflecting varying qualities of life. Physicians and nurses correctly predicted patients' treatment preferences in from 59% to 84% and 53% to 78% of cases, respectively, for the various decisions. For most decisions, neither physicians nor nurses were significantly more accurate in their predictions than expected by chance alone. Moreover, nurses and physicians did not significantly agree with one another in their predictions of patients' preferences for any of these decisions. These results suggest that while nurses' and physicians' perceptions of patients' preferences for life-sustaining treatment are not necessarily similar, neither nurses nor physicians systematically understand their elderly patients' resuscitation preferences.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bedell S. E., Delbanco T. L. Choices about cardiopulmonary resuscitation in the hospital. When do physicians talk with patients? N Engl J Med. 1984 Apr 26;310(17):1089–1093. doi: 10.1056/NEJM198404263101706. [DOI] [PubMed] [Google Scholar]
- Farber N. J., Weiner J. L., Boyer E. G., Green W. P., Diamond M. P., Copare I. M. Cardiopulmonary resuscitation. Values and decisions--a comparison of health care professionals. Med Care. 1985 Dec;23(12):1391–1398. [PubMed] [Google Scholar]
- Frampton M. W., Mayewski R. J. Physicians' and nurses' attitudes toward withholding treatment in a community hospital. J Gen Intern Med. 1987 Nov-Dec;2(6):394–399. doi: 10.1007/BF02596364. [DOI] [PubMed] [Google Scholar]
- Gramelspacher G. P., Howell J. D., Young M. J. Perceptions of ethical problems by nurses and doctors. Arch Intern Med. 1986 Mar;146(3):577–578. [PubMed] [Google Scholar]
- Landis J. R., Koch G. G. The measurement of observer agreement for categorical data. Biometrics. 1977 Mar;33(1):159–174. [PubMed] [Google Scholar]
- Starr T. J., Pearlman R. A., Uhlmann R. F. Quality of life and resuscitation decisions in elderly patients. J Gen Intern Med. 1986 Nov-Dec;1(6):373–379. doi: 10.1007/BF02596420. [DOI] [PubMed] [Google Scholar]
- Theis E. C. Ethical issues. A nursing perspective. N Engl J Med. 1986 Nov 6;315(19):1222–1224. doi: 10.1056/NEJM198611063151910. [DOI] [PubMed] [Google Scholar]
- Uhlmann R. F., McDonald W. J., Inui T. S. Epidemiology of no-code orders in an academic hospital. West J Med. 1984 Jan;140(1):114–116. [PMC free article] [PubMed] [Google Scholar]
- Watts D. T., Cassel C. K., Hickam D. H. Nurses' and physicians' attitudes toward tube-feeding decisions in long-term care. J Am Geriatr Soc. 1986 Aug;34(8):607–611. doi: 10.1111/j.1532-5415.1986.tb05767.x. [DOI] [PubMed] [Google Scholar]
- Wolff M. L., Smolen S., Ferrara L. Treatment decisions in a skilled-nursing facility: discordance with nurses' preferences. J Am Geriatr Soc. 1985 Jun;33(6):440–445. doi: 10.1111/j.1532-5415.1985.tb07156.x. [DOI] [PubMed] [Google Scholar]