Table 2.
Experiences of healthcare professionals with LST limitation at designated ICUs: description and analysis according to vocation (nurses/physicians).
| Question | Answer | All, N (%) | Physician, N (%) | Nurse, N (%) | Mann–Whitney | |
|---|---|---|---|---|---|---|
| U | p | |||||
| I.11. Knowledge on whom to reach when encountering ethical dilemmas | 0a | 1 (0.9%) | 1 (3.2%) | 0 (0.0%) | ||
| No | 73 (64.6%) | 18 (58.1%) | 55 (67.1%) | |||
| Yes | 39 (34.5%) | 12 (38.7%) | 27 (32.9%) | |||
| I.12. Ever contacted ethical committee | No | 93 (82.3%) | 22 (71.0%) | 71 (86.6%) | ||
| Yes | 20 (17.7%) | 9 (29.0%) | 11 (13.4%) | |||
| II.1.1. Experiencing DNACPR decisions | 0a | 10 (8.8%) | 3 (9.7%) | 7 (8.5%) | 923.000 | 0.302 |
| Never | 44 (38.9%) | 9 (29.0%) | 35 (42.7%) | |||
| Rarely | 47 (41.6%) | 16 (51.6%) | 31 (37.8%) | |||
| Frequently | 12 (10.6%) | 3 (9.7%) | 9 (11.0%) | |||
| II.1.2. Experiencing withholding LST | 0a | 14 (12.4%) | 3 (9.7%) | 11 (13.4%) | 606.500 | <.001 |
| Never | 41 (36.3%) | 3 (9.7%) | 38 (46.3%) | |||
| Rarely | 48 (42.5%) | 22 (71.0%) | 26 (31.7%) | |||
| Frequently | 10 (8.8%) | 3 (9.7%) | 7 (8.5%) | |||
| II.1.3. Experiencing withdrawing of artificial ventilation | 0a | 10 (8.8%) | 3 (9.7%) | 7 (8.5%) | 840.500 | 0.066 |
| Never | 66 (58.4%) | 14 (45.2%) | 52 (63.4%) | |||
| Rarely | 30 (26.5%) | 11 (35.5%) | 19 (23.2%) | |||
| Frequently | 7 (6.2%) | 3 (9.7%) | 4 (4.9%) | |||
| II.1.4. Experiencing withdrawing of endotracheal tube | 0a | 10 (8.8%) | 3 (9.7%) | 7 (8.5%) | 985.500 | 0.506 |
| Never | 81 (71.7%) | 21 (67.7%) | 60 (73.2%) | |||
| Rarely | 16 (14.2%) | 4 (12.9%) | 12 (14.6%) | |||
| Frequently | 6 (5.3%) | 3 (9.7%) | 3 (3.7%) | |||
| II.1.5. Experiencing withdrawing of inotropes | 0a | 11 (9.7%) | 3 (9.7%) | 8 (9.8%) | 712.000 | 0.008 |
| Never | 48 (42.5%) | 7 (22.6%) | 41 (50.0%) | |||
| Rarely | 42 (37.2%) | 16 (51.6%) | 26 (31.7%) | |||
| Frequently | 12 (10.6%) | 5 (16.1%) | 7 (8.5%) | |||
| II.1.6. Experiencing withdrawing of antibiotics | 0a | 10 (8.8%) | 3 (9.7%) | 7 (8.5%) | 926.500 | 0.284 |
| Never | 65 (57.5%) | 15 (48.4%) | 50 (61.0%) | |||
| Rarely | 30 (26.5%) | 11 (35.5%) | 19 (23.2%) | |||
| Frequently | 8 (7.1%) | 2 (6.5%) | 6 (7.3%) | |||
| II.1.7. Experiencing withdrawing of hydration | 0a | 10 (8.8%) | 3 (9.7%) | 7 (8.5%) | 1,023.000 | 0.688 |
| Never | 94 (83.2%) | 25 (80.6%) | 69 (84.1%) | |||
| Rarely | 8 (7.1%) | 3 (9.7%) | 5 (6.1%) | |||
| Frequently | 1 (0.9%) | 0 (0.0%) | 1 (1.2%) | |||
| II.2. Recording of DNACPR decisions | 0a | 1 (0.9%) | 1 (3.2%) | 0 (0.0%) | 1,230.000 | 1.000 |
| No | 43 (38.1%) | 11 (35.5%) | 32 (39.0%) | |||
| In writing | 43 (38.1%) | 11 (35.5%) | 32 (39.0%) | |||
| Orally | 26 (23.0%) | 8 (25.8%) | 18 (22.0%) | |||
| II.3. Compliance with DNACPR decisions | 0a | 4 (3.5%) | 1 (3.2%) | 3 (3.7%) | 1,262.000 | 0.535 |
| Never | 16 (14.2%) | 4 (12.9%) | 12 (14.6%) | |||
| Rarely | 21 (18.6%) | 8 (25.8%) | 13 (15.9%) | |||
| Always | 72 (63.7%) | 18 (58.1%) | 54 (65.9%) | |||
| II.4. Recording of LST limitation decisions | 0a | 1 (0.9%) | 0 (0.0%) | 1 (1.2%) | 1,059.500 | 0.177 |
| No instructions used | 40 (35.4%) | 9 (29.0%) | 31 (37.8%) | |||
| Oral instructions | 32 (28.3%) | 12 (38.7%) | 20 (24.4%) | |||
| Written instructions | 40 (35.4%) | 10 (32.3%) | 30 (36.6%) | |||
| II.5.1. Involvement in LST limitation decision-making | 0a | 5 (4.4%) | 2 (6.5%) | 3 (3.7%) | 629.500 | <.001 |
| No | 84 (74.3%) | 13 (41.9%) | 71 (86.6%) | |||
| Yes | 24 (21.2%) | 16 (51.6%) | 8 (9.8%) | |||
| II.6. Initiator of LST limitation discussions | 0a | 29 (25.7%) | 7 (22.6%) | 22 (26.8%) | 864.000 | 0.038 |
| Doctor + family/legal guardian | 4 (3.5%) | 1 (3.2%) | 3 (3.7%) | |||
| Doctor + nurse | 2 (1.8%) | 0 (0.0%) | 2 (2.4%) | |||
| Doctor's initiative | 68 (60.2%) | 23 (74.2%) | 45 (54.9%) | |||
| Family/legal guardian's initiative | 10 (8.8%) | 0 (0.0%) | 10 (12.2%) | |||
| II.7.2. LST limitation decision-making process includes physicians (ICU and others involved in treatment) | 0a | 8 (7.1%) | 0 (0.0%) | 8 (9.8%) | 1,307.500 | 0.229 |
| Strongly disagree | 13 (11.5%) | 5 (16.1%) | 8 (9.8%) | |||
| Disagree | 5 (4.4%) | 1 (3.2%) | 4 (4.9%) | |||
| Undecided | 4 (3.5%) | 1 (3.2%) | 3 (3.7%) | |||
| Agree | 38 (33.6%) | 14 (45.2%) | 24 (29.3%) | |||
| Strongly agree | 45 (39.8%) | 10 (32.3%) | 35 (42.7%) | |||
| II.7.3. LST limitation decision-making process includes physicians and nurses | 0a | 15 (13.3%) | 3 (9.7%) | 12 (14.6%) | 861.500 | 0.341 |
| Strongly disagree | 27 (23.9%) | 5 (16.1%) | 22 (26.8%) | |||
| Disagree | 18 (15.9%) | 5 (16.1%) | 13 (15.9%) | |||
| Undecided | 20 (17.7%) | 8 (25.8%) | 12 (14.6%) | |||
| Agree | 24 (21.2%) | 8 (25.8%) | 16 (19.5%) | |||
| Strongly agree | 9 (8.0%) | 2 (6.5%) | 7 (8.5%) | |||
| II.7.4. LST limitation decision-making process includes consultation of ethics committee | 0a | 13 (11.5%) | 2 (6.5%) | 11 (13.4%) | 1,129.500 | 0.426 |
| Strongly disagree | 43 (38.1%) | 13 (41.9%) | 30 (36.6%) | |||
| Disagree | 16 (14.2%) | 8 (25.8%) | 8 (9.8%) | |||
| Undecided | 24 (21.2%) | 3 (9.7%) | 21 (25.6%) | |||
| Agree | 7 (6.2%) | 3 (9.7%) | 4 (4.9%) | |||
| Strongly agree | 10 (8.8%) | 2 (6.5%) | 8 (9.8%) | |||
| II.8. Family members/legal guardians involvement in LST limitation decision-making | 0a | 1 (0.9%) | 1 (3.2%) | 1 (1.2%) | 1,114.000 | 0.411 |
| Never | 8 (7.1%) | 3 (9.7%) | 5 (6.1%) | |||
| Rarely | 10 (8.8%) | 1 (3.2%) | 9 (11.0%) | |||
| Usually | 43 (38.1%) | 10 (32.3%) | 33 (40.2%) | |||
| Always | 50 (44.2%) | 16 (51.6%) | 34 (41.5%) | |||
| II.11. Frequency of no consensus among physicians | 0a | 3 (2.7%) | 1 (3.2%) | 2 (2.4%) | 1,348.500 | 0.154 |
| Never | 11 (9.7%) | 5 (16.1%) | 6 (7.3%) | |||
| Rarely | 88 (77.9%) | 23 (74.2%) | 65 (79.3%) | |||
| Frequently | 11 (9.7%) | 2 (6.5%) | 9 (11.0%) | |||
| II.12. Frequency of no consensus among physicians and family members | 0a | 4 (3.5%) | 1 (3.2%) | 3 (3.7%) | 849.000 | 0.004 |
| Never | 17 (15.0%) | 0 (0.0%) | 17 (20.7%) | |||
| Rarely | 79 (69.9%) | 24 (77.4%) | 55 (67.1%) | |||
| Frequently | 13 (11.5%) | 6 (19.4%) | 7 (8.5%) | |||
| II.13. Disagreement with LST limitation decisions | 0a | 2 (1.8%) | 1 (3.2%) | 1 (1.2%) | 1,215.500 | 1.000 |
| Never | 50 (44.2%) | 13 (41.9%) | 37 (45.1%) | |||
| Rarely | 54 (47.8%) | 16 (51.6%) | 38 (46.3%) | |||
| Frequently | 7 (6.2%) | 1 (3.2%) | 6 (7.3%) | |||
| II.15. Time from decision to treatment withdrawal | 0a | 8 (7.1%) | 1 (3.2%) | 7 (8.5%) | ||
| Immediately | 10 (8.8%) | 2 (6.5%) | 8 (9.8%) | 1,211.000 | 0.486 | |
| Immediately after decision and family agreement | 65 (57.5%) | 18 (58.1%) | 47 (57.3%) | |||
| About 6 h | 13 (11.5%) | 5 (16.1%) | 8 (9.8%) | |||
| About 24 h | 12 (10.6%) | 4 (12.9%) | 8 (9.8%) | |||
| More than 24 h | 5 (4.4%) | 1 (3.2%) | 4 (4.9%) | |||
a
0 = Non-response to a given questionnaire item.