Attitudes of hospitalized patients toward life support: A survey of 200 medical inpatients

Frankl, David; Oye, Robert K.; Bellamy, Paule E.

doi:10.1016/0002-9343(89)90436-1

Cited by 179 publications

(91 citation statements)

References 14 publications

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“…This lack of communication has been observed in other settings, 13,14 despite evidence that patients want to have these discussions. 15 However, we found that the physician's perception of the patient's preference was not more likely to be accurate among those who reported communicating with the physician. Moreover, the SUPPORT intervention, designed to improve communication about these issues between patients and physicians, failed to change practice.…”

Section: Discussionmentioning

confidence: 60%

Resuscitation Preferences Among Patients With Severe Congestive Heart Failure

et al. 1998

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for the SUPPORT InvestigatorsBackground-We sought to describe the resuscitation preferences of patients hospitalized with an exacerbation of severe congestive heart failure, perceptions of those preferences by their physicians, and the stability of the preferences. Methods and Results-Of 936 patients in this study, 215 (23%) explicitly stated that they did not want to be resuscitated.Significant correlates of not wanting to be resuscitated included older age, perception of a worse prognosis, poorer functional status, and higher income. The physician's perception of the patient's preference disagreed with the patient's actual preference in 24% of the cases overall. Only 25% of the patients reported discussing resuscitation preferences with their physician, but discussion of preferences was not significantly associated with higher agreement between the patient and physician. Of the 600 patients who responded to the resuscitation question again 2 months later, 19% had changed their preferences, including 14% of those who initially wanted resuscitation (69 of 480) and 40% of those who initially did not (48 of 120). The physician's perception of the patient's hospital resuscitation preference was correct for 84% of patients who had a stable preference and 68% of those who did not. Conclusions-Almost one quarter of patients hospitalized with severe heart failure expressed a preference not to be resuscitated. The physician's perception of the patient's preference was not accurate in about one quarter of the cases, but communication was not associated with greater agreement between the patient and the physician. A substantial proportion of patients who did not want to be resuscitated changed their minds within 2 months of discharge.(Circulation. 1998;98:648-655.)

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Section: Discussionmentioning

confidence: 60%

Resuscitation Preferences Among Patients With Severe Congestive Heart Failure

et al. 1998

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“…Unlike cultures that are averse to end-of-life discussions, 51,52 our results indicated that Japanese and Japanese Americans alike accept the notion of communication about end-of-life care. The fact that few subjects had communicated with physicians, similar to the pattern in mainstream U.S. samples, 4,53 suggests that fundamental barriers to endof-life discussion exist. One possible explanation is that discussing end-of-life issues is desirable but not a high priority for patients in the routine encounter.…”

Section: Discussionmentioning

confidence: 89%

Acculturation of attitudes toward end-of-life care

et al. 2002

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“…8,9 Previous studies have shown that the desire for tube feedings tends to decrease as the hypothetical degree of cognitive impairment increases. [22][23][24] This may explain why a larger percentage (53%) of the subjects in another nursing home study opted for tube feedings when provided the hypothetical scenario of being "unable to eat" with no mention of associated cognitive status. 7 Likewise, preferences for tube feedings among elderly outpatients has been shown to vary according to hypothetical scenario, with 50% of subjects opting for tube feedings in the event of "severely impaired health," 25 while 2.4% in another study opted for tube feedings if having "Alzheimer's disease."…”

Section: Discussionmentioning

confidence: 99%

Tube Feeding Preferences Among Nursing Home Residents

O’Brien

Siegert²,

Grisso

et al. 1997

J Gen Intern Med

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OBJECTIVE:To determine the preferences of nursing home residents regarding the use of tube feedings and to characterize the clinical, functional, and psychosocial factors that are associated with preferences. DESIGN:In-person survey.SETTING: Forty-nine randomly selected nursing homes. PATIENTS/PARTICIPANTS:Three hundred seventy-nine randomly selected, decisionally capable, nursing home residents. MAIN RESULTS:Thirty-three percent of participants would prefer tube feedings if no longer able to eat because of permanent brain damage. Factors positively associated with preferences for tube feedings include male gender, African-American race, never having discussed treatment preferences with family members or health care providers, never having signed an advance directive, and believing that tube feeding preferences will be respected by the nursing home staff. Twenty-five percent of the participants changed from preferring tube feedings to not preferring tube feedings on learning that physical restraints are sometimes applied during the tube feeding process.CONCLUSIONS: Demographic and social factors are associated with preferences for tube feedings. The provision of information about the potential use of physical restraint altered a proportion of nursing home residents' treatment preferences.

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Attitudes of hospitalized patients toward life support: A survey of 200 medical inpatients

Cited by 179 publications

References 14 publications

Resuscitation Preferences Among Patients With Severe Congestive Heart Failure

Resuscitation Preferences Among Patients With Severe Congestive Heart Failure

Acculturation of attitudes toward end-of-life care

Tube Feeding Preferences Among Nursing Home Residents

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