"Do you want us to try to resuscitate?": Conversational practices generating patient decisions regarding cardiopulmonary resuscitation.

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State: Public
Version: author
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_9FC2C15C5439
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
"Do you want us to try to resuscitate?": Conversational practices generating patient decisions regarding cardiopulmonary resuscitation.
Journal
Patient education and counseling
Author(s)
Sterie A.C., Weber O., Jox R.J., Rubli Truchard E.
ISSN
1873-5134 (Electronic)
ISSN-L
0738-3991
Publication state
Published
Issued date
04/2022
Peer-reviewed
Oui
Volume
105
Number
4
Pages
887-894
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
To explore how physicians elicit patients' preferences about cardio-pulmonary resuscitation (CPR) during hospital admission interviews.
Conversation analysis of 37 audio-recorded CPR patient-physician discussions at admission to a geriatric hospital.
The most encountered practice is when physicians submit an option to the patient's validation ("do you want us to resuscitate"). Through it, physicians display presuppositions about the patient's preference, which is not elicited as an autonomous contribution. Through open elicitors ("what would you wish"), physicians treat patients as knowledgeable about options and autonomous in determining their preference. A third practice is related to patients delivering their preference in anticipation of the request and is encountered only for choices against CPR. These decisions are revealed as informed and autonomous, and the patient as collaborative.
The way that physicians elicit patients' preferences about CPR influences the delivery of autonomous and informed decisions. Our findings point to an asymmetry in ways of initiating talk about the possibility of not attempting CPR, potentially exacerbated by the context of admission interviews.
Decisions about the relevancy life-sustaining interventions need an adequate setting in order to allow for patient participation. Our findings have implications for communication training in regard to involving patients in conversations about goals of care.
Keywords
Aged, Cardiopulmonary Resuscitation, Communication, Decision Making, Humans, Patient Participation, Physician-Patient Relations, Physicians, Resuscitation Orders, Anticipation, Cardiopulmonary resuscitation, Conversation analysis, Decision making, Geriatrics
Pubmed
Open Access
Yes
Create date
15/09/2021 10:26
Last modification date
27/04/2022 6:37
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