"If I Become a Vegetable, Then no": A Thematic Analysis of How Patients and Physicians Refer to Prognosis When Discussing Cardiopulmonary Resuscitation.

Details

Ressource 1Download: Sterie AC et al. Gerontol Geriatr Med 2023.pdf (182.00 [Ko])
State: Public
Version: Final published version
License: CC BY-NC 4.0
Serval ID
serval:BIB_39879CE3B571
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
"If I Become a Vegetable, Then no": A Thematic Analysis of How Patients and Physicians Refer to Prognosis When Discussing Cardiopulmonary Resuscitation.
Journal
Gerontology & geriatric medicine
Author(s)
Sterie A.C., Castillo C., Jox R.J., Büla C.J., Rubli Truchard E.
ISSN
2333-7214 (Print)
ISSN-L
2333-7214
Publication state
Published
Issued date
2023
Peer-reviewed
Oui
Volume
9
Pages
23337214231208824
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Background: Documenting decisions about the relevance cardiopulmonary resuscitation (CPR) is a standard practice at hospital admission yet a complex task. Objective: Our aim was to explore how physicians approach and discuss CPR prognosis with older patients recently admitted to a post-acute care unit. Method: We recorded 43 conversations between physicians and patients about the relevancy of CPR that took place at admission at the geriatric rehabilitation service of a Swiss university hospital. Thematic analysis determined (i) who initiated the talk about CPR prognosis, (ii) at what point in the conversation, and (iii) how prognosis was referred to. Results: Prognosis was mentioned in 65% of the conversations. We categorized the content of references to CPR prognosis in five themes: factors determining the prognosis (general health, age, duration of maneuvers); life (association of CPR with life, survival); proximal adverse outcomes (broken ribs, intensive care); long-term adverse outcomes (loss of autonomy, suffering a stroke, pain, generic, uncertainty); and being a burden. Discussion and conclusion: Discussing CPR is important to all patients, including those for whom it is not recommended. Information about CPR prognosis is essential to empower and support patients in expressing their expectations from life-prolonging interventions and attain shared decision-making.
Keywords
Cpr, cardiopulmonary resuscitation, geriatric patients, patient-physician communication, prognostics, shared decision-making, CPR
Pubmed
Web of science
Open Access
Yes
Create date
16/11/2023 15:48
Last modification date
19/12/2023 8:19
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