Factors explaining variability among caregivers in the intent to restrict life-support interventions in a pediatric intensive care unit.
To explore patient-related factors which influence the decisions of pediatric intensive care unit (ICU) caregivers to restrict life-support interventions.
A university-affiliated pediatric ICU.
All physicians and nurses caring for oncology or cardiology ICU patients.
Seven patient characteristics were systematically presented in 16 theoretical case scenarios.
Measurements and Main Results
Individual linear regression models were constructed for each participant by calculating the importance caregivers placed on seven patient characteristics when deciding about starting intravenous vasopressors, performing chest compressions, and withdrawing life support.
We compared the numerical and descriptive (very low, low, moderate, high) probability of survival.
We surveyed 86 caregivers and 56 (65%) responded.
The most important factors influencing decisions were family preferences (76% of decisions), followed by probability of survival (50%), and functional status (47%). There was marked variability among respondents in 38 (79%)/48 of the questions ; 20% to 50% of caregivers chose opposing directions of patient management when they were asked to indicate the likelihood that they would perform a specific life-support intervention.
The same term was never used by all respondents to describe the probability of survival for a scenario. (...)
Mots-clés Pascal : Unité soin intensif, Pédiatrie, Personnel sanitaire, Pratique professionnelle, Questionnaire, Prise décision, Arrêt traitement, Pronostic, Homme, Etats Unis, Amérique du Nord, Amérique, Soin intensif
Mots-clés Pascal anglais : Intensive care unit, Pediatrics, Health staff, Professional practice, Questionnaire, Decision making, Withdrawal, Prognosis, Human, United States, North America, America, Intensive care
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0264043
Code Inist : 002B30A05. Création : 11/06/1997.