Physicians are frequently unaware of patient preferences for end-of-life care.
Identifying and exploring barriers to patient-physician communication about end-of-life issues may help guide physicians and their patients toward more effective discussions.
To examine correlates and associated outcomes of patient communication and patient preferences for communication with physicians about cardiopulmonary resuscitation and prolonged mechanical ventilation.
Prospective cohort study.
Five tertiary care hospitals.
1832 (85%) of 2162 eligible patients completed interviews.
Surveys of patient characteristics and preferences for end-of-life care ; perceptions of prognosis, decision making, and quality of life ; and patient preferences for communication with physicians about end-of-life decisions.
Fewer than one fourth (23%) of seriously ill patients had discussed preferences for cardiopulmonary resuscitation with their physicians.
Of patients who had not discussed their preferences for resuscitation, 58% were not interested in doing so.
Of patients who had not discussed and did not want to discuss their preferences, 25% did not want resuscitation.
In multivariable analyses, patient factors independently associated with not wanting to discuss preferences for cardiopulmonary resuscitation included being of an ethnicity other than black (adjusted odds ratio [OR], 1.48 [95% Cl, 1.10 to 1. (...)
Mots-clés Pascal : Soin palliatif, Relation médecin malade, Etude cohorte, Communication information, Décision, Qualité vie, Ventilation mécanique, Réanimation, Pronostic, Enquête opinion, Homme, Appareil respiratoire pathologie, Traitement instrumental
Mots-clés Pascal anglais : Palliative care, Physician patient relation, Cohort study, Information communication, Decision, Quality of life, Mechanical ventilation, Resuscitation, Prognosis, Opinion inquiry, Human, Respiratory disease, Instrumentation therapy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0370108
Code Inist : 002B27C. Création : 12/09/1997.