The seriously ill hospitalized patient: preferred role in end-of-life decision making? Export

@article{citeulike:4652410, abstract = {PURPOSE: The objective of this study was to further our understanding of the decision-making process near the end of life. Specifically, we ascertained the seriously ill patients' preferred role in the decision-making process, what factors were associated with this role, and how this stated preference related to physicians' perception of preferred role. MATERIALS AND METHODS: Prospective cohort study of hospitalized patients with end-stage congestive heart disease, chronic pulmonary disease, cirrhosis, or metastatic cancer. Eligible patients were interviewed to ascertain their personal views on end-of-life decision making, desired role, and level of symptoms experienced. RESULTS: A total of 135 patients were enrolled in this study. The majority of patients (103, 76\%) had thought about end-of-life issues although only 48 (36\%) had discussed them with their doctor in the hospital. With respect to preferred role in decision making, in the scenario of a competent patient, 14 (10\%) preferred to leave all decisions to the doctor, 12 (9\%) preferred that the doctor make the final decision after considering their opinion, 43 (32\%) preferred that the doctor shared responsibility with them to make the decision, 32 (24\%) patients preferred to make the final decision after considering the doctor's opinion, 21 (16\%) preferred to make the treatment decision alone, and 13 (10\%) did not answer. Physicians were not able to accurately predict patient's preferred role nor could the variability in patient choice be accounted for by demographic or symptom covariates. CONCLUSION: Seriously ill hospitalized patients desire to discuss end-of-life issues with their physicians but their preferred role in decision making is variable and difficult to predict.}, author = {Heyland, D. K. and Tranmer, J. and O'Callaghan, C. J. and Gafni, A.}, citeulike-article-id = {4652410}, citeulike-linkout-0 = {http://dx.doi.org/10.1053/jcrc.2003.YJCRC2}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/12640606}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=12640606}, doi = {10.1053/jcrc.2003.YJCRC2}, issn = {0883-9441}, journal = {Journal of critical care}, keywords = {decisionmaking, eol, nfr}, month = {March}, number = {1}, pages = {3--10}, posted-at = {2009-05-28 06:26:42}, priority = {2}, title = {The seriously ill hospitalized patient: preferred role in end-of-life decision making?}, url = {http://dx.doi.org/10.1053/jcrc.2003.YJCRC2}, volume = {18}, year = {2003} }

TY - JOUR ID - citeulike:4652410 L3 - citeulike-article-id:4652410 N2 - PURPOSE: The objective of this study was to further our understanding of the decision-making process near the end of life. Specifically, we ascertained the seriously ill patients' preferred role in the decision-making process, what factors were associated with this role, and how this stated preference related to physicians' perception of preferred role. MATERIALS AND METHODS: Prospective cohort study of hospitalized patients with end-stage congestive heart disease, chronic pulmonary disease, cirrhosis, or metastatic cancer. Eligible patients were interviewed to ascertain their personal views on end-of-life decision making, desired role, and level of symptoms experienced. RESULTS: A total of 135 patients were enrolled in this study. The majority of patients (103, 76%) had thought about end-of-life issues although only 48 (36%) had discussed them with their doctor in the hospital. With respect to preferred role in decision making, in the scenario of a competent patient, 14 (10%) preferred to leave all decisions to the doctor, 12 (9%) preferred that the doctor make the final decision after considering their opinion, 43 (32%) preferred that the doctor shared responsibility with them to make the decision, 32 (24%) patients preferred to make the final decision after considering the doctor's opinion, 21 (16%) preferred to make the treatment decision alone, and 13 (10%) did not answer. Physicians were not able to accurately predict patient's preferred role nor could the variability in patient choice be accounted for by demographic or symptom covariates. CONCLUSION: Seriously ill hospitalized patients desire to discuss end-of-life issues with their physicians but their preferred role in decision making is variable and difficult to predict. IS - 1 JF - Journal of critical care SN - 0883-9441 EP - 10 TI - The seriously ill hospitalized patient: preferred role in end-of-life decision making? VL - 18 SP - 3 KW - decisionmaking KW - eol KW - nfr AU - Heyland, DK AU - Tranmer, J AU - O'Callaghan, CJ AU - Gafni, A PY - 2003/03// UR - http://dx.doi.org/10.1053/jcrc.2003.YJCRC2 ER -