Abstract:
CONTEXT:Accurate documentation of preferences for cardiopulmonary resuscitation at hospital admission is critical to ensure that patients receive resuscitation or not in accordance with their wishes. OBJECTIVES:We sought to identify and characterize inconsistencies in patient-reported and clinician-ordered resuscitation status in patients hospitalized with acute decompensated heart failure (ADHF). METHODS:Southeastern Minnesota residents hospitalized with ADHF were prospectively enrolled into a study that included the administration of face-to-face questionnaires from January 2014 to February 2016. Patient-reported resuscitation status was assessed at enrollment using a validated question. Clinician-ordered resuscitation preferences at hospital admission were abstracted from the electronic medical record. RESULTS:Of the 400 patients administered the questionnaire; 213 (53.3%) stated their resuscitation preference as Full Code, 166 (41.5%) do-not-resuscitate (DNR), and 21 (5.3%) were unsure. In comparison, clinician-ordered resuscitation status was Full Code in 263 (65.8%) patients, DNR in 133 (33.3%), and not documented in four (1.0%). Patient-reported and clinician-ordered resuscitation status was discordant in 20% of patients, of whom 5.6% elected Full Code by questionnaire and had a DNR clinician order, and 14.4% elected DNR by questionnaire but had a Full Code clinician order. Differences in age, comorbidities, health literacy, marital status, completion of advance directives, hospital length of stay, and discharge destination in patients with discordant vs. concordant resuscitation preferences were observed. CONCLUSIONS:Patient-reported and clinician-ordered resuscitation preferences were discordant in 20% of patients hospitalized with ADHF. The underlying etiology of these inconsistencies may reflect factors such as patient indecisiveness or patient-clinician miscommunication and requires further exploration.
journal_name
J Pain Symptom Managejournal_title
Journal of pain and symptom managementauthors
Young KA,Wordingham SE,Strand JJ,Roger VL,Dunlay SMdoi
10.1016/j.jpainsymman.2016.11.010subject
Has Abstractpub_date
2017-04-01 00:00:00pages
745-750issue
4eissn
0885-3924issn
1873-6513pii
S0885-3924(16)31221-0journal_volume
53pub_type
杂志文章abstract::A treatment program was developed involving cognitive and behavioral strategies for the treatment of migraine headaches with adolescents at the Children's Hospital of Eastern Ontario. These techniques include: a headache diary, progressive relaxation techniques, cognitive restructuring, distraction or attention focusi...
journal_title:Journal of pain and symptom management
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doi:10.1016/0885-3924(89)90007-9
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journal_title:Journal of pain and symptom management
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abstract::The European Organization for Research and Treatment of Cancer colorectal cancer (CRC)-specific quality-of-life questionnaire module (QLQ-CR38) assesses health-related quality of life in patients with CRC. We studied its psychometric properties and clinical validity in Hong Kong Chinese patients with CRC. The 38 items...
journal_title:Journal of pain and symptom management
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journal_title:Journal of pain and symptom management
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:Journal of pain and symptom management
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journal_title:Journal of pain and symptom management
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journal_title:Journal of pain and symptom management
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journal_title:Journal of pain and symptom management
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journal_title:Journal of pain and symptom management
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journal_title:Journal of pain and symptom management
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