A video depicting resuscitation did not impact upon patients' decision-making
Authors Richardson-Royer C, Naqvi I, Riffel C, Harvey L, Smith D, Ayalew D, Motayar N, Amoateng-Adjepong Y, Manthous CA
Received 24 July 2017
Accepted for publication 18 October 2017
Published 12 February 2018 Volume 2018:11 Pages 73—77
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Caitlin Richardson-Royer,1 Imran Naqvi,1 Christopher Riffel,1 Lawrence Harvey,1 Domonique Smith,1 Dagmawe Ayalew,1 Nasim Motayar,1 Yaw Amoateng-Adjepong,1,2 Constantine A Manthous3
1The Jewish Hospital of Cincinnati, Cincinnati, OH, USA; 2Yale University School of Medicine, New Haven, CT, USA; 3Lawrence & Memorial Hospital, New London, CT, USA
Background: Previous studies have demonstrated that video of and scripted information about cardiopulmonary resuscitation (CPR) can be deployed during clinician–patient end-of-life discussions. Few studies, however, examine whether video adds to verbal information-sharing. We hypothesized that video augments script-only decision-making.
Methods: Patients aged >65 years admitted to hospital wards were randomized to receive evidence-based information (“script”) vs. script plus video of simulated CPR and intubation. Patients’ decisions registered in the hospital record, by hospital discharge were compared for the two groups.
Results: Fifty script-only intervention patients averaging 77.7 years were compared to 50 script+video patients with a mean age of 74.7 years. Eleven of 50 (22%) in each group declined CPR; and an additional three (script) vs. four (script+video) refused intubation for respiratory failure. There were no differences in sex, self-reported health trajectory, functional limitations, length of stay, or mortality associated with decisions.
Conclusion: The rate at which verbally informed hospitalized elders opted out of resuscitation was not impacted by adding a video depiction of CPR.
Keywords: end of life, cardiopulmonary resuscitation, CPR, intubation, mechanical ventilation, autonomy
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