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Text
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<a href="http://doi.org/10.1097/00003246-199703000-00011" target="_blank" rel="noreferrer">http://doi.org/10.1097/00003246-199703000-00011</a>
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Title
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Factors explaining variability among caregivers in the intent to restrict life-support interventions in a pediatric intensive care unit
Publisher
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Critical Care Medicine
Date
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1997
Subject
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Child; Cross-Sectional Studies; Humans; Intensive Care Units; Adult; Attitude of Health Personnel; Medical Staff; Prognosis; Questionnaires; Euthanasia; Life Support Care; Activities of Daily Living; Linear Models; Nursing Staff; Pediatric; Empirical Approach; Professional Patient Relationship; Death and Euthanasia; decision making; Family/psychology; ICU Decision Making; Intervention; Interventions; Passive; Hospital/psychology
Creator
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Randolph AG; Zollo MB; Wigton RS; Yeh TS
Description
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OBJECTIVE: To explore patient-related factors which influence the decisions of pediatric intensive care unit (ICU) caregivers to restrict life-support interventions. DESIGN: Cross-sectional survey. SETTING: A university-affiliated pediatric ICU. SUBJECTS: All physicians and nurses caring for oncology or cardiology ICU patients. INTERVENTIONS: 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. CONCLUSION: Critically ill children and their families could face markedly different attitudes about the restriction of life-support interventions, depending on which nurses and physicians are involved in their care.
1997
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<a href="http://doi.org/10.1097/00003246-199703000-00011" target="_blank" rel="noreferrer">10.1097/00003246-199703000-00011</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
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Journal Article
1997
Activities of Daily Living
Adult
Attitude Of Health Personnel
Backlog
Child
Critical Care Medicine
Cross-sectional Studies
Death and Euthanasia
Decision Making
Empirical Approach
Euthanasia
Family/psychology
Hospital/psychology
Humans
ICU Decision Making
Intensive Care Units
Intervention
Interventions
Journal Article
Life Support Care
Linear Models
Medical Staff
Nursing Staff
Passive
Pediatric
Professional Patient Relationship
Prognosis
Questionnaires
Randolph AG
Wigton RS
Yeh TS
Zollo MB