Nava Stefano, Santoro Carmen, Grassi Mario, Hill Nicholas
Respiratory Unit, Fondazione S Maugeri, IRCCS Istituto Scientifico di Pavia, Pavia, Italy.
Int J Chron Obstruct Pulmon Dis. 2008;3(2):295-300. doi: 10.2147/copd.s1805.
The decision whether or not to undertake cardiopulmonary resuscitation (CPR) is a major ethical challenge. Patient preferences may be influenced by multiple factors, including information given by the media.
We wanted to assess whether patients' knowledge about CPR survival and outcomes was related to presentation by the media.
100 consecutive patients with COPD and chronic respiratory failure (CRF) and 100 patients at their first hospital admission for respiratory problems were enrolled. A questionnaire was administered to the patients seeking to ascertain their exposure to health information from the media, and to obtain their opinions on 1) the probability of survival after CPR, 2) the maximal length of time from collapse to CPR that allows a reasonable chance of survival, and 3) long-term outcomes of CPR survivors.
The patients overestimated the success rate of CPR (63% of them estimated a hospital survival > 40%), while the estimate of long-term outcome and timing of the procedure were more realistic. Bivariate correlations analysis showed significant correlation between the rate of correct responses and the viewing of educational television programs (p = 0.039), but not medical stories, reading of health-oriented newspapers, use of the internet, age, educational level, and the presence of CRF.
In conclusion, we have shown that both COPD and "newly admitted" patients' estimate of survival after CPR is much higher than reported by the current literature. A correct knowledge of CPR procedures and outcomes is significantly correlated with the exposure to "educational" medical TV programs, but not medical stories, newspapers, or internet sources.
决定是否进行心肺复苏(CPR)是一项重大的伦理挑战。患者的偏好可能受到多种因素的影响,包括媒体提供的信息。
我们想评估患者对心肺复苏生存情况和结果的了解是否与媒体报道有关。
连续纳入100例慢性阻塞性肺疾病(COPD)和慢性呼吸衰竭(CRF)患者以及100例因呼吸问题首次入院的患者。对患者进行问卷调查,以确定他们从媒体获取健康信息的情况,并获取他们对以下方面的看法:1)心肺复苏后的生存概率;2)从心脏骤停到进行心肺复苏的最长时间,在此时间内有合理的生存机会;3)心肺复苏幸存者的长期结局。
患者高估了心肺复苏的成功率(63%的患者估计医院生存率>40%),而对长期结局和操作时机的估计则更为现实。双变量相关性分析显示,正确回答率与观看教育类电视节目之间存在显著相关性(p = 0.039),但与医疗报道、阅读健康类报纸、使用互联网、年龄、教育水平以及是否存在CRF无关。
总之,我们发现COPD患者和“新入院”患者对心肺复苏后生存情况的估计均远高于当前文献报道。对心肺复苏程序和结果的正确了解与接触“教育类”医学电视节目显著相关,但与医疗报道、报纸或互联网来源无关。