Department of Anaesthesiology, Vejle Hospital, (V66), Kabbeltoft 25, 7100 Vejle, Denmark.
Intensive Care Med. 2011 Oct;37(10):1696-705. doi: 10.1007/s00134-011-2345-7. Epub 2011 Aug 30.
The purpose of the study was to determine the views of intensive care nurses, intensivists, and primary physicians regarding collaboration and other aspects of withholding and withdrawing therapy in the intensive care unit (ICU).
A questionnaire survey was conducted in seven hospitals in the Region of Southern Denmark, including six regional and four university ICUs. Four hundred ninety-five nurses, 135 intensivists, and 146 primary physicians participated in the study. The primary physicians came from two regional hospitals.
The unified response rate was 84%. "Futile therapy" and "Patient's wish" were for all participants the main reasons for considering withholding or withdrawing therapy. Of primary physicians 63% found their general experience of collaboration very or extremely satisfactory compared to 36% of intensivists and 27% of nurses. Forty-three percent of nurses, 29% of intensivists, and 2% of primary physicians found that decisions regarding withdrawal of therapy were often, very often, or always unnecessarily postponed. Intensivists with ICU as their main workplace were more satisfied with the collaboration and more rarely found that end-of-life decisions were changed or postponed compared to intensivists who did not have ICU as their main workplace.
Nurses, intensivists and primary physicians differ in their perception of collaboration and other aspects of withholding and withdrawing therapy practises at the ICU. Multi-disciplinary patient conferences, nurse involvement in the decision-making process, and guidelines for withholding and withdrawing therapy are recommended.
本研究旨在确定重症监护病房护士、重症监护医师和初级医师对协作以及重症监护病房（ICU）中停止和撤销治疗等方面的看法。
在丹麦南部地区的七家医院进行了问卷调查，包括六家地区医院和四家大学 ICU。共有 495 名护士、135 名重症监护医师和 146 名初级医师参与了这项研究。这些初级医师来自两家地区医院。
统一的回复率为 84%。对于所有参与者来说，“无效治疗”和“患者意愿”是考虑停止或撤销治疗的主要原因。与 36%的重症监护医师和 27%的护士相比，63%的初级医师认为他们的一般协作经验非常或极其满意。43%的护士、29%的重症监护医师和 2%的初级医师认为，关于停止治疗的决定经常、非常经常或总是不必要地推迟。将 ICU 作为主要工作场所的重症监护医师对协作的满意度更高，并且很少发现临终决策被更改或推迟，而不是将 ICU 作为主要工作场所的重症监护医师。
护士、重症监护医师和初级医师在 ICU 停止和撤销治疗的协作和其他方面的看法存在差异。建议开展多学科患者会议、护士参与决策过程以及停止和撤销治疗的指南。
