Wilson Michael E, Krupa Artur, Hinds Richard F, Litell John M, Swetz Keith M, Akhoundi Abbasali, Kashyap Rahul, Gajic Ognjen, Kashani Kianoush
1Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN. 2Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN. 3Department of Critical Care Medicine, University of Hawaii, John A. Burns School of Medicine, Honolulu, HI. 4Anesthesia Clinical Research Unit, Mayo Clinic, Rochester, MN. 5Divisions of Emergency and Critical Care Medicine, Beth Israel Deaconess Medical Center, Boston, MA. 6Division of General Internal Medicine, Mayo Clinic, Rochester, MN. 7Divisions of Nephrology and Critical Care Medicine, Mayo Clinic, Rochester, MN.
Crit Care Med. 2015 Mar;43(3):621-9. doi: 10.1097/CCM.0000000000000749.
To determine if a video depicting cardiopulmonary resuscitation and resuscitation preference options would improve knowledge and decision making among patients and surrogates in the ICU.
Randomized, unblinded trial.
Single medical ICU.
Patients and surrogate decision makers in the ICU.
The usual care group received a standard pamphlet about cardiopulmonary resuscitation and cardiopulmonary resuscitation preference options plus routine code status discussions with clinicians. The video group received usual care plus an 8-minute video that depicted cardiopulmonary resuscitation, showed a simulated hospital code, and explained resuscitation preference options.
One hundred three patients and surrogates were randomized to usual care. One hundred five patients and surrogates were randomized to video plus usual care. Median total knowledge scores (0-15 points possible for correct answers) in the video group were 13 compared with 10 in the usual care group, p value of less than 0.0001. Video group participants had higher rates of understanding the purpose of cardiopulmonary resuscitation and resuscitation options and terminology and could correctly name components of cardiopulmonary resuscitation. No statistically significant differences in documented resuscitation preferences following the interventions were found between the two groups, although the trial was underpowered to detect such differences. A majority of participants felt that the video was helpful in cardiopulmonary resuscitation decision making (98%) and would recommend the video to others (99%).
A video depicting cardiopulmonary resuscitation and explaining resuscitation preference options was associated with improved knowledge of in-hospital cardiopulmonary resuscitation options and cardiopulmonary resuscitation terminology among patients and surrogate decision makers in the ICU, compared with receiving a pamphlet on cardiopulmonary resuscitation. Patients and surrogates found the video helpful in decision making and would recommend the video to others.
确定一段描述心肺复苏及复苏偏好选项的视频是否能提高重症监护病房（ICU）患者及其代理人的相关知识水平并改善其决策能力。
随机、非盲试验。
单一医疗ICU。
ICU中的患者及其代理决策者。
常规护理组收到一份关于心肺复苏及心肺复苏偏好选项的标准宣传册，并与临床医生进行常规的代码状态讨论。视频组在接受常规护理的基础上，还观看了一段8分钟的视频，该视频描述了心肺复苏过程，展示了模拟的医院急救场景，并解释了复苏偏好选项。
103名患者及其代理人被随机分配至常规护理组。105名患者及其代理人被随机分配至视频加常规护理组。视频组的总知识得分中位数（正确答案可能得0 - 15分）为13分，而常规护理组为10分，p值小于0.0001。视频组参与者对心肺复苏目的、复苏选项及术语的理解率更高，且能正确说出心肺复苏的组成部分。尽管该试验检测此类差异的效能不足，但干预后两组在记录的复苏偏好方面未发现统计学上的显著差异。大多数参与者认为该视频有助于心肺复苏决策（98%），并会向他人推荐该视频（99%）。
与仅收到一份关于心肺复苏的宣传册相比，一段描述心肺复苏并解释复苏偏好选项的视频能提高ICU患者及其代理决策者对院内心肺复苏选项及心肺复苏术语的了解。患者及其代理人认为该视频对决策有帮助，并会向他人推荐。
