Sharma Rupali, Jayathissa Sisira, Weatherall Mark
Public Health Physician, Population Health Team, CM Health, Auckland.
N Z Med J. 2016 Jan 8;129(1428):26-36.
To determine the knowledge in cardiopulmonary resuscitation (CPR) process, preference for CPR, and desire to participate in end-of-life decision making amongst older hospitalised patients.
We prospectively interviewed 100 participants above 65 years of age awaiting discharge from acute medical ward and collected demographics, knowledge of CPR and opinion on CPR in various clinical scenarios.
Amongst the participants, 58% had good understanding of all components of CPR and 91% overestimated its success. Fifty-eight percent wished to have CPR in current health status, but this declined if they were presented a hypothetical scenario of critical illness (46%), functional impairment (17%), terminal illness (13%) and dementia (13%). Tertiary education, male gender and not living alone were associated with accepting CPR. Ninety-three percent were comfortable discussing CPR and 84% felt comfortable documenting their wishes in the medical notes. Seventy percent wished such discussion to include themselves and their family.
Older inpatients have a reasonable understanding of the components of CPR and wish to be involved in CPR decision-making. Clinical scenarios with poor prognosis may lead to patients declining CPR. Discussion and documentation of resuscitation wishes is useful in routine assessment process among elderly hospitalised patients.
确定老年住院患者对心肺复苏（CPR）过程的了解、对CPR的偏好以及参与临终决策的意愿。
我们前瞻性地采访了100名65岁以上等待从急性内科病房出院的参与者，收集了人口统计学信息、CPR知识以及他们在各种临床场景下对CPR的看法。
在参与者中，58%对CPR的所有组成部分有良好的理解，91%高估了其成功率。58%的人希望在当前健康状况下接受CPR，但如果向他们呈现重病（46%）、功能障碍（17%）、绝症（13%）和痴呆（13%）的假设情景，这一比例会下降。受过高等教育、男性以及非独居与接受CPR相关。93%的人愿意讨论CPR，84%的人愿意在病历中记录自己的意愿。70%的人希望这种讨论包括他们自己和他们的家人。
老年住院患者对CPR的组成部分有合理的理解，并希望参与CPR决策。预后不良的临床情景可能导致患者拒绝CPR。在老年住院患者的常规评估过程中，讨论和记录复苏意愿是有用的。
