Varon J, Fromm R E, Sternbach G L, Combs A H
Department of Medicine, Baylor College of Medicine, Houston, TX 77030.
Am J Emerg Med. 1993 May;11(3):290-2. doi: 10.1016/0735-6757(93)90144-z.
Having previously described some of the attitudes of health care providers toward resuscitation for themselves, based on an individual's beliefs about the likelihood of success of cardiopulmonary resuscitation (CPR), the differences among attitudes of physicians at different levels of training have now been assessed. A multi-question survey was sent to medical students, house officers, and attending physicians at two university medical centers. Sociodemographic information, questions regarding beliefs about outcome after CPR, and personal desires were included. Respondents were asked to identify the clinical condition carrying the worst prognosis during cardiac arrest from among: metastatic cancer (MC), end-stage renal disease (ESRD), acquired immunodeficiency syndrome (AIDS), sepsis, and myocardial infarction (MI), and to specify their resuscitation desires should they be affected by these conditions. The preferences of each group regarding resuscitation given their least favored diagnosis were assessed using chi 2 analysis of trends for binomial proportions. Approximately 186 questionnaires were evaluated and consisted of 90 by medical students (MS), 67 by house officers (HOs), and 29 by attending physicians (APs). Resuscitation desires for each diagnosis were MC, 7 of 40; ESRD, 8 of 34; AIDS, 10 of 74; sepsis, 10 of 15; and MI, 20 of 23. chi 2 test for trend of desire to be resuscitated from the self-selected worst prognostic category by level of training demonstrated no significant decrease in desire to be resuscitated with increasing level of training. Physician's beliefs about CPR may be influenced by their experiences with particular patients and events.(ABSTRACT TRUNCATED AT 250 WORDS)
先前已经描述了一些医疗服务提供者基于个人对心肺复苏术(CPR)成功可能性的信念,对自身复苏的态度。现在已经评估了不同培训水平的医生态度之间的差异。向两所大学医学中心的医学生、住院医师和主治医师发送了一份多问题调查问卷。问卷内容包括社会人口统计学信息、关于CPR后结果的信念问题以及个人愿望。受访者被要求从转移性癌症(MC)、终末期肾病(ESRD)、获得性免疫缺陷综合征(AIDS)、败血症和心肌梗死(MI)中,确定心脏骤停期间预后最差的临床情况,并说明如果他们受到这些情况影响时的复苏愿望。使用二项式比例趋势的卡方分析,评估了每组在其最不喜欢的诊断情况下对复苏的偏好。共评估了约186份问卷,其中医学生(MS)90份、住院医师(HOs)67份、主治医师(APs)29份。每种诊断情况下的复苏愿望分别为:MC,40人中有7人;ESRD,34人中有8人;AIDS,74人中有10人;败血症,15人中有10人;MI,23人中有20人。按培训水平对从自我选择的最差预后类别中进行复苏的愿望趋势进行卡方检验表明,随着培训水平的提高,复苏愿望没有显著降低。医生对CPR的信念可能会受到他们对特定患者和事件的经历的影响。(摘要截于250字)