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Titolo:
End-of-life care in the pediatric intensive care unit: Attitudes and practices of pediatric critical care physicians and nurses
Autore:
Burns, JP; Mitchell, C; Griffith, JL; Truog, RD;
Indirizzi:
Tufts Univ, Sch Med, Boston, MA 02111 USA Tufts Univ Boston MA USA 02111Tufts Univ, Sch Med, Boston, MA 02111 USA New England Med Ctr, Biostat Res Ctr, Boston, MA 02111 USA New England MedCtr Boston MA USA 02111 tat Res Ctr, Boston, MA 02111 USA Dept Patient Care Serv, Boston, MA USA Dept Patient Care Serv Boston MA USA t Patient Care Serv, Boston, MA USA Childrens Hosp, Boston, MA 02115 USA Childrens Hosp Boston MA USA 02115Childrens Hosp, Boston, MA 02115 USA Harvard Univ, Sch Med, Dept Anesthesia, Boston, MA 02115 USA Harvard UnivBoston MA USA 02115 d, Dept Anesthesia, Boston, MA 02115 USA
Titolo Testata:
CRITICAL CARE MEDICINE
fascicolo: 3, volume: 29, anno: 2001,
pagine: 658 - 664
SICI:
0090-3493(200103)29:3<658:ECITPI>2.0.ZU;2-E
Fonte:
ISI
Lingua:
ENG
Soggetto:
NOT-RESUSCITATE ORDERS; PALLIATIVE CARE; DECISION-MAKING; NATIONAL SURVEY; SUPPORT; WITHDRAWAL; EDUCATION; DEATH; ILL; VARIABILITY;
Keywords:
critical illness/therapy; critical illness; decision-making; life support care; physician-patient relations; terminal care/statistics and numerical data; knowledge; attitudes; practice; ethics; medical;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
51
Recensione:
Indirizzi per estratti:
Indirizzo: Burns, JP Harvard Univ, Sch Med, Dept Anesthesia, Boston, MA 02115 USA Harvard Univ Boston MA USA 02115 esthesia, Boston, MA 02115 USA
Citazione:
J.P. Burns et al., "End-of-life care in the pediatric intensive care unit: Attitudes and practices of pediatric critical care physicians and nurses", CRIT CARE M, 29(3), 2001, pp. 658-664

Abstract

Objective: To determine the attitudes and practices of pediatric critical care attending physicians and pediatric critical care nurses on end-of-lifecare. Design: Cross-sectional survey. Setting: A random sample of clinicians at 31 pediatric hospitals in the United States. Measurements and Main Results: The survey was completed by 110/130 (85%) physicians and 92/130 (71%) nurses. The statement that withholding and withdrawing life support is unethical was not endorsed by any of the physicians or nurses. More physicians (78%) than nurses (57%) agreed or strongly agreed that withholding and withdrawing are ethically the same (p < .001). Physicians were more likely than nurses to report that families are well informed about the advantages and limitations of further therapy (99% vs. 89%; p <.003); that ethical issues are discussed well within the team (92% vs. 59%; p < .0003), and that ethical issues are discussed well with the family (91% vs. 79%; p < .0002). On multivariable analyses, fewer years of practice in pediatric critical care was the only clinician characteristic associatedwith attitudes on end-of-life care dissimilar to the consensus positions reached by national medical and nursing organizations on these issues. Therewas no association between clinician characteristics such as their political or religious affiliation, practice-related variables such as the size oftheir intensive care unit or the presence of residents and fellows, and particular attitudes about end-of-life care. Conclusions: Nearly two-thirds of pediatric critical care physicians and nurses express views on end-of-life care in strong agreement with consensus positions on these issues adopted by national professional organizations. Clinicians with fewer years of pediatric critical care practice are less likely to agree with this consensus. Compared with physicians, nurses are significantly less likely to agree that families are well informed and ethical issues are well discussed when assessing actual practice in their intensivecare unit. More collaborative education and regular case review on bioethical issues are needed as part of standard practice in the intensive care unit.

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Documento generato il 22/09/20 alle ore 16:54:10