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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Respiratory support withdrawal in intensive care units: families, physicians and nurses views on two hypothetical clinical scenarios. | Fumis and Deheinzelin Critical Care 2010 14 R235 http ccforum.eom content 14 6 R235 KS CRITICAL CARE RESEARCH Open Access Respiratory support withdrawal in intensive care units families physicians and nurses views on two hypothetical clinical scenarios Renata RL Fumis1 t Daniel Deheinzelin2t Abstract Introduction Evidence suggests that dying patients physical and emotional suffering is inadequately treated in intensive care units. Although there are recommendations regarding decisions to forgo life-sustaining therapy deciding on withdrawal of life support is difficult and it is also difficult to decide who should participate in this decision. Methods We distributed a self-administered questionnaire in 13 adult intensive care units ICUs assessing the attitudes of physicians and nurses regarding end-of-life decisions. Family members from a medical-surgical ICU in a tertiary cancer hospital were also invited to participate. Questions were related to two hypothetical clinical scenarios one with a competent patient and the other with an incompetent patient asking whether the ventilator treatment should be withdrawn and about who should make this decision. Results Physicians 155 and nurses 204 of 12 ICUs agreed to take part in this study along with 300 family members. The vast majority of families 78.6 physicians 74.8 and nurses 75 want to discuss end-of-life decisions with competent patients. Most of the physicians and nurses desire family involvement in end-of-life decisions. Physicians are more likely to propose withdrawal of the ventilator with competent patients than with incompetent patients 74.8 X 60.7 P 0.028 . When the patient was incompetent physicians 34.8 were significantly less prone than nurses 23.0 and families 14.7 to propose decisions regarding withdrawal of the ventilator support P 0.001 . Conclusions Physicians nurses and families recommended limiting life-support therapy with terminally ill patients and favored family participation. In decisions .
