ICU Admission Preferences in the Hypothetical Event of Acute Critical Illness: A Survey of Very Old Norwegians and Their Next-of-Kins
OBJECTIVES:. To explore older patients’ ICU admission preferences and their next-of-kins’ ability to predict these preferences. DESIGN:. Self-administered survey. SETTING:. Three outpatient clinics, urban tertiary teaching hospital, Norway. PATIENTS:. Purposive sample of outpatients 80 years old or...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2024-12-01
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| Series: | Critical Care Explorations |
| Online Access: | http://journals.lww.com/10.1097/CCE.0000000000001185 |
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| author | Gabriele Leonie Schwarz, MD Elisabeth Skaar, MD, PhD Ingrid Miljeteig, MD, PhD Karl Ove Hufthammer, PhD Karen E. A. Burns, MD, MSc, FRCPC Reidar Kvåle, MD, PhD Hans Flaatten, MD, PhD Margrethe A. Schaufel, MD, PhD |
| author_facet | Gabriele Leonie Schwarz, MD Elisabeth Skaar, MD, PhD Ingrid Miljeteig, MD, PhD Karl Ove Hufthammer, PhD Karen E. A. Burns, MD, MSc, FRCPC Reidar Kvåle, MD, PhD Hans Flaatten, MD, PhD Margrethe A. Schaufel, MD, PhD |
| author_sort | Gabriele Leonie Schwarz, MD |
| collection | DOAJ |
| description | OBJECTIVES:. To explore older patients’ ICU admission preferences and their next-of-kins’ ability to predict these preferences.
DESIGN:. Self-administered survey.
SETTING:. Three outpatient clinics, urban tertiary teaching hospital, Norway.
PATIENTS:. Purposive sample of outpatients 80 years old or older regarded as potential ICU candidates and their next-of-kins.
INTERVENTIONS:. None.
MEASUREMENTS AND MAIN RESULTS:. We asked about the patients’ ICU admission preferences in three hypothetical scenarios of acute critical illness. Next-of-kin respondents were asked to make a proxy statement regarding the older respondents’ wishes regarding ICU admission. For each treatment choice, all respondents could provide their level of confidence. Additionally, we sought to identify demographic and healthcare-related characteristics that potentially influenced ICU admission preferences and proxy accuracy. Of 202 outpatients 80 years old or older, equal proportions opted for (39%; CI, 33–45%) and against (40%; CI, 34–46%) ICU admission, and one in five (21%; CI, 17–26%) did not wish to engage decision-making. Male gender, religiosity, and prior ICU experience increased the likelihood of older respondents opting for ICU admission. Although next-of-kins’ proxy statements only weakly agreed with the older respondents’ true ICU admission preferences (52%; CI, 45–59%), they agreed with the next-of-kins’ own ICU admission preferences (79%; CI, 73–84%) to a significantly higher degree. Decisional confidence was high for both the older and the next-of-kin respondents.
CONCLUSIONS:. In this purposive sample of Norwegian potential ICU candidates 80 years old or older, we found substantial variation in the ICU admission preferences of very old patients. The next-of-kins’ proxy statements did not align with the ICU admission preferences of the older respondents in half of the pairs, but next-of-kins’ and older respondents’ confidence levels in rendering these judgments were high. |
| format | Article |
| id | doaj-art-142bb49a8d5e46b7b195b923797837b7 |
| institution | Kabale University |
| issn | 2639-8028 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Critical Care Explorations |
| spelling | doaj-art-142bb49a8d5e46b7b195b923797837b72024-12-24T09:46:07ZengWolters KluwerCritical Care Explorations2639-80282024-12-01612e118510.1097/CCE.0000000000001185202412000-00007ICU Admission Preferences in the Hypothetical Event of Acute Critical Illness: A Survey of Very Old Norwegians and Their Next-of-KinsGabriele Leonie Schwarz, MD0Elisabeth Skaar, MD, PhD1Ingrid Miljeteig, MD, PhD2Karl Ove Hufthammer, PhD3Karen E. A. Burns, MD, MSc, FRCPC4Reidar Kvåle, MD, PhD5Hans Flaatten, MD, PhD6Margrethe A. Schaufel, MD, PhD71 Department of Surgical Services, Haukeland University Hospital, Bergen, Norway.3 Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.5 Bergen Centre for Ethics and Priority Setting, University of Bergen, Bergen, Norway.7 Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway.6 Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.1 Department of Surgical Services, Haukeland University Hospital, Bergen, Norway.2 Department of Clinical Medicine, University of Bergen, Bergen, Norway.2 Department of Clinical Medicine, University of Bergen, Bergen, Norway.OBJECTIVES:. To explore older patients’ ICU admission preferences and their next-of-kins’ ability to predict these preferences. DESIGN:. Self-administered survey. SETTING:. Three outpatient clinics, urban tertiary teaching hospital, Norway. PATIENTS:. Purposive sample of outpatients 80 years old or older regarded as potential ICU candidates and their next-of-kins. INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. We asked about the patients’ ICU admission preferences in three hypothetical scenarios of acute critical illness. Next-of-kin respondents were asked to make a proxy statement regarding the older respondents’ wishes regarding ICU admission. For each treatment choice, all respondents could provide their level of confidence. Additionally, we sought to identify demographic and healthcare-related characteristics that potentially influenced ICU admission preferences and proxy accuracy. Of 202 outpatients 80 years old or older, equal proportions opted for (39%; CI, 33–45%) and against (40%; CI, 34–46%) ICU admission, and one in five (21%; CI, 17–26%) did not wish to engage decision-making. Male gender, religiosity, and prior ICU experience increased the likelihood of older respondents opting for ICU admission. Although next-of-kins’ proxy statements only weakly agreed with the older respondents’ true ICU admission preferences (52%; CI, 45–59%), they agreed with the next-of-kins’ own ICU admission preferences (79%; CI, 73–84%) to a significantly higher degree. Decisional confidence was high for both the older and the next-of-kin respondents. CONCLUSIONS:. In this purposive sample of Norwegian potential ICU candidates 80 years old or older, we found substantial variation in the ICU admission preferences of very old patients. The next-of-kins’ proxy statements did not align with the ICU admission preferences of the older respondents in half of the pairs, but next-of-kins’ and older respondents’ confidence levels in rendering these judgments were high.http://journals.lww.com/10.1097/CCE.0000000000001185 |
| spellingShingle | Gabriele Leonie Schwarz, MD Elisabeth Skaar, MD, PhD Ingrid Miljeteig, MD, PhD Karl Ove Hufthammer, PhD Karen E. A. Burns, MD, MSc, FRCPC Reidar Kvåle, MD, PhD Hans Flaatten, MD, PhD Margrethe A. Schaufel, MD, PhD ICU Admission Preferences in the Hypothetical Event of Acute Critical Illness: A Survey of Very Old Norwegians and Their Next-of-Kins Critical Care Explorations |
| title | ICU Admission Preferences in the Hypothetical Event of Acute Critical Illness: A Survey of Very Old Norwegians and Their Next-of-Kins |
| title_full | ICU Admission Preferences in the Hypothetical Event of Acute Critical Illness: A Survey of Very Old Norwegians and Their Next-of-Kins |
| title_fullStr | ICU Admission Preferences in the Hypothetical Event of Acute Critical Illness: A Survey of Very Old Norwegians and Their Next-of-Kins |
| title_full_unstemmed | ICU Admission Preferences in the Hypothetical Event of Acute Critical Illness: A Survey of Very Old Norwegians and Their Next-of-Kins |
| title_short | ICU Admission Preferences in the Hypothetical Event of Acute Critical Illness: A Survey of Very Old Norwegians and Their Next-of-Kins |
| title_sort | icu admission preferences in the hypothetical event of acute critical illness a survey of very old norwegians and their next of kins |
| url | http://journals.lww.com/10.1097/CCE.0000000000001185 |
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