Menu
×
Folly Beach Library
9 a.m. - 1 p.m.
Phone: (843) 588-2001
Edgar Allan Poe/Sullivan's Island Library
Closed for renovations
Phone: (843) 883-3914
West Ashley Library
9 a.m. - 4 p.m.
Phone: (843) 766-6635
Wando Mount Pleasant Library
9 a.m. - 6 p.m.
Phone: (843) 805-6888
Village Library
9 a.m. - 6 p.m.
Phone: (843) 884-9741
St. Paul's/Hollywood Library
9 a.m. - 6 p.m.
Phone: (843) 889-3300
Otranto Road Library
9 a.m. - 6 p.m.
Phone: (843) 572-4094
Mt. Pleasant Library
9 a.m. – 6 p.m.
Phone: (843) 849-6161
McClellanville Library
9 a.m. - 1 p.m.
Phone: (843) 887-3699
Keith Summey North Charleston Library
9 a.m. – 6 p.m.
Phone: (843) 744-2489
John's Island Library
9 a.m. - 6 p.m.
Phone: (843) 559-1945
Hurd/St. Andrews Library
9 a.m. - 6 p.m.
Phone: (843) 766-2546
Miss Jane's Building (Edisto Library Temporary Location)
9 a.m. – 3 p.m.
Phone: (843) 869-2355
Dorchester Road Library
9 a.m. - 6 p.m.
Phone: (843) 552-6466
John L. Dart Library
9 a.m. - 6 p.m.
Phone: (843) 722-7550
Baxter-Patrick James Island
9 a.m. - 6 p.m.
Phone: (843) 795-6679
Main Library
9 a.m. - 6 p.m.
Phone: (843) 805-6930
Bees Ferry West Ashley Library
9 a.m. - 6 p.m.
Phone: (843) 805-6892
Mobile Library
9 a.m. - 5 p.m.
Phone: (843) 805-6909
Today's Hours
Folly Beach Library
9 a.m. - 1 p.m.
Phone: (843) 588-2001
Edgar Allan Poe/Sullivan's Island Library
Closed for renovations
Phone: (843) 883-3914
West Ashley Library
9 a.m. - 4 p.m.
Phone: (843) 766-6635
Wando Mount Pleasant Library
9 a.m. - 6 p.m.
Phone: (843) 805-6888
Village Library
9 a.m. - 6 p.m.
Phone: (843) 884-9741
St. Paul's/Hollywood Library
9 a.m. - 6 p.m.
Phone: (843) 889-3300
Otranto Road Library
9 a.m. - 6 p.m.
Phone: (843) 572-4094
Mt. Pleasant Library
9 a.m. – 6 p.m.
Phone: (843) 849-6161
McClellanville Library
9 a.m. - 1 p.m.
Phone: (843) 887-3699
Keith Summey North Charleston Library
9 a.m. – 6 p.m.
Phone: (843) 744-2489
John's Island Library
9 a.m. - 6 p.m.
Phone: (843) 559-1945
Hurd/St. Andrews Library
9 a.m. - 6 p.m.
Phone: (843) 766-2546
Miss Jane's Building (Edisto Library Temporary Location)
9 a.m. – 3 p.m.
Phone: (843) 869-2355
Dorchester Road Library
9 a.m. - 6 p.m.
Phone: (843) 552-6466
John L. Dart Library
9 a.m. - 6 p.m.
Phone: (843) 722-7550
Baxter-Patrick James Island
9 a.m. - 6 p.m.
Phone: (843) 795-6679
Main Library
9 a.m. - 6 p.m.
Phone: (843) 805-6930
Bees Ferry West Ashley Library
9 a.m. - 6 p.m.
Phone: (843) 805-6892
Mobile Library
9 a.m. - 5 p.m.
Phone: (843) 805-6909
Patron Login
menu
Item request has been placed!
×
Item request cannot be made.
×
![loading](/sites/all/modules/hf_eds/images/loading.gif)
Prevalence of and Factors Related to Discordance About Prognosis Between Physicians and Surrogate Decision Makers of Critically Ill Patients.
Item request has been placed!
×
Item request cannot be made.
×
![loading](/sites/all/modules/hf_eds/images/loading.gif)
- Author(s): White, Douglas B.; Ernecoff, Natalie; Praewpannarai Buddadhumaruk; Seoyeon Hong; Weissfeld, Lisa; Curtis, J. Randall; Luce, John M.; Lo, Bernard; Buddadhumaruk, Praewpannarai; Hong, Seoyeon
- Source:
JAMA: Journal of the American Medical Association; 5/17/2016, Vol. 315 Issue 19, p2086-2094, 9p- Subject Terms:
ATTITUDE (Psychology); CATASTROPHIC illness; COMPARATIVE studies; CONFLICT (Psychology); CULTURE; DECISION making; GUARDIAN & ward; INTENSIVE care units; RESEARCH methodology; MEDICAL cooperation; PHYSICIANS; PROBABILITY theory; PROGNOSIS; READABILITY (Literary style); RESEARCH; TERMINAL care; QUALITATIVE research; EVALUATION research - Source:
- Additional Information
- Abstract:
Importance: Misperceptions about prognosis by individuals making decisions for incapacitated critically ill patients (surrogates) are common and often attributed to poor comprehension of medical information.Objective: To determine the prevalence of and factors related to physician-surrogate discordance about prognosis in intensive care units (ICUs).Design, Setting, and Participants: Mixed-methods study comprising quantitative surveys and qualitative interviews conducted in 4 ICUs at a major US medical center involving surrogate decision makers and physicians caring for patients at high risk of death from January 4, 2005, to July 10, 2009.Main Outcomes and Measures: Discordance about prognosis, defined as a difference between a physician's and a surrogate's prognostic estimates of at least 20%; misunderstandings by surrogates (defined as any difference between a physician's prognostic estimate and a surrogate's best guess of that estimate); differences in belief (any difference between a surrogate's actual estimate and their best guess of the physician's estimate).Results: Two hundred twenty-nine surrogate decision makers (median age, 47 [interquartile range {IQR}, 35-56] years; 68% women) and 99 physicians were involved in the care of 174 critically ill patients (median age, 60 [IQR, 47-74] years; 44% women). Physician-surrogate discordance about prognosis occurred in 122 of 229 instances (53%; 95% CI, 46.8%-59.7%). In 65 instances (28%), discordance was related to both misunderstandings by surrogates and differences in belief about the patient's prognosis; 38 (17%) were related to misunderstandings by surrogates only; 7 (3%) were related to differences in belief only; and data were missing for 12. Seventy-five patients (43%) died. Surrogates' prognostic estimates were much more accurate than chance alone, but physicians' prognostic estimates were statistically significantly more accurate than surrogates' (C statistic, 0.83 vs 0.74; absolute difference, 0.094; 95% CI, 0.024-0.163; P = .008). Among 71 surrogates interviewed who had beliefs about the prognosis that were more optimistic than that of the physician, the most common reasons for optimism were a need to maintain hope to benefit the patient (n = 34), a belief that the patient had unique strengths unknown to the physician (n = 24), and religious belief (n = 19).Conclusions and Relevance: Among critically ill patients, discordant expectations about prognosis were common between patients' physicians and surrogate decision makers and were related to misunderstandings by surrogates about physicians' assessments of patients' prognoses and differences in beliefs about patients' prognoses. [ABSTRACT FROM AUTHOR] - Abstract: Copyright of JAMA: Journal of the American Medical Association is the property of American Medical Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Abstract:
Contact CCPL
Copyright 2022 Charleston County Public Library Powered By EBSCO Stacks 3.3.0 [350.3] | Staff Login
No Comments.