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DC Field | Value | Language |
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dc.contributor | Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP | - |
dc.contributor.author | FORTE, Daniel Neves | - |
dc.contributor.author | VINCENT, Jean Louis | - |
dc.contributor.author | VELASCO, Irineu Tadeu | - |
dc.contributor.author | PARK, Marcelo | - |
dc.date.accessioned | 2013-07-30T14:41:42Z | - |
dc.date.available | 2013-07-30T14:41:42Z | - |
dc.date.issued | 2012 | - |
dc.identifier.citation | INTENSIVE CARE MEDICINE, v.38, n.3, p.404-412, 2012 | - |
dc.identifier.issn | 0342-4642 | - |
dc.identifier.uri | https://observatorio.fm.usp.br/handle/OPI/415 | - |
dc.description.abstract | This study investigated the association between physician education in EOL and variability in EOL practice, as well as the differences between beliefs and practices regarding EOL in the ICU. Physicians from 11 ICUs at a university hospital completed a survey presenting a patient in a vegetative state with no family or advance directives. Questions addressed approaches to EOL care, as well physicians' personal, professional and EOL educational characteristics. The response rate was 89%, with 105 questionnaires analyzed. Mean age was 38 +/- A 8 years, with a mean of 14 +/- A 7 years since graduation. Physicians who did not apply do-not-resuscitate (DNR) orders were less likely to have attended EOL classes than those who applied written DNR orders [0/7 vs. 31/47, OR = 0.549 (0.356-0.848), P = 0.001]. Physicians who involved nurses in the decision-making process were more likely to be ICU specialists [17/22 vs. 46/83, OR = 4.1959 (1.271-13.845), P = 0.013] than physicians who made such decisions among themselves or referred to ethical or judicial committees. Physicians who would apply ""full code"" had less often read about EOL [3/22 vs. 11/20, OR = 0.0939 (0.012-0.710), P = 0.012] and had less interest in discussing EOL [17/22 vs. 20/20, OR = 0.210 (0.122-0.361), P < 0.001], than physicians who would withdraw life-sustaining therapies. Forty-four percent of respondents would not do what they believed was best for their patient, with 98% of them believing a less aggressive attitude preferable. Legal concerns were the leading cause for this dichotomy. Physician education about EOL is associated with variability in EOL decisions in the ICU. Moreover, actual practice may differ from what physicians believe is best for the patient. | - |
dc.language.iso | eng | - |
dc.publisher | SPRINGER | - |
dc.relation.ispartof | Intensive Care Medicine | - |
dc.rights | restrictedAccess | - |
dc.subject | EOL care | - |
dc.subject | Critical care | - |
dc.subject | Education | - |
dc.subject | Brazil | - |
dc.subject.other | end-of-life | - |
dc.subject.other | intensive-care | - |
dc.subject.other | decision-making | - |
dc.subject.other | palliative care | - |
dc.subject.other | unit | - |
dc.subject.other | attitudes | - |
dc.subject.other | withdrawal | - |
dc.subject.other | support | - |
dc.subject.other | nurses | - |
dc.subject.other | challenges | - |
dc.title | Association between education in EOL care and variability in EOL practice: a survey of ICU physicians | - |
dc.type | article | - |
dc.rights.holder | Copyright SPRINGER | - |
dc.identifier.doi | 10.1007/s00134-011-2400-4 | - |
dc.identifier.pmid | 22222566 | - |
dc.subject.wos | Critical Care Medicine | - |
dc.type.category | original article | - |
dc.type.version | publishedVersion | - |
hcfmusp.author.external | VINCENT, Jean Louis:Univ Libre Bruxelles, Dept Intens Care, Erasme Univ Hosp, Brussels, Belgium | - |
hcfmusp.description.beginpage | 404 | - |
hcfmusp.description.endpage | 412 | - |
hcfmusp.description.issue | 3 | - |
hcfmusp.description.volume | 38 | - |
hcfmusp.origem | WOS | - |
hcfmusp.origem.id | 2-s2.0-84862537232 | - |
hcfmusp.origem.id | WOS:000300776300007 | - |
hcfmusp.publisher.city | NEW YORK | - |
hcfmusp.publisher.country | USA | - |
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dc.description.index | MEDLINE | - |
hcfmusp.lim.ref | 2012 | - |
hcfmusp.citation.scopus | 53 | - |
hcfmusp.scopus.lastupdate | 2024-04-12 | - |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - FM/MCM Artigos e Materiais de Revistas Científicas - HC/ICHC Artigos e Materiais de Revistas Científicas - HC/InCor Artigos e Materiais de Revistas Científicas - LIM/51 |
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