Development, validation, and results of a survey to measure understanding of cardiopulmonary resuscitation choices among ICU patients and their surrogate decision makers

Michael Wilson, Abbasali Akhoundi, Artur K. Krupa, Richard F. Hinds, John M. Litell, Ognjen Gajic, Kianoush Kashani

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Shared-decision-making about resuscitation goals of care for intensive care unit (ICU) patients depends on a basic understanding of cardiopulmonary resuscitation (CPR). Our objective was to develop and validate a survey to assess comprehension of CPR among ICU patients and surrogate decision-makers. Methods: We developed a 12-item verbally-administered survey incorporating input from patients, clinicians, and expert focus groups. Results: We administered the survey to 32 ICU patients and 37 surrogates, as well as to 20 resident physicians to test discriminative validity. Median (interquartile range) total knowledge scores were 7 (5-10) for patients, 9 (7-12) for surrogates, and 14.5 (14-15) for physicians (p <.001). Forty-four percent of patients and 24% of surrogates could not explain the purpose of CPR. Eighty-eight percent of patients and 73% of surrogates could not name chest compressions and breathing assistance as two components of CPR in the hospital. Forty-one percent of patients and 24% of surrogates could not name a single possible complication of CPR. Forty-three percent of participants could not specify that CPR would be performed with a full code order and 25% of participants could not specify that CPR would not be performed with a do-not-resuscitate order. Internal consistency (Cronbach's alpha = 0.97) and test-retest reliability (Pearson correlation = 0.96, p < .001) were high. Conclusions: This easily administered survey, developed to measure knowledge of CPR and resuscitation preference options among ICU patients and surrogates, showed strong face validity, content validity, internal consistency, test-retest reliability, and discriminative validity. A substantial proportion of ICU patients and surrogates decision-makers have poor knowledge of CPR and basic resuscitation options.

Original languageEnglish (US)
Article number15
JournalBMC Anesthesiology
Volume14
DOIs
StatePublished - Mar 8 2014

Fingerprint

Cardiopulmonary Resuscitation
Intensive Care Units
Reproducibility of Results
Resuscitation
Names
Surveys and Questionnaires
Resuscitation Orders
Patient Care Planning
Physicians
Focus Groups
Decision Making
Respiration
Thorax

Keywords

  • Cardiopulmonary resuscitation
  • Health knowledge
  • Intensive care unit
  • Questionnaires

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Development, validation, and results of a survey to measure understanding of cardiopulmonary resuscitation choices among ICU patients and their surrogate decision makers. / Wilson, Michael; Akhoundi, Abbasali; Krupa, Artur K.; Hinds, Richard F.; Litell, John M.; Gajic, Ognjen; Kashani, Kianoush.

In: BMC Anesthesiology, Vol. 14, 15, 08.03.2014.

Research output: Contribution to journalArticle

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abstract = "Background: Shared-decision-making about resuscitation goals of care for intensive care unit (ICU) patients depends on a basic understanding of cardiopulmonary resuscitation (CPR). Our objective was to develop and validate a survey to assess comprehension of CPR among ICU patients and surrogate decision-makers. Methods: We developed a 12-item verbally-administered survey incorporating input from patients, clinicians, and expert focus groups. Results: We administered the survey to 32 ICU patients and 37 surrogates, as well as to 20 resident physicians to test discriminative validity. Median (interquartile range) total knowledge scores were 7 (5-10) for patients, 9 (7-12) for surrogates, and 14.5 (14-15) for physicians (p <.001). Forty-four percent of patients and 24{\%} of surrogates could not explain the purpose of CPR. Eighty-eight percent of patients and 73{\%} of surrogates could not name chest compressions and breathing assistance as two components of CPR in the hospital. Forty-one percent of patients and 24{\%} of surrogates could not name a single possible complication of CPR. Forty-three percent of participants could not specify that CPR would be performed with a full code order and 25{\%} of participants could not specify that CPR would not be performed with a do-not-resuscitate order. Internal consistency (Cronbach's alpha = 0.97) and test-retest reliability (Pearson correlation = 0.96, p < .001) were high. Conclusions: This easily administered survey, developed to measure knowledge of CPR and resuscitation preference options among ICU patients and surrogates, showed strong face validity, content validity, internal consistency, test-retest reliability, and discriminative validity. A substantial proportion of ICU patients and surrogates decision-makers have poor knowledge of CPR and basic resuscitation options.",
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AU - Wilson, Michael

AU - Akhoundi, Abbasali

AU - Krupa, Artur K.

AU - Hinds, Richard F.

AU - Litell, John M.

AU - Gajic, Ognjen

AU - Kashani, Kianoush

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N2 - Background: Shared-decision-making about resuscitation goals of care for intensive care unit (ICU) patients depends on a basic understanding of cardiopulmonary resuscitation (CPR). Our objective was to develop and validate a survey to assess comprehension of CPR among ICU patients and surrogate decision-makers. Methods: We developed a 12-item verbally-administered survey incorporating input from patients, clinicians, and expert focus groups. Results: We administered the survey to 32 ICU patients and 37 surrogates, as well as to 20 resident physicians to test discriminative validity. Median (interquartile range) total knowledge scores were 7 (5-10) for patients, 9 (7-12) for surrogates, and 14.5 (14-15) for physicians (p <.001). Forty-four percent of patients and 24% of surrogates could not explain the purpose of CPR. Eighty-eight percent of patients and 73% of surrogates could not name chest compressions and breathing assistance as two components of CPR in the hospital. Forty-one percent of patients and 24% of surrogates could not name a single possible complication of CPR. Forty-three percent of participants could not specify that CPR would be performed with a full code order and 25% of participants could not specify that CPR would not be performed with a do-not-resuscitate order. Internal consistency (Cronbach's alpha = 0.97) and test-retest reliability (Pearson correlation = 0.96, p < .001) were high. Conclusions: This easily administered survey, developed to measure knowledge of CPR and resuscitation preference options among ICU patients and surrogates, showed strong face validity, content validity, internal consistency, test-retest reliability, and discriminative validity. A substantial proportion of ICU patients and surrogates decision-makers have poor knowledge of CPR and basic resuscitation options.

AB - Background: Shared-decision-making about resuscitation goals of care for intensive care unit (ICU) patients depends on a basic understanding of cardiopulmonary resuscitation (CPR). Our objective was to develop and validate a survey to assess comprehension of CPR among ICU patients and surrogate decision-makers. Methods: We developed a 12-item verbally-administered survey incorporating input from patients, clinicians, and expert focus groups. Results: We administered the survey to 32 ICU patients and 37 surrogates, as well as to 20 resident physicians to test discriminative validity. Median (interquartile range) total knowledge scores were 7 (5-10) for patients, 9 (7-12) for surrogates, and 14.5 (14-15) for physicians (p <.001). Forty-four percent of patients and 24% of surrogates could not explain the purpose of CPR. Eighty-eight percent of patients and 73% of surrogates could not name chest compressions and breathing assistance as two components of CPR in the hospital. Forty-one percent of patients and 24% of surrogates could not name a single possible complication of CPR. Forty-three percent of participants could not specify that CPR would be performed with a full code order and 25% of participants could not specify that CPR would not be performed with a do-not-resuscitate order. Internal consistency (Cronbach's alpha = 0.97) and test-retest reliability (Pearson correlation = 0.96, p < .001) were high. Conclusions: This easily administered survey, developed to measure knowledge of CPR and resuscitation preference options among ICU patients and surrogates, showed strong face validity, content validity, internal consistency, test-retest reliability, and discriminative validity. A substantial proportion of ICU patients and surrogates decision-makers have poor knowledge of CPR and basic resuscitation options.

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