DNACPR Decisions: Perceptions of older patients and their families
Research type
Research Study
Full title
Understanding and perceptions of older people and their carers of Do Not Attempt Cardio-pulmonary Resuscitation decisions: A mixed methods observational study.
IRAS ID
185953
Contact name
Laura Pearson
Contact email
Sponsor organisation
University Hospital Birmingham
Duration of Study in the UK
0 years, 6 months, 1 days
Research summary
Do not attempt cardiopulmonary resuscitation (DNACPR) decisions are part of everyday practice for doctors working with older people. However, the associated discussions with patients and their relatives are often suboptimal. This can lead to unnecessary distress, which can lead to conflict when implementing DNACPR orders and in turn, negatively impact on the doctor-patient relationship.
AIMS
To establish the understanding of older patients and their relatives with regards to DNACPR decisions, specifically:
1. What is their knowledge of the meaning of resuscitation and DNACPR orders?
2. What do they perceive to be the implications of such decisions?
3. What factors do they feel are important in making and communicating these decisions?
4. What are their previous experiences regarding DNACPR decisions?
5. Do patient options and knowledge of DNACPR vary according to their self-reported quality of life?METHODS
This research will be conducted at University Hospitals Birmingham enrolling both inpatients over the age of 65 years (during their period of convalescence), and relatives of these patients. Data will be collected over 6-8 months using a mixed methods approach (questionnaires and semi-structured interviews). All participants will be asked to complete a questionnaire, and a smaller cohort (15-20 participants) will undertake the interview. Data will relate to 4 main themes: Knowledge/understanding of DNACPR decisions, personal feelings about DNACPR decisions and discussions, previous experiences of DNACPR discussions and quality of life.EXPECTED OUTCOMES/BENEFITS
Gaining a greater appreciation of what older patients and their relatives understand by resuscitation and DNACPR decisions will help physicians tailor discussions to ensure that they provide the information needed for them to comprehend why and how such decisions are being made. Furthermore, it will inform physicians how to improve the way in which the decisions are communicated, which should help to alleviate distress and fear. In addition, the findings could help shape formal training programmes in advance care planning discussions.REC name
West Midlands - South Birmingham Research Ethics Committee
REC reference
17/WM/0091
Date of REC Opinion
18 Apr 2017
REC opinion
Further Information Favourable Opinion