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Development, validation, and results of a survey to measure understanding of cardiopulmonary resuscitation choices among ICU patients and their surrogate decision makers Wilson ME; Akhoundi A; Krupa AK; Hinds RF; Litell JM; Gajic O; Kashani KBMC Anesthesiol 2014[Mar]; 14 (ä): 15BACKGROUND: 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.|Adult[MESH]|Aged[MESH]|Cardiopulmonary Resuscitation/methods/*psychology[MESH]|Choice Behavior[MESH]|Comprehension[MESH]|Data Collection/*standards[MESH]|Decision Making[MESH]|Female[MESH]|Humans[MESH]|Intensive Care Units/*standards[MESH]|Male[MESH]|Middle Aged[MESH]|Patient Participation/methods/*psychology[MESH]|Proxy/*psychology[MESH]|Resuscitation Orders/*psychology[MESH] |
