Patients' preferences for intensive care.
OBJECTIVE
To determine patients' preferences for intensive care and to evaluate the influence of a recent ICU experience on preferences for future ICU treatment.


METHODS
Survey of nonrandomized patient sample using structured interviews.


METHODS
Large, urban, tertiary academic medical center.


METHODS
Eighty-four adult inpatients discharged from the medical ICU between June and August 1990.


METHODS
Agreement with life-supportive care under each of four potential outcome scenarios was assessed on a 5-point scale. An overall preference score was created by summing scores for the four items. Patients were also asked about their recent experiences in the ICU.


RESULTS
Patients identified sources of stress associated with their ICU stay, yet most (76%) rated their ICU experience positively. Preferences for future intensive care varied with perceived outcome, and were strongest for health restoration and weakest for persistent vegetative states. No significant relationships were found between ICU preferences and any demographic or clinical variable except race.


CONCLUSIONS
Patients tolerate intensive care well and desire it to restore health. Most patients modify their desire for intensive care if less favorable outcomes are likely. Patients' preferences for intensive care cannot be predicted from demographic features or previous ICU experiences.
Elpern
E H
EH
Department of Medicine, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL.
Patterson
P A
PA
Gloskey
D
D
Bone
R C
RC
D000046:Academic Medical Centers; D001294:Attitude to Health; D002641:Chicago / Q000453:epidemiology; D002755:Choice Behavior; D003422:Critical Care / Q000523:psychology* / Q000592:standards; D005260:Female; D006302:Health Services Research; D006801:Humans; D008020:Life Support Care / Q000523:psychology; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care; D010358:Patient Participation; D017060:Patient Satisfaction; D018570:Risk Assessment; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires