title: Specialist physician approaches to discussing cardiopulmonary resuscitation for frail older adults: a qualitative study.
abstract: BACKGROUND
  Despite the impact and importance of end-of-life discussions, little is known about how physicians discuss cardiopulmonary resuscitation (CPR) with patients and their families. The necessary components for successful communication about CPR are poorly understood and an established framework to structure these conversations is lacking. Here, we were motivated to understand how physicians approach resuscitation planning with families when older patients have limited life expectancy and a high burden of illness.
  
  
  METHODS
  Qualitative analysis was conducted of semi-structured interviews of 28 physicians of varying medical sub-specialties in a tertiary care hospital.
  
  
  RESULTS
  Most physicians explored the surrogates' goals and values, but few provided explicit information about the patients' overall health status or expected long-term health outcome related to CPR and underlying illnesses.
  
  
  CONCLUSIONS
  There is considerable heterogeneity in physicians' approaches to CPR discussions. The principle of autonomy is dominant with less emphasis on providing adequate information for effective decision-making.
authors.affiliation: Centre for Health Care of the Elderly, Queen Elizabeth II Health Sciences Centre, 5955 Veterans' Memorial Lane, Ste. 2650, Halifax, Nova Scotia, Canada B3H 2E1. laurie.mallery@cdha.nshealth.ca
authors.forename: Laurie
authors.initials: L
authors.lastname: Mallery
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Hubbard
authors.forename: Paige
authors.initials: P
authors.lastname: Moorhouse
authors.forename: Katalin
authors.initials: K
authors.lastname: Koller
authors.forename: Eamonn M P
authors.initials: EM
authors.lastname: Eeles
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation; D003657:Decision Making; D005260:Female; D016330:Frail Elderly; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008511:Medicine; D011368:Professional-Family Relations; D036301:Qualitative Research