title: Seriously ill hospitalized patients' perspectives on the benefits and harms of two models of hospital CPR discussions.
abstract: OBJECTIVE
  To describe seriously ill patients' perspectives on expert-endorsed approaches for hospital cardiopulmonary resuscitation (CPR) discussions.
  
  
  METHODS
  We created two videos depicting a hospital doctor discussing CPR with a seriously ill patient. One depicted a values-based approach with a doctor's recommendation, and one an information-focused approach without a recommendation. During semi-structured interviews, 20 seriously ill hospitalized patients viewed and commented on both videos. We conducted a thematic analysis to describe benefits and harms of specific discussion components.
  
  
  RESULTS
  Half of participants reported no preference between the videos; 35% preferred the information-focused, and 15% the values-based. Participants' reactions to the discussion components varied. They identified both benefits and harms with components in both videos, though most felt comfortable with all components (range, 60-65%) except for the doctor's recommendation in the values-based video. Only 40% would feel comfortable receiving a recommendation, while 65% would feel comfortable with the doctor eliciting their CPR preference as in the information-focused video, p=0.03.
  
  
  CONCLUSIONS
  Participants' reactions to expert-endorsed discussion components varied. Most would feel uncomfortable receiving a doctor's recommendation about CPR.
  
  
  CONCLUSIONS
  Participants' varied reactions suggest the need to tailor CPR discussions to individual patients. Many patients may find doctor's recommendations to be problematic.
authors.affiliation: Division of Hospital Medicine, University of California, San Francisco, USA; Palliative Care Program, University of California, San Francisco, USA; Department of Medicine, University of California, San Francisco, USA. Electronic address: Wendy.Anderson@ucsf.edu.
authors.forename: Wendy G
authors.initials: WG
authors.lastname: Anderson
authors.forename: Jenica W
authors.initials: JW
authors.lastname: Cimino
authors.forename: Bernard
authors.initials: B
authors.lastname: Lo
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation; D003142:Communication; D016638:Critical Illness; D003657:Decision Making; D005260:Female; D006760:Hospitalization; D006801:Humans; D007297:Inpatients; D008297:Male; D010358:Patient Participation; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D036301:Qualitative Research; D013637:Tape Recording
keywords: Communication; Decision making; Ethics; Hospital medicine