Table 4 Effectiveness of the Decision Aid
From: Evaluation of the CPR video decision aid with patients with end stage renal disease
Outcome | Patient n = 49 | Family n = 8 | ||||
|---|---|---|---|---|---|---|
Pre | Post | p-value | Pre | Post | p-value | |
CPR test questions n (%) correct answers | ||||||
1. When the heart stops beating, brain death will occur in: several minutes. | 23 (47%) | 40 (81%) | 5 (63%) | 6 (75%) | ||
2. CPR includes the following treatments: pressing hard and fast on the breastbone to pump blood through the heart to the body. | 39 (80%) | 46 (94%) | 7 (88%) | 8 (100%) | ||
3. If CPR is successful and the heart restarts the person: usually needs a machine to help with breathing, medicines, and fluids while trying to recover in ICU (Intensive Care Unit). | 18 (37%) | 39 (80%) | 1 (13%) | 6 (75%) | ||
4. The most serious possible harm from the heart stopping and needing to have CPR is: severe brain damage from lack of oxygen | 32 (65%) | 42 (86%) | 4 (50%) | 8 (100%) | ||
5. When CPR is effective it will: restart the heart but have absolutely no effect on other medical conditions. | 25 (51%) | 39 (80%) | 8 (100%) | 8 (100%) | ||
6. If 100 people have a chronic condition (heart failure, kidney failure, chronic lung disease) and their heart stops, how many will survive CPR and recover well enough to leave the hospital?: very few people (10 out of 100). | 15 (31%) | 43 (88%) | 3 (38%) | 8 (100%) | ||
7. If the patient decides NOT to have CPR: they can receive treatments to relieve suffering AND for other medical conditions if wanted. | 25 (51%) | 43 (88%) | 6 (75%) | 7 (88%) | ||
8. The healthcare team wants to talk to hospitalized patients about the CPR decision because: the right decision about CPR depends on what is most important to the individual patient in addition to the patient’s medical conditions. | 28 (57%) | 43 (88%) | 5 (63%) | 7 (88%) | ||
9. Of all the people who survive CPR, how many will have severe brain damage?: a few survivors. | 30 (61%) | 34 (69%) | 5 (63%) | 7 (88%) | ||
Knowledge (out of 9) M (range, SD) | 4.8 (0–8, 1.65) | 7.5 (4–9, 1.40) | 0.000 | 5.6 (4–7, 1.31) | 8.1 (6–9, 0.99) | 0.000 |
Decisional Self-Efficacy (0 = extremely low; 100 = extremely high) M (range, SD) | 84 (20–100, 17.04) | 86 (39–100, 14.13) | 0.005 | 86 (52–100, 15.98) | 92 (77–100, 8.23) | 0.203 |
Certainty | ||||||
Decisional conflict scale (0 = no conflict; 100 = high conflict) M(range, SD) | 13.57 (0–70, 18.34) | 1.25 (0–10, 3.54) | ||||
SURE n (%) | ||||||
4 (no decisional conflict) | 36 (72%) | |||||
3 | 6 (12%) | |||||
2 | 3 (6%) | |||||
1 | 3 (6%) | |||||
0 (high decisional conflict) | 2 (4%) | |||||
Preference n (%) | ||||||
Have CPR | 28 (57%) | |||||
No CPR | 13 (27%) | |||||
Unsure | 8 (16%) | |||||
Physician Order n (%) | ||||||
Have CPR = 1 | 43 (86%) | 36 (72%) | ||||
No CPR = 2 | 7 (14%) | 14 (28%) | ||||
M (range, SD) | 1.14 (1–2, 0.35) | 1.28 (1–2, 0.45) | 0.007 | |||
Observation of 50 single interactions between each patient/family and physician | ||||||
OPTION (score out of 48) M (range, SD) | 25.66 (9–47, 7.41) | |||||
Physician Exit Survey | ||||||
Relevance of the CPR decision for my patient M (range, SD) (Not relevant 0-1-2-3-4 Very relevant) | 3.60 (2–4, 0.53) | |||||
Satisfaction felt with discussion about CPR with patient M (range, SD) (Not at all 0-1-2-3-4 Completely) | 3.18 (1–4, 0.79) | |||||
Overall experience with the CPR discussion M (range, SD) (Very easy 0-1-2-3-4 Very Difficult) | 0.80 (0–3, 0.80) | |||||