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Article: Questionnaire survey on medical futility and termination of resuscitation in cardiac arrest patients among emergency physicians in Hong Kong

TitleQuestionnaire survey on medical futility and termination of resuscitation in cardiac arrest patients among emergency physicians in Hong Kong
有關香港急症科醫生對心搏停止病人的無效醫療和停止搶救概念的問卷調查
Authors
KeywordsCardiopulmonary resuscitation
Health knowledge
attitudes
practice
Heart arrest
Issue Date2019
PublisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org/
Citation
Hong Kong Medical Journal, 2019, v. 25 n. 3, p. 183-191 How to Cite?
AbstractIntroduction: The perceptions of medical futility and decisions about termination of resuscitation (TOR) for out-of-hospital cardiac arrest (OHCA) are highly heterogeneous and dependent on the practice of the attending emergency physicians. The objective of this study was to report and investig ate the knowledge, attitudes, and practices regarding medical futility and TOR during management of OHCA in Hong Kong. Methods: A cross-sectional survey was conducted among emergency medicine physicians in Hong Kong. The questionnaire assessed participants’ background, knowledge, attitudes, and behaviours concerning medical futility and TOR in management of OHCA. Composite scores were calculated to reflect knowledge, attitudes, and practices of OHCA treatment. Subgroup analysis and multiple regression analysis were used to explore the relationship between participants’ background, knowledge, attitudes, and behaviours. Results: The response rate to this survey was 57% (140/247). Independent predictors of less aggressive resuscitation in OHCA patients included status as a Fellow of the Hong Kong College of Emergency Medicine (β= -0.314, P=0.028) and being an Advanced Cardiac Life Support instructor (β= -0.217, P=0.032). There was no difference in aggressiveness of resuscitation in terms of years of clinical experience (β=0.015, P=0.921), knowledge of TOR (β=0.057, P=0.509), or attitudes about TOR (β= -0.103, P=0.214). The correlation between knowledge and attitudes was low (Spearman’s coefficient=0.02, P=0.795). Conclusion: Clinical practice and behaviour of TOR was not demonstrated to have associations with knowledge or attitude. Status as a Fellow of the Hong Kong College of Emergency Medicine or Advanced Cardiac Life Support instructor were the only two parameters identified that had significant relationships with earlier TOR in medically futile patients with OHCA.
Persistent Identifierhttp://hdl.handle.net/10722/277252
ISSN
2017 Impact Factor: 1.226
2015 SCImago Journal Rankings: 0.279

 

DC FieldValueLanguage
dc.contributor.authorSo, CW-
dc.contributor.authorLui, CT-
dc.contributor.authorTsui, KL-
dc.contributor.authorChan, KL-
dc.contributor.authorLaw, AKK-
dc.contributor.authorWong, YK-
dc.contributor.authorLi, T-
dc.contributor.authorWong, CL-
dc.contributor.authorLeung, SC-
dc.date.accessioned2019-09-20T08:47:30Z-
dc.date.available2019-09-20T08:47:30Z-
dc.date.issued2019-
dc.identifier.citationHong Kong Medical Journal, 2019, v. 25 n. 3, p. 183-191-
dc.identifier.issn1024-2708-
dc.identifier.urihttp://hdl.handle.net/10722/277252-
dc.description.abstractIntroduction: The perceptions of medical futility and decisions about termination of resuscitation (TOR) for out-of-hospital cardiac arrest (OHCA) are highly heterogeneous and dependent on the practice of the attending emergency physicians. The objective of this study was to report and investig ate the knowledge, attitudes, and practices regarding medical futility and TOR during management of OHCA in Hong Kong. Methods: A cross-sectional survey was conducted among emergency medicine physicians in Hong Kong. The questionnaire assessed participants’ background, knowledge, attitudes, and behaviours concerning medical futility and TOR in management of OHCA. Composite scores were calculated to reflect knowledge, attitudes, and practices of OHCA treatment. Subgroup analysis and multiple regression analysis were used to explore the relationship between participants’ background, knowledge, attitudes, and behaviours. Results: The response rate to this survey was 57% (140/247). Independent predictors of less aggressive resuscitation in OHCA patients included status as a Fellow of the Hong Kong College of Emergency Medicine (β= -0.314, P=0.028) and being an Advanced Cardiac Life Support instructor (β= -0.217, P=0.032). There was no difference in aggressiveness of resuscitation in terms of years of clinical experience (β=0.015, P=0.921), knowledge of TOR (β=0.057, P=0.509), or attitudes about TOR (β= -0.103, P=0.214). The correlation between knowledge and attitudes was low (Spearman’s coefficient=0.02, P=0.795). Conclusion: Clinical practice and behaviour of TOR was not demonstrated to have associations with knowledge or attitude. Status as a Fellow of the Hong Kong College of Emergency Medicine or Advanced Cardiac Life Support instructor were the only two parameters identified that had significant relationships with earlier TOR in medically futile patients with OHCA.-
dc.languageeng-
dc.publisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org/-
dc.relation.ispartofHong Kong Medical Journal = 香港醫學雜誌-
dc.rightsHong Kong Medical Journal. Copyright © Hong Kong Academy of Medicine Press.-
dc.subjectCardiopulmonary resuscitation-
dc.subjectHealth knowledge-
dc.subjectattitudes-
dc.subjectpractice-
dc.subjectHeart arrest-
dc.titleQuestionnaire survey on medical futility and termination of resuscitation in cardiac arrest patients among emergency physicians in Hong Kong-
dc.title有關香港急症科醫生對心搏停止病人的無效醫療和停止搶救概念的問卷調查-
dc.typeArticle-
dc.identifier.emailLeung, SC: lsc676a@hku.hk-
dc.identifier.authorityLeung, SC=rp02523-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.12809/hkmj187755-
dc.identifier.pmid31178438-
dc.identifier.scopuseid_2-s2.0-85067904661-
dc.identifier.hkuros305590-
dc.identifier.volume25-
dc.identifier.issue3-
dc.identifier.spage183-
dc.identifier.epage191-
dc.publisher.placeHong Kong-

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