Sunday, July 26, 2015

A Short Video, a Big End-of-Life Difference -- Science of Us

"A team of 16 researchers led by Dr. Areej El-Jawahri of Mass General Hospital and Harvard Medical School, a member of a group calling itself the Video Images of Disease for Ethical Outcomes (VIDEO) Consortium, wanted to see whether a short video about CPR and intubation could affect a patient's end-of-life preferences. They found 150 patients, 76 years old on average, at MGH and Newton-Wellesley Hospital (which is in the Boston suburbs) who had serious health conditions and who doctors said had a year or less to live. Half of them, the control group, were given normal end-of-life care, including discussions with their doctors about CPR and intubation, as per the hospitals' policies. The other half was shown a three-minute video about CPR and intubation that sought to explain to patients exactly what these procedures entail. (I've requested a copy and will include it if the researchers send it.)

The results were pretty stark. Prior to the experiment, 84 percent of the control group and 81 percent of the video group said they wanted CPR if it was necessary to keep them alive. After the experiment, the control group's preference remained about the same (81 percent still wanted to be resuscitated), while the video group's preference fell severely: Just 43 percent of patients said they wanted CPR after seeing the video. The numbers for intubation were similar: For the control group, once again 84 percent wanted it before the experiment and 81 percent after, and for the video group there was a shift from 77 percent all the way down to 36 percent. Members of the video group who were discharged and later readmitted to the same hospital were also much more likely to refuse CPR and intubation upon their readmission, as compared to members of the control group who were similarly readmitted."

A Short Video, a Big End-of-Life Difference -- Science of Us

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