Poster Presentations: Tuesday, October 25, 2011 |

Video Education About Resuscitation Preferences Is Well-Tolerated by Patients and Their Surrogates FREE TO VIEW

Artur Krupa, MD; John Litell, MD; Michael Wilson, MD; Richard Hinds, RRT; Laurie Meade, RN; Kianoush Kashani, MD; Ognjen Gajic, MD
Chest. 2011;140(4_MeetingAbstracts):260A. doi:10.1378/chest.1117929
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PURPOSE: Decisions about resuscitation preferences are often made by patients or their surrogates at the time of admission to the intensive care unit or general wards. Prior studies have reported poor healthcare literacy among patients and surrogates regarding resuscitation status. Video educational tools have been used in a variety of clinical settings to guide decision making. We assessed the impact of video education about resuscitation terminology on patients and their surrogates specifically in terms of satisfaction, utility, and associated stress and anxiety.

METHODS: We produced a ten-minute educational video explaining resuscitation terminology and demonstrating chest compressions, defibrillation, endotracheal intubation, and mechanical ventilation. Images were combined with narration. Terminology was explained using standardized formatting for lay audiences. Intensive care unit patients and/or their surrogate decision makers watched the video and were subsequently surveyed about their impressions. The survey instrument was composed of Likert scales for comfort, anxiety, and satisfaction as well as helpfulness of the video in assisting decision making. Participants were also asked if they would recommend this video to others.

RESULTS: Twenty-eight participants (16 patients and 12 surrogates) were surveyed. Among patients, 8/16 (50 %) indicated no anxiety, 3/16 (18%) indicated mild anxiety, 5/16 (31%) indicated moderate anxiety, and none indicated severe anxiety. Among surrogates, 9/12 (75%) indicated no anxiety, 1/12 (8%) indicated mild anxiety, 1/12 (8%) indicated moderate anxiety, and 1/12 (8%) indicated severe anxiety. Thirteen of sixteen patients (81%) and all surrogates reported being satisfied with video education. All patients and 10/12 (83%) of surrogates felt comfortable watching the video. All patients and surrogates found the video helpful. All patients and surrogates would recommend the video to others.

CONCLUSIONS: Our results indicate that video education is acceptable to patients and their surrogates and it is associated predominantly with minimal harm, as reflected by anxiety level.

CLINICAL IMPLICATIONS: Innovative strategies are needed to adequately prepare hospitalized patients and surrogate decision makers to establish their resuscitation preferences. Properly prepared videos may help to address this need.

DISCLOSURE: The following authors have nothing to disclose: Artur Krupa, John Litell, Michael Wilson, Richard Hinds, Laurie Meade, Kianoush Kashani, Ognjen Gajic

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