Academic Journal

1175 WAS ICU RIGHT FOR YOU? AN EXPLORATORY QUALITATIVE STUDY OF PATIENTS >=65 YRS AND NEXT OF KIN IN COVID-19: THE ESCALATE STUDY

التفاصيل البيبلوغرافية
العنوان: 1175 WAS ICU RIGHT FOR YOU? AN EXPLORATORY QUALITATIVE STUDY OF PATIENTS >=65 YRS AND NEXT OF KIN IN COVID-19: THE ESCALATE STUDY
المؤلفون: Warner, B E, Harry, A, Wells, M, Brett, S J, Antcliffe, D B
المصدر: Age and Ageing ; volume 52, issue Supplement_1 ; ISSN 0002-0729 1468-2834
بيانات النشر: Oxford University Press (OUP)
سنة النشر: 2023
مصطلحات موضوعية: Geriatrics and Gerontology, Aging, General Medicine
الوصف: Introduction The decision to admit an older patient to the intensive care unit (ICU) should reflect shared goals of care. Resource limitations during the Covid-19 pandemic highlighted challenges in selecting candidates for escalation. Patients and next of kin (NoK) who have experienced ICU are well-placed to reflect on whether the admission was right for them. Objective To explore older patients’ (>65 years) and their loved ones’ views on escalation decision making. Methods Qualitative study involving semi-structured interviews with patients, NoK of survivors and NoK of deceased who experienced UK ICU admission with Covid-19 respiratory failure between March 2020 and February 2021. A preliminary questionnaire was used to maximise sample diversity of age, sex, ethnicity, survival, decision regret and impact of event scores. Interview data were collected via video conferencing or telephone. Transcripts were analysed using framework analysis. Results 30 participants were interviewed. Results Five themes were identified: ‘Inevitability’ - a sense that the illness and its management are out of the control of the patient or their loved one; ‘Disconnect’ - differences between hospital and lay person narratives; challenges to bridging that gap included effective communication aided by technology; ‘Acceptance’ - of the consequences, good or bad, of an intensive care admission as unalterable; ‘Beyond comprehension’ - participants had not contemplated ill health or ICU prior to admission and even with the benefit of hindsight struggled to describe which potential outcomes would be acceptable or unacceptable if they needed to be involved in similar decision-making around escalation in the future; ‘Covid-19’ - unique impact of a pandemic. Conclusion This study, which includes bereaved NoK as well as patients and NoK of survivors, adds perspective to inform decision making regarding treatment escalation of older people.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1093/ageing/afac322.009
الاتاحة: http://dx.doi.org/10.1093/ageing/afac322.009
https://academic.oup.com/ageing/article-pdf/52/Supplement_1/afac322.009/48715440/afac322.009.pdf
Rights: https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model
رقم الانضمام: edsbas.22B1BD79
قاعدة البيانات: BASE
الوصف
DOI:10.1093/ageing/afac322.009