Discrepancy in resuscitation beliefs among physicians at various levels of training

Abstract

Having previously described some of the attitudes of health care providers toward resuscitation for themselves, based on an individual's beliefs about the likelihood of success of cardiopulmonary resuscitation (CPR), the differences among attitudes of physicians at different levels of training have now been assessed. A multi-question survey was sent to medical students, house officers, and attending physicians at two university medical centers. Sociodemographic information, questions regarding beliefs about outcome after CPR, and personal desires were included. Respondents were asked to identify the clinical condition carrying the worst prognosis during cardiac arrest from among: metastatic cancer (MC), end-stage renal disease (ESRD), acquired immunodeficiency syndrome (AIDS), sepsis, and myocardial infarction (MI), and to specify their resuscitation desires should they be affected by these conditions. The preferences of each group regarding resuscitation given their least favored diagnosis were assessed using chi 2 analysis of trends for binomial proportions. Approximately 186 questionnaires were evaluated and consisted of 90 by medical students (MS), 67 by house officers (HOs), and 29 by attending physicians (APs). Resuscitation desires for each diagnosis were MC, 7 of 40; ESRD, 8 of 34; AIDS, 10 of 74; sepsis, 10 of 15; and MI, 20 of 23. chi 2 test for trend of desire to be resuscitated from the self-selected worst prognostic category by level of training demonstrated no significant decrease in desire to be resuscitated with increasing level of training. Physician's beliefs about CPR may be influenced by their experiences with particular patients and events.(ABSTRACT TRUNCATED AT 250 WORDS)