The DOI matches its Crossref record; 9 of the 9 references it cites were found in a registry or an index.
Why are some ReSPECT conversations left incomplete? A qualitative case study analysis
Open accessAbstract
Background: As an emergency care and treatment planning process (ECTP), a key feature of the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) is the engagement of patients and/or their representatives in conversations about treatment options including, but not limited to, cardiopulmonary resuscitation (CPR). However, qualitative research suggests that some ReSPECT conversations lead to partial or no decision-making about treatment recommendations. This paper explores why some ReSPECT conversations are left incomplete. Methods: Drawing on observation and interview data collected in four National Health Service (NHS) hospital sites in England, this paper offers an in-depth exploration of six case studies in which ReSPECT conversations were incomplete. Using thematic analysis, we triangulate fieldnote data documenting these conversations with interview data in which the doctors who conducted these conversations shared their perceptions and reflected on their decision-making processes. Results: We identified two themes, both focused on 'mismatch': (1) Mismatch between the doctor's clinical priorities and the patient's/family's immediate needs; and (2) mismatch between the doctor's conversation scripts, which included patient autonomy, the feasibility of CPR, and what medicine can and should do to prolong a patient's life, and the patient's/family's understandings of these concepts. Conclusions: This case study analysis of six ReSPECT conversations found that mismatch between doctors' priorities and understandings and those of patients and/or their relatives led to incomplete ReSPECT conversations. Future research should explore methods to overcome these mismatches.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The conversations themselves were persuasive.
“The conversations themselves, as in previous accounts [14, 45, 46, 52, 53], were persuasive, and clinicians sought to negotiate the conversation to a hopefully rapid and amicable conclusion in line with the medical view.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Using thematic analysis in psychology
Braun, V., & Clarke, V. (2006) · Qualitative Research in Psychology · doi:10.1191/1478088706qp063oa · Cited by 194,414
What is Motivational Interviewing?
Rollnick, S., & Miller, W. R. (1995) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s135246580001643x · Cited by 1,737
Lund, S., Richardson, A., & May, C. (2015) · PLOS ONE · doi:10.1371/journal.pone.0116629 · Cited by 325
Resuscitation policy should focus on the patient, not the decision
Fritz, Z., Slowther, A.-M., & Perkins, G. D. (2017) · BMJ · doi:10.1136/bmj.j813 · Cited by 162
Self-citationDo not attempt cardiopulmonary resuscitation orders in acute medical settings: a qualitative study
Cohn, S., Fritz, Z. B. M., Frankau, J. M., Laroche, C. M., & Fuld, J. P. (2013) · QJM · doi:10.1093/qjmed/hcs222 · Cited by 67
Interpretation and intent: a study of the (mis)understanding of DNAR orders in a teaching hospital
Fritz, Z., Fuld, J., Haydock, S., & Palmer, C. (2010) · Resuscitation · doi:10.1016/j.resuscitation.2010.05.014 · Cited by 65
Eli, K., Hawkes, C. A., Ochieng, C., Huxley, C. J., Baldock, C., Fortune, P.-M., Fuld, J., Perkins, G. D., Slowther, A.-M., & Griffiths, F. (2021) · Resuscitation · doi:10.1016/j.resuscitation.2021.01.013 · Cited by 29
Self-citationHuxley, C. J., Eli, K., Hawkes, C. A., Perkins, G. D., George, R., Griffiths, F., & Slowther, A.-M. (2021) · BMC Family Practice · doi:10.1186/s12875-021-01486-w · Cited by 20 · cited 2×
“Similarly, we have previously reported that GPs view ReSPECT conversations as ongoing and processual.(19) However, excepting one doctor who encouraged the patient to take her time, the participating doctors aimed at completing the decision-making process in one conversation, timing conversations according to clinical…”
BackgroundMethodSelf-citationThe over-interpretation of DNAR
Stewart, M., & Baldry, C. (2011) · Clinical Governance: An International Journal · doi:10.1108/14777271111124473 · Cited by 10
Flagged first, then by citations
Research works printed but not linked: 15
- Mockford, 2015, Do not attempt cardiopulmonary resuscitation (DNACPR) orders: a systematic review of the barriers and facilitators of decision-making and implementation, Resuscitation, 88, 99, 10.1016/j.resuscitation.2014.11.016 · DOI · Paper page
- Moffat, 2016, Does resuscitation status affect decision making in a deteriorating patient? Results from a randomised vignette study, J Evaluation Clinical Practice, 22, 921, 10.1111/jep.12559 · DOI · Paper page
- Hawkes, 2020, Development of the recommended summary plan for emergency care and treatment (ReSPECT), Resuscitation, 148, 98, 10.1016/j.resuscitation.2020.01.003 · DOI · Paper page
- Eli, 2020, Secondary care consultant clinicians’ experiences of conducting emergency care and treatment planning conversations in England: an interview-based analysis, BMJ Open, 10, 10.1136/bmjopen-2019-031633 · DOI · Paper page
- Terry G, Hayfield N, Clarke V, et al. Thematic analysis. In: C. W, W. S-Ro, eds. The SAGE handbook of qualitative research in psychology. London: Sage 2017:17-37. · DOI · Paper page
- Clark, 2007, A critical realist approach to understanding and evaluating heart health programmes, Health, 11, 513, 10.1177/1363459307080876 · DOI
- Eli, 2022, Caring in the silences: Why physicians and surgeons do not discuss emergency care and treatment planning with their patients – a hospital-based ethnographic case study in England, BMJ Open, 12, 10.1136/bmjopen-2020-046189 · DOI · Paper page
- Barclay, 2010, Having the difficult conversations about the end of life, BMJ, 341, 10.1136/bmj.c4862 · DOI
- Harter, 2009, Narratives as dialogic, contested, and aesthetic performances, J Appl Commun Res, 37, 140, 10.1080/00909880902792255 · DOI
- Harter, 2009, Healing through stories: A special issue on narrative medicine, J Appl Commun Res, 37, 113, 10.1080/00909880902792271 · DOI
- Charon, 2009, The polis of a discursive narrative medicine, J Appl Commun Res, 37, 196, 10.1080/00909880902792222 · DOI
- Miller WR, Rollnick S. Motivational Interviewing: Helping People Change: Guilford Press 2012.
- Pollak, 2011, Applying motivational interviewing techniques to palliative care communication, J Palliative Med, 14, 587, 10.1089/jpm.2010.0495 · DOI
- Ko, 2016, Feasibility and acceptability of a brief motivational stage-tailored intervention to advance care planning: a pilot study, Am J Hospice Palliative Med, 33, 834, 10.1177/1049909115593736 · DOI
- Anderson, 2018, Make your wishes about you (MY WAY): using motivational interviewing to foster advance care planning for patients with chronic kidney disease, Nephrology Nursing J, 45, 411
Cited by
Sorted by citations
Recommended summary plan for emergency care and treatment: ReSPECT a mixed-methods study
Perkins, G. D., Hawkes, C. A., Eli, K., Griffin, J., Jacques, C., Huxley, C. J., Couper, K., Ochieng, C., Fuld, J., Fritz, Z., et al. (2022) · Health and Social Care Delivery Research · doi:10.3310/lfpe3627 · Cited by 16
Self-citationWarner, B. E., Wells, M., Vindrola-Padros, C., & Brett, S. J. (2025) · BMC Geriatrics · doi:10.1186/s12877-025-06893-7
“The conversations themselves, as in previous accounts [14, 45, 46, 52, 53], were persuasive, and clinicians sought to negotiate the conversation to a hopefully rapid and amicable conclusion in line with the medical view.”
Metadata
- Authors
- Eli, K., Huxley, C. J., Hawkes, C. A., Perkins, G. D., Slowther, A.-M., & Griffiths, F.
- Affiliations
- University of Warwick (GB)
- University Hospitals Birmingham NHS Foundation Trust (GB)
- Corresponding author
- Eli, Karin
- Griffiths, Frances
- ORCID
- Venue
- Resuscitation Plus
- Publisher
- Elsevier BV
- Published
- 2022-06
- Volume
- 10
- Pages
- 100255
- ISSN
- 2666-5204 (ISSN-L)
- PMC
- PMC9207560
- OpenAlex
- W4282927175
- Cited by
- 12
- References
- 9
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 5 · 2023: 1
- FWCI
- 1.77
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Resuscitation Plus (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Warwick Research Archive Portal (University of Warwick) (submittedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Funders
- Australian Research Council
- National Institute for Health and Care Research (15/15/09)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Family and Patient Care in Intensive Care Units
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Keywords
- respect, cardiopulmonary resuscitation, advance care planning, physician-patient communication, patient autonomy, treatment decision-making, clinician perceptions, family representatives
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
