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Cited by 28Palliative Care and End-of-Life IssuesCardiac Arrest and ResuscitationPatient-Provider Communication in Healthcare

The DOI matches its Crossref record.

Barriers to involving older people in their resuscitation decisions: the primary-secondary care mismatch highlights the potential role of general practitioners

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Holland, C. L., Bowker, L. K., Myint, P. K.·2013·International Journal of Clinical Practice
DOI 10.1111/ijcp.12067
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Abstract

BACKGROUND: 'Do Not Attempt Cardiopulmonary Resuscitation' (DNACPR) orders are made frequently for older people in hospital. Sensitive anticipatory discussion is encouraged where possible, but usually this does not happen, despite the evidence suggesting that many older patients would like to be involved in such decisions. METHODS: Current clinical practice in both primary care and secondary care and perceived barriers to patient involvement in resuscitation decisions was assessed using a questionnaire in Medicine for the Elderly physicians in two hospitals, and General Practitioners of teaching practices in Norfolk. RESULTS: Response rate was 51% (n = 24/47). Hospital-based clinicians made DNACPR decisions more frequently, but discussed decisions with patients in less than 25% of cases. By contrast, GPs thought that patient involvement was more important and felt that they had a better understanding of the patient's wishes due to the long-term relationship they shared. Mental capacity was seen as the biggest barrier to patient involvement by both groups. Other barriers included lack of understanding, communication difficulties and practical concerns. CONCLUSION: Further support and training could help clinicians improve their resuscitation decision-making practice. Advanced discussion in Primary Care with older people before they lose capacity may have a role in increasing their involvement in resuscitation decision making.

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Crossref · 10.1111/ijcp.12067

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  • Patients' mental or cognitive function was seen as the most important barrier to their involvement in resuscitation decisions.

    “Patients’ mental or cognitive function was seen as the most important barrier to their involvement in resuscitation decisions.47”

    From Do not attempt cardiopulmonary resuscitation decision-making process: scoping review (2025) · cites this paper as [47]

  • Practitioners may not discuss resuscitation decisions if they believe that it would be distressing or the person lacks capacity.

    “Practitioners may not discuss resuscitation decisions if they believe that it would be distressing or the person lacks capacity47”

    From Do not attempt cardiopulmonary resuscitation decision-making process: scoping review (2025) · cites this paper as [47]

  • The setting for DNACPR discussions was felt to be a barrier due to issues such as lack of privacy and the difficulty in finding appropriate time.

    “The setting for the discussions was felt to be a barrier due to issues such as lack of privacy and the difficulty in finding appropriate time.47”

    From Do not attempt cardiopulmonary resuscitation decision-making process: scoping review (2025) · cites this paper as [47]

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Research works printed but not linked: 23

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Metadata

Authors
Holland, C. L., Bowker, L. K., & Myint, P. K.
Affiliations
University of East Anglia (GB)
Corresponding author
Bowker, L. K.
ORCID
Myint, P. K.
Venue
International Journal of Clinical Practice
Publisher
Hindawi Limited
Published
2013-03-24
Volume
67
Issue
4
Pages
379-384
ISSN
1368-5031 (ISSN-L)
DOI
10.1111/ijcp.12067
OpenAlex
W1530888396
Cited by
28
References
0
Citations by year
2025: 1 · 2024: 3 · 2023: 3 · 2022: 3 · 2021: 5 · 2020: 4 · 2019: 1 · 2017: 3 · 2016: 2 · 2015: 1 · 2014: 2
FWCI
1.70
Type
journal article
Language
en
Open access
Licence
doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 891 d)
Locations
  • International Journal of Clinical Practice (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Health Sciences › Medicine › Emergency Medicine › Cardiac Arrest and Resuscitation
  • Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
Keywords
DNACPR, resuscitation decisions, older adults, patient involvement, general practitioners, decision-making capacity, barriers to patient involvement, communication difficulties, clinician training
MeSH terms
Adult, Aged, Attitude of Health Personnel, England, Female, Health Status, Humans, Male, Medical Staff, Hospital, Middle Aged, Patient Participation, Physician-Patient Relations, Physician's Role, Primary Health Care, Resuscitation Orders, Mental Competency, Comprehension, General Practitioners, Secondary Health Care, Secondary Care

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