RESUSCITATION IN CANCER - COMPARISON OF PATIENT AND HEALTH STAFF PREFERENCES

One hundred oncology patients from a major teaching hospital and their treating health staff were studied in the second phase of research ex amining attitudes towards cardiopulmonary resuscitation (CPR). A descr iptive approach was used incorporating semistructured interviews of pa tients and established questionnaire measures, examining knowledge of and attitude towards disease and treatment, psychological functioning, and current and projected attitude toward resuscitation. Health staff also participated in a semistructured interview. This phase of the pr oject focused particularly on a direct comparison of patient and staff assessments. In current circumstances, 10% of patients refused resusc itation. This was associated with disease of good prognosis. In a futu re hypothetical deteriorated scenario presented to patients, 39% decli ned resuscitation. This was associated with a past history of suicidal behavior. In current circumstances, health staff designated 14% of pa tients ''Do-Not-Resuscitate'' (DNR)-this was associated with a number of variables considered to predict poor outcome in resuscitation. In t he future scenario, staff designated 54% of patients DNR-this was asso ciated again with poor resuscitation outcome variables, but also indep endently, with a past psychiatric history. Comparison of patient and h ealth staff preferences for resuscitation showed moderate yet signific ant concordance in current circumstances but not in the future scenari o. The findings indicate firstly the feasibility of discussing resusci tation preferences with seriously ill patients and secondly an urgent need to improve patient and staff discussions regarding resuscitation, as staff and patients' attitudes to resuscitation differ.