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Medline ® Abstract for Reference 130

of 'Psychosocial issues in advanced illness'

130
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End-of-life care preferences of patients enrolled in cardiovascular rehabilitation programs.
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Heffner JE, Barbieri C
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Chest. 2000 May;117(5):1474-81.
 
STUDY OBJECTIVES: The study assessed the interests of ambulatory cardiac patients in advance planning and their willingness to participate in rehabilitation program-based end-of-life education.
DESIGN: Observational survey study.
SETTING: Fourteen outpatient cardiac rehabilitation programs in 11 states.
PARTICIPANTS: Four hundred fifteen subjects enrolled in cardiac rehabilitation.
MEASUREMENTS AND RESULTS: A questionnaire determined patient preferences for advance planning, completion of advance directives, completion of patient-physician discussions on end-of-life care, and effects of health status on patient acceptance of life-sustaining interventions. Seventy-two percent of patients wanted to direct their own end-of-life care, 86% desired more information on advance directives, 62% wanted to learn about life-sustaining care, and 96% were receptive to advance-planning discussions with theirphysicians. Seventy-two percent of patients had considered that they might require life-sustaining care in the future; acceptability of resuscitative care depended on health status and probability of survival. However, only 15% had discussed advance planning with their physicians, and 10% were confident that their physicians understood their end-of-life wishes. Physicians and cardiovascular rehabilitation programs were considered desirable sources of information on advance planning.
CONCLUSIONS: Cardiac patients enrolled in rehabilitation programs want to learn more about end-of-life care and need more opportunities to discuss advance planning with their physicians. Patients consider cardiovascular rehabilitation programs to be acceptable sites for advance planning education.
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Department of Medicine, Medical University of South Carolina, Charleston 29425, USA. heffnerj@musc.edu
PMID