-- Robert Preidt
WEDNESDAY, March 7 (HealthDay News) -- Even when told that death
is likely, families of intensive care patients tend to be overly
optimistic about the possibility of recovery, a new study
Because they often have to make treatment decisions for patients
too ill to express their own wishes, it's important for family
members to have a clear understanding of their loved one's
prognosis, said Dr. Douglas White, an associate professor in the
department of critical care medicine at the University of
Pittsburgh School of Medicine.
"Research has shown us that prognostic information influences treatment decisions near the end of life," White said in a university news release. "But there's evidence of disconnect between what the doctor says and how the surrogates interpret the meaning."
The study, which appears in the March 6 issue of the
Annals of Internal Medicine, included 80 surrogate decision makers at three ICUs in San Francisco who read statements such as "He will definitely survive," "He has a 90 percent chance of surviving," "He has a 5 percent chance of surviving," and "He will definitely not survive."
The participants, who were told that the statements were
hypothetical and not related to their own loved one's prognosis,
were asked to interpret the statements about the patients' chances
The participants accurately assessed the survival odds when a
patient's prognosis was generally good, but that was not the case
with poor prognoses. Forty percent of participants were overly
optimistic in their interpretation of a 50 percent survival chance,
and nearly two-thirds were too optimistic in their interpretation
of a 5 percent survival chance.
When the participants were asked to explain their overly
optimistic interpretations, their responses included statements
such as, "I hold on to hope strongly," "There is still hope," and
"[The doctors] are not giving you a real figure."
"Our research indicates that in the ICU setting, family members want to see the glass as half full, even if it's really nearly empty," White said. "They accurately interpreted statements conveying good prognoses, which means it's not a simple misunderstanding of numbers that explains their misperceptions. Instead, they appear to be biased to optimism as a coping strategy to deal with the highly stressful situation of having a loved one near death."
The Society of Critical Care Medicine has more about
making decisions for ICU patients.
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