Missed opportunities! End of life decision making and discussions in implantable cardioverter defibrillator recipients

Background: Recent guidelines highlight the need for clinician-patient discussions regarding end-of-life (EOL) choices prior to implantable cardioverter defibrillator (ICD) implantation. Health literacy could affect the quality and quantity of such discussions. Objective: Our objective was to determine the association of health literacy with experiences, attitudes, and knowledge of the ICD at EOL. Methods: In this cross-sectional study, we used validated instruments to measure health literacy and patient experiences, attitudes, and knowledge of the ICD at EOL. Results: Of the 240 ICD recipients, 76% of participants reported never having discussed the implications of a future withdrawal of defibrillation therapy with their healthcare provider. Increased odds of choosing to maintain defibrillation therapy were associated with female gender and lower ICD knowledge. Conclusions: From patients perspectives, EOL discussions with providers were minimal. Most patients hold misperceptions about ICD function that could interfere with optimal EOL care, particularly for those with inadequate health literacy. (C) 2019 Elsevier Inc. All rights reserved.

MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Omvårdnad hsv//swe
MEDICAL AND HEALTH SCIENCES Health Sciences Nursing hsv//eng
Implantable cardioverter defibrillator; End of life; End-of-Life Issues in Implantable Cardioverter; Defibrillator Patients Questionnaire; Hospital Anxiety and Depression Scale; Newest Vital Sign

Chung, Misook L.Univ Kentucky, KY USA (author)
Etaee, FarshidUniv Kentucky, KY USA (author)
Hammash, MunaUniv Louisville, KY 40292 USA (author)
Thylén, IngelaLinköpings universitet,Avdelningen för omvårdnad,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US(Swepub:liu)ingjo45 (author)
Biddle, Martha J.Univ Kentucky, KY USA (author)
Elayi, Samy C.Univ Florida, FL USA (author)
Czarapata, Mary M.Univ Kentucky, KY USA (author)
McEvedy, SamanthaLa Trobe Univ, Australia (author)
Cameron, JanMonash Univ, Australia (author)
Haedtke, Christine A.Indianapolis Sch Nursing, IN USA (author)
Ski, Chantal F.Queens Univ Belfast, North Ireland (author)
Thompson, David R.Queens Univ Belfast, North Ireland (author)
Moser, Debra K.Univ Kentucky, KY USA (author)
Univ Kentucky, KY USAUniv Louisville, KY 40292 USA (creator_code:org_t)

By the author/editor: Miller, Jennifer ...; Chung, Misook L.; Etaee, Farshid; Hammash, Muna; Thylén, Ingela; Biddle, Martha J ...; show more...; Elayi, Samy C.; Czarapata, Mary ...; McEvedy, Samanth ...; Cameron, Jan; Haedtke, Christi ...; Ski, Chantal F.; Thompson, David ...; Moser, Debra K.; show less...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Health Sciences; and Nursing

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