Authors (including presenting author) :
Lee WY(1)
Affiliation :
(1)Department of Medicine,Queen Elizabeth Hospital
Introduction :
Due to advance in medical technology, the life expectancy in Hong Kong became longer. Hong Kong ranked the 7th longest life expectancy around the world in 2017. However, the quality of death was relatively low and on a decreasing trend. The quality of death in Hong Kong ranked the 20th in 2010 but fell to the 22nd in 2015. End of life issue is often considered as a taboo in traditional Chinese culture which elderly were reluctant to discuss openly. Elderly may miss the chance to express their wish or opinion to their family members on their own end of life care options. Especially for fragile elderly, their health condition are more prone to rapid deterioration and effectiveness of performing cardiopulmonary resuscitation (CPR) when they suffered from cardiac arrest is low. When a patient suffered from unexpected life threatening event or was incapable to make own decision, family members became important surrogates to make decision on “Do Not Attempt CPR (DNACPR)”on behalf of patient for patient’s best interest. This is an important and hard decision to families as they have to face the possibility of losing their loved ones while concerning patient’s wish and best interest. However, there is limited research related to family members’decision on DNACPR in Hong Kong. This study served as identifying the factors that influenced family members’decision on DNACPR for elderly. With a higher acceptance and understanding of DNACPR by family members, quality of death for elderly are expected to improve.
Objectives :
To explore factors influencing family members’ decision on DNACPR
Methodology :
A qualitative research with convenience sampling in an acute medical ward was conducted. Relatives who were the decision makers of DNACPR for patients aged over 65 and with minor or mentally incompetent were invited to join an in-depth interview. The demographic data of the relatives was collected. Recorder tapes were used to record the interview.
Result & Outcome :
Total 7 families with 6 women and 4 men were interviewed. The quality of life of patients, patients’ pre-morbid health status, support from health care professional and life experience of family members were considered as factors that influenced family members’ decision on DNACPR. Due to tradition in Chinese Culture, elderly is reluctant to discuss end of life issue. It is common for family members to be indecisive about DNACPR decision for elderly patients. Understanding the factors which can influence family members’ decision on DNACPR allows health care professional to communicate with family members more easily to make decision and improve patients’quality of death.
