Intensive care decisions about level of aggressiveness of care



Questionnaires were used to assess (a) the factors intensive care unit resident physicians (N = 33) and nurses (N = 57) perceived as influential in making decisions about level of aggressiveness of patient care (LAC), (b) who residents and nurses believed should be involved versus who was involved in decision making, and (c) the amount of collaboration they perceived in their practices. Questionnaires then were used to assess decision making about 314 patients. All providers agreed that patient request influenced their LAC decisions, with possibility of benefit and diagnosis ranked second and third. Although both nurses and residents believed capable patients should be making LAC decisions, providers identified attending physicians as the most common participants in decision making for specific patients. Residents were more satisfied with the decision making process than nurses, t = 2.05 (88), p =.04. There was no relationship between perceptions of nurse–resident collaboration and providers' inclusion of others in the LAC decision process. ©1995 John Wiley & Sons, Inc.