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Sammanfattning

Many lives can be saved today thanks to modern resuscitation technology. However, heart-lung resuscitation (HLR) is sometimes used in situations where it is of little or no use to the patient. The aim of this study was to map physicians’ experience of situations where they had decided not to resuscitate and to study whether there are any differences in the experience of different groups of physicians. The study was quantitative and the instrument was a questionnaire where data were statistically analysed. The result shows that clinical belonging affects physicians’ attitudes and experience and largely determines whether or not they decide to refrain from heart – lung resuscitation. The patients’ and their families’ wishes as well as the patients’ diagnoses, prognoses, and age formed the basis of the physicians’ decisions. The anaesthesiologists represented to a lesser degree the view that the nurse should be involved in the decision than the physicians at the medico-geriatric clinic (p=0.006), the gynaecological clinic (p=0.04), and the surgical clinic (p=0.03). Twenty-nine per cent experienced that the patient was involved in the decision to refrain from HLR. The physicians at the surgical clinic represented to a lesser degree the view that the patient took part in the decision than the physicians at the anaesthetic and medico-geriatric clinics (p=0.001 and p=0.05, respectively). Sixty-five per cent experienced that family members took part in the decision to refrain from HLR. More than half of the physicians were of the opinion that the decision-making and the documentation of the decision to refrain from HLR can be improved. Only 29 % were of the opinion that there were clear guidelines regarding where to document the decision. In the study, wishes were expressed that guidelines shared by different clinics should be drawn up.

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