Skip to main content
construction release_alert
Scholars@Duke will be undergoing maintenance April 11-15. Some features may be unavailable during this time.
cancel
Journal cover image

Prior capacity of patients lacking decision making ability early in hospitalization: implications for advance directive administration. The SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments.

Publication ,  Journal Article
Wenger, NS; Oye, RK; Bellamy, PE; Lynn, J; Phillips, RS; Desbiens, NA; Kussin, P; Youngner, SJ
Published in: J Gen Intern Med
October 1994

OBJECTIVE: To investigate the appropriateness of hospitalization as the time to elicit patients' medical care preferences, the authors evaluated the capability of seriously ill patients to participate in decision making early in hospitalization and their decision making capacity two weeks before hospital entry. DESIGN: Cross-sectional study with retrospective evaluation of preadmission decision making capacity. SETTING: Five acute care teaching hospitals. PATIENTS: Four thousand three hundred one acutely ill hospitalized adults meeting predetermined severity of illness criteria in nine specific disease categories. MEASUREMENTS: Surrogate decision makers' estimates of the prior mental capacities of patients unable to be interviewed early in hospitalization about care preferences due to intubation, coma, or cognitive impairment. Comparison of the demographics, degrees of sickness at admission, and outcomes of interviewable vs noninterviewable patients. MAIN RESULTS: Forty percent of the patients were not interviewable concerning preferences. Of these, 83% could have participated in treatment decisions two weeks prior to hospitalization. The patients who were not interviewable were more acutely ill, had less chronic disease, and were more likely to die during hospitalization than the interviewable patients. CONCLUSIONS: Many acutely ill patients likely to die in the hospital lost their ability to make medical care decisions around the time of hospital admission. Preferences for care and advance directives should be discussed in the outpatient setting or very early in hospital admission.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Gen Intern Med

DOI

ISSN

0884-8734

Publication Date

October 1994

Volume

9

Issue

10

Start / End Page

539 / 543

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Patient Participation
  • Middle Aged
  • Male
  • Humans
  • Hospitalization
  • General & Internal Medicine
  • Female
  • Decision Making
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Wenger, N. S., Oye, R. K., Bellamy, P. E., Lynn, J., Phillips, R. S., Desbiens, N. A., … Youngner, S. J. (1994). Prior capacity of patients lacking decision making ability early in hospitalization: implications for advance directive administration. The SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments. J Gen Intern Med, 9(10), 539–543. https://doi.org/10.1007/BF02599276
Wenger, N. S., R. K. Oye, P. E. Bellamy, J. Lynn, R. S. Phillips, N. A. Desbiens, P. Kussin, and S. J. Youngner. “Prior capacity of patients lacking decision making ability early in hospitalization: implications for advance directive administration. The SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments.J Gen Intern Med 9, no. 10 (October 1994): 539–43. https://doi.org/10.1007/BF02599276.
Journal cover image

Published In

J Gen Intern Med

DOI

ISSN

0884-8734

Publication Date

October 1994

Volume

9

Issue

10

Start / End Page

539 / 543

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Patient Participation
  • Middle Aged
  • Male
  • Humans
  • Hospitalization
  • General & Internal Medicine
  • Female
  • Decision Making