The acceptability of an information leaflet explaining cardiopulmonary resuscitation policy in the hospice setting: a qualitative study exploring patients' views

Background: Guidelines advise that patients receiving palliative care should be given realistic information about cardiopulmonary resuscitation (CPR) and encouraged to participate in decisions about this. For many patients attending a hospice, CPR is unlikely to be successful because of advanced disease. It is difficult to predict which patients would like to discuss CPR and whether such discussion might cause distress. Aim: This research set out to determine the acceptability and understanding of a patient information leaflet about CPR given to inpatients and day-unit patients in one hospice, and to seek patients' views on communication about resuscitation. Methods: Semi-structured interviews were carried out with five hospice inpatients and one day-unit patient and analysed using interpretative phenomenological analysis for emergent themes. Results and conclusions: The leaflet was acceptable to the participants but was interpreted in the context of their understanding of their illness and prognosis. The leaflet alone is not a reliable method of communicating resuscitation policy and should be followed up by the opportunity to ask questions, if the patient wishes. Many factors influence patient choices about CPR. Realistic information about prognosis and about the risks and harms of CPR would allow patients to make a better-informed decision. However, if a patient prefers not to talk about their prognosis and end-of-life issues, then this should be respected.