• W Meyer, F Balck, and H Speidel.
• Klinik für Psychotherapie und Psychosomatik, Universität Kiel.
• Nervenarzt. 1994 Sep 1;65(9):602-10.

AbstractThe cognitions of 20 emergency-physicians while working on a mobile resuscitation unit were examined by means of questionnaire in over 260 situations of resuscitation. A pattern of cognitions could be detected: Emergency physicians appear not to think very much during resuscitation. If there are thoughts, these usually concern the obvious, or what is immediately present in the situation, i.e. the patient or the patient's relatives; repression may also play a role. Cognitions which are reflective of self are rare and only develop late in the situation, depending on the surroundings and the amount of stress. The cognitions concerning the relatives are frequent in those situations with direct physician-relative contact. The physicians often report in retrospect having felt compelled to a decision for resuscitation by the presence of the relatives; nevertheless, the decision itself appears to be a result, rather, of their cognitions of the relatives. Distancing by means of cognition was ubiquitously employed as a coping strategy by physicians when in situations which were perceived as not having a positive outcome. Thoughts about "own death" or "about the patient" are specific, however, for certain groups of doctors. Results of the present investigation suggest that physicians have cognitions about relatives during the process of decision making, and cognitions about the patient during the resuscitation manoeuvre.

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