Are physicians on the same page about do-not-resuscitate? To examine individual physicians’ influence on do-not-resuscitate decision-making: a retrospective and observational study

Chen, Yen-Yuan; Su, Melany; Huang, Su‐Cheng; Chu, Tzong‐Shinn; Lin, Ming-Tsan; Chiu, Yu‐Chun; Lin, Kuan-Han

doi:10.1186/s12910-019-0429-z

Cited by 7 publications

(12 citation statements)

References 40 publications

(37 reference statements)

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“…Person-centered conversations focused on patients’ illness understanding, goals, fears, sources of strength, values, and acceptable tradeoffs can support more goal-consistent care . However, such discussions are typically infrequent, occur late in the illness trajectory, and generally focus more on patients’ resuscitation preferences (ie, code status) rather than their values and goals …”

Section: Introductionsupporting

confidence: 89%

“… 8 However, such discussions are typically infrequent, occur late in the illness trajectory, and generally focus more on patients’ resuscitation preferences (ie, code status) rather than their values and goals. 1 , 2 , 3 , 9 , 10 , 11 , 12 , 13 , 14 , 15 …”

Section: Introductionmentioning

confidence: 99%

“…8 However, such discussions are typically infrequent, occur late in the illness trajectory, and generally focus more on patients' resuscitation preferences (ie, code status) rather than their values and goals. [1][2][3][9][10][11][12][13][14][15] Multiple educational programs and tools have sought to enhance this communication. 13,[16][17][18] The Serious Illness Care Program (SICP) uses a multifaceted system-change approach to build clinician capacity for more timely and person-centered conversations about the values and priorities of patients with serious illness.…”

Section: Introductionmentioning

confidence: 99%

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Clinicians’ Perspectives After Implementation of the Serious Illness Care Program

et al. 2021

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Key Points Question What were hospital clinicians’ experiences and perceptions of the Serious Illness Care Program (SICP), a multifaceted capacity-building intervention to improve communication with patients who are seriously ill? Findings In this qualitative study including 23 clinicians from 2 hospitals in Canada, clinicians stated that the various structural and organizational elements of the SICP supported changes in their behavior, shifted the focus of goals-of-care conversations beyond discussion of resuscitation preferences (ie, code status), and influenced them on personal and professional levels. Meaning The findings of this study suggest that clinicians may find the SICP helpful in supporting them to engage in meaningful communication that goes beyond discussion of code status with patients who are hospitalized with serious illness.

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Section: Introductionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinicians’ Perspectives After Implementation of the Serious Illness Care Program

et al. 2021

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“…With regard to the influence of physician specialty, 36.7% of the physicians stated that the physician specialty influenced DNR decision-making. This finding correlates with the results of other previous studies and indicates the influence of education, training background, and personal characteristics on the DNR order [33][34][35].…”

Section: Discussionsupporting

confidence: 91%

Knowledge gaps, attitudes, and practices regarding end-of-life medical care among physicians in an academic medical center

et al. 2023

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Introduction: End-of-life medical care (ELMC) plans and do-not-resuscitate (DNR) decision-making are usually affected by multiple factors compared to other medical care decisions. ELMC and DNR policy implementation are still diversified and heterogeneous, especially in Saudi Arabia, because policymakers have adopted no guidelines. Thus, this study investigated physicians’ knowledge, attitude, and practice regarding ELMC and DNR. Methods: A cross-sectional study design was adopted. Three hundred physicians working at King Fahad Hospital of the University, Khobar, Saudi Arabia, were randomly selected and administered an anonymous self-administered questionnaire using the Likert scale. Data analysis was carried out using SPSS 23.0. Results: Of 300 distributed questionnaires, 264 (88%) were completed and analysed. Knowledge gaps and negative attitudes were observed, a quarter of the participants were opposed to issuing a DNR order, and 29.0% considered DNR as equal to euthanasia as they practice. The participants’ patient age and religious factors were the most critical factors in the ELMC plan and DNR decision. The physician’s level of acceptance regarding a set of ELMC interventions and DNR decisions showed heterogenicity and uncertainty among participants. Conclusions: The ELMC plan and DNR decision-making should be appropriately addressed in the medical residents’ training programs to bridge the knowledge gap and the physicians’ negative attitudes during their practice. Additionally, there is a need to update and unify the DNR policies at the national level, considering the patient’s right to be informed and involved actively during the decision process making. Finally, more prospective research is needed for the global standardization of ELMC.

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“… 18 However, in the study of Chen, no statistically significant difference was found between the genders in terms of their views on DNR. 23 In our study, it was determined that parental education level, which is an indicator of the influence of the family on the development of individual values, is associated with the end-of-life decisions of the physician. Physicians with at least one parent with higher education have a more liberal and positive perspective on DNR.…”

Section: Discussionmentioning

confidence: 99%

Physician perspectives on the DNR order in Turkey: A survey of physicians in Internal Medicine

Hüseyin¹,

Pelin²,

Canan³

2023

Afr H. Sci.

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Background: Do not resuscitate (DNR) is a controversial ethico-legal issue and there is no legal regulation in Turkey. Evaluating the physicians' views on DNR is critical to the current problems and contributes to legal regulation. Objectives: To examine the views of intensive care unit residents on DNR and the sociocultural and occupational factors affecting them. Methods: The research is a descriptive cross-sectional study. The sample of the study consists of 203 residents of internal medicine working in the intensive care unit in a university hospital. A questionnaire form was used as a data collection tool. Results: 62.6% of the physicians know that there is no legal regulation regarding DNR in Turkey, and 14.3% think that DNR is performed. Female physicians approve of DNR at a higher rate than men (p<0.01). Physicians with more experience in the profession stated that not all patients should be performed cardiopulmonary resuscitation (p<0.01), and DNR should be a right (p<0.05). The vast majority of physicians stated that DNR should be legal (88.1%) and should be included in residency training (85.6%). Conclusions: It is necessary to establish legal regulations on DNR and implement residency training programs that will ensure the continuous professional development of physicians. Keywords: Do not resuscitate (DNR); physicians' views; legal regulation.

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Are physicians on the same page about do-not-resuscitate? To examine individual physicians’ influence on do-not-resuscitate decision-making: a retrospective and observational study

Cited by 7 publications

References 40 publications

Clinicians’ Perspectives After Implementation of the Serious Illness Care Program

Clinicians’ Perspectives After Implementation of the Serious Illness Care Program

Knowledge gaps, attitudes, and practices regarding end-of-life medical care among physicians in an academic medical center

Physician perspectives on the DNR order in Turkey: A survey of physicians in Internal Medicine

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