Knowledge and attitude toward do-not-resuscitate among patients and their relatives visiting outpatient clinics at King Abdulaziz University Hospital, Jeddah, Saudi Arabia

Ahmadi, Jawaher R Al; Aljehani, Sondos N.; Bahakeem, Lujain M.; Hijan, Bushra A.; Mayet, Sarah A.; Badahdah, Yosra A.

doi:10.15537/smj.2020.1.24782

Cited by 7 publications

(15 citation statements)

References 8 publications

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“…Studies in which patients were included as a target population reported a lack of knowledge of the medical conditions for DNR practice [ 62 , 65 , 66 , 68 , 69 ]. Patients expressed a will to participate in discussions with doctors on planning end-of-life care and making their own decisions.…”

Section: Discussionmentioning

confidence: 99%

Current state of ethical challenges reported in Saudi Arabia: a systematic review & bibliometric analysis from 2010 to 2021

Woodman

Waheed

Rasheed³

et al. 2022

BMC Med Ethics

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Background Over the past few years, five domains of importance about the current state of bioethics in Saudi Arabia have shaped the perspective of most research: doctor-patient relationship, informed consent, do-not-resuscitate, organ donation, and transplantation, medical students’ knowledge and attitudes about medical ethics curriculum. This systematic review aimed to systematically identify, compile, describe and discuss ethical arguments and concepts in the best-studied domains of bioethics in Saudi Arabia and to present cultural, social, educational, and humane perspectives. Methods Six databases were searched using Boolean operators (PubMed, Embase, Web of Science, Scopus, CINAHL, Google Scholar) from December 2020–June 2021. The search and report process followed the statement and flowchart of preferred reporting items for systematic reviews and meta-analyses (PRISMA). Resutls The search resulted in 1651 articles, of which 82 studies were selected for a final review and assessment. There is a gradual increase in research, whereby a substantial increase was observed from 2017. Most of the published articles focused on ‘Organ Donation & Transplantation’ with 33 articles, followed by ‘Doctor-Patient Relations’ with 18 publications. Most of the published articles were from Central Province (33), followed by Western Province (16). The authorship pattern showed a collaborative approach among researchers. The thematic analysis of keywords analysis showed that ‘Saudi Arabia,’ ‘attitude PHC,’ ‘organ donation,’ ‘knowledge and education,’ and ‘donation’ have been used the most commonly. Conclusion This systematic quantitative synthesis is expected to guide researchers, stakeholders, and policymakers about the strengths and gaps in knowledge and attitudes regarding medical ethics in Saudi Arabia, both among the general public and health professionals.

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Section: Discussionmentioning

confidence: 99%

Current state of ethical challenges reported in Saudi Arabia: a systematic review & bibliometric analysis from 2010 to 2021

Woodman

Waheed

Rasheed³

et al. 2022

BMC Med Ethics

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“…Family members play a key role in the decision-making process [ 9 ]. Physicians’ failure to provide adequate information about DNR consent to patients or their families, as well as the inability of patients and their families to participate in end-of-life care decisions, might lead to situations in which a patient experiences prolonged suffering before death [ 2 , 5 , 30 ]. Family relations are close in Asian countries, and toward the end of a patient’s life, the thoughts and feelings of the patient’s family members are a critical concern.…”

Section: Discussionmentioning

confidence: 99%

“…The support of physicians is of major importance in addressing concerns regarding patients’ and family members’ emotional reactions [ 15 ]. Medical teams can publicly discuss their views on DNR decision-making to further inform patients’ family members about the implications of DNR consent and to encourage them to reach consensus on end-of-life care decisions [ 5 , 22 , 23 ]. Taiwan has incorporated family palliative care consultation into its health care policy, which encourages physicians and other medical staff to provide sufficient information and suggestions to reduce information asymmetry between patients and their families.…”

Section: Discussionmentioning

confidence: 99%

“…DNR policies were first enacted in the United States in 1976. On 7 June 2000, Taiwan’s Ministry of Health and Welfare enacted the Natural Death Act , which contains provisions enshrining a patient’s right to choose a natural death [ 3 , 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…A persistent problem with consent is that DNR discussions do not occur frequently enough and decisions are often made in the final stage of a patient’s disease, at which point the patient is often unable to make the DNR decision autonomously or lacks effective communication in the hospital (Yuen et al, 2011, [ 5 , 6 , 7 , 8 , 9 ]. Furthermore, cultural background may influence DNR decision-making.…”

Section: Introductionmentioning

confidence: 99%

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Investigating Key Factors Related to the Decision of a Do-Not-Resuscitate Consent

Lin

Liu

Huang

et al. 2021

IJERPH

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Background: The decision to sign a do-not-resuscitate (DNR) consent is critical for patients concerned about their end-of-life medical care. Taiwan’s National Health Insurance Administration (NHIA) introduced a family palliative care consultation fee to encourage family palliative care consultations; since its implementation, identifying which families require such consultations has become more important. In this study, the Taiwanese version of the Palliative Care Screening Tool (TW–PCST) was used to determine each patient’s degree of need for a family palliative care consultation. Objective: This study analyzed factors associated with signing DNR consents. The results may inform family palliative care consultations for families in need, thereby achieving a higher DNR consent rate and promoting the effective use of medical resources, including time, labor, and funding. Method: In this retrospective study, logistic regression analysis was conducted to determine which factors affected the DNR decisions of 2144 deceased patients (aged ≥ 20 years), whose records were collected from the Taipei City Hospital health information system from 1 January to 31 December 2018. Results: Among the 1730 patients with a DNR consent, 1298 (75.03%) received family palliative care consultations. The correlation between DNR consent and family palliative care consultations was statistically significant (p < 0.001). Through logistic regression analysis, we determined that participation in family palliative care consultation, TW–PCST score, type of ward, and length of stay were significant variables associated with DNR consent. Conclusions: This study determined that TW–PCST scores can be used as a measurement standard for the early identification of patients requiring family palliative care consultations. Family palliative care consultations provide opportunities for patients’ family members to participate in discussions about end-of-life care and DNR consent and provide patients and their families with accurate medical information regarding the end-of-life care decision-making process. The present results can serve as a reference to increase the proportion of patients willing to sign DNR consents and reduce the provision of ineffective life-prolonging medical treatment.

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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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Knowledge and attitude toward do-not-resuscitate among patients and their relatives visiting outpatient clinics at King Abdulaziz University Hospital, Jeddah, Saudi Arabia

Cited by 7 publications

References 8 publications

Current state of ethical challenges reported in Saudi Arabia: a systematic review & bibliometric analysis from 2010 to 2021

Current state of ethical challenges reported in Saudi Arabia: a systematic review & bibliometric analysis from 2010 to 2021

Investigating Key Factors Related to the Decision of a Do-Not-Resuscitate Consent

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

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