Misunderstanding of the Term DNR in a Middle - Eastern Teaching Hospital

Ismail, Mohamed; Khashaba, Shehab; Elmusharaf, Khalifa

doi:10.12816/0014417

Cited by 4 publications

(7 citation statements)

References 18 publications

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“…Our findings evidence that the concept of EOLC, in ICUs in Bahrain, is poorly understood and articulated. 36 A finding cannot be attributed only to cultural values. Studies in Western contexts have also highlighted the ambiguity and uncertainty practitioners experience in attempting to accurately predict when the death of a patient will occur.…”

Section: Discussionmentioning

confidence: 93%

Nurses’ care practices at the end of life in intensive care units in Bahrain

O’Neill¹,

Yaqoob²,

Faraj

et al. 2016

Nurs Ethics

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Section: Discussionmentioning

confidence: 93%

Nurses’ care practices at the end of life in intensive care units in Bahrain

O’Neill¹,

Yaqoob²,

Faraj

et al. 2016

Nurs Ethics

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“…Moreover, some physicians were not adequately informed of the DNR order to conduct these discussions with patients and family. 22…”

Section: Discussionmentioning

confidence: 99%

“…Culturally, there is a pervasive misinterpretation of the term across various regions in the Middle East. A study done by Ismail et al (2015) found that both patients and family members equate the DNR order with watching the patient die without providing any curative or palliative relief. Moreover, some physicians were not adequately informed of the DNR order to conduct these discussions with patients and family.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, some physicians were not adequately informed of the DNR order to conduct these discussions with patients and family. 22 Physician demographics in the Middle East are generally unique: most physicians are originally from the Middle East or the Indian Sub-continent. However, their training background varies with consultants (attendings) who are primarily western trained while most junior staff (medical officers or specialists) is generally trained in the Middle East.…”

Section: Discussionmentioning

confidence: 99%

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The State of the Do-Not-Resuscitate Order in a Pediatric Intensive Care Unit in the Middle East: A Retrospective Study

et al. 2022

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Objectives The Do-Not-Resuscitate (DNR) order is part of most hospitals’ policies on the process of making and communicating decisions about a patient's resuscitation status. Yet it has not become a part of our society's ritual of dying in the Middle East especially among children. Given the diversity of pediatric patients, the DNR order continues to represent a challenge to all parties involved in the care of children including the medical team and the family. Methods This was a retrospective review of the medical charts of patients who had died in the pediatric intensive care unit (PICU) of a tertiary academic institution in Beirut, Lebanon within the period of January 2012 and December 2017. Results Eighty-two charts were extracted, 79 were included in the analysis. Three were excluded as one patient had died in the Emergency Department (ED) and 2 charts were incomplete. Most patients were male, Lebanese, and from Muslim families. These patients clinically presented with primary cardiac and oncological diseases or were admitted from the ED with respiratory distress or from the operating room for post-operative management. The primary cause of death was multiorgan failure and cardiac arrest. Only 34% of families had agreed to a DNR order prior to death and 10% suggested “soft” resuscitation. Most discussions were held in the presence of the parents, the PICU team and the patient's primary physician. Conclusions The DNR order presents one of the most difficult challenges for all care providers involved, especially within a culturally conservative setting such as Lebanon. As the numbers suggest, it is difficult for parents to reach the decision to completely withhold resuscitative measures for pediatric patients, instead opting for “soft” resuscitations like administering epinephrine without chest compressions.

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“…8 Although, the concept of DNR order does not mean not to treat the terminally ill patient, this concept is often misunderstood and poorly complied by health professionals. 9 So, to effectively use and prevent misuse of DNR order, health professional must be educated about DNR. 4 Nursing care is directed towards meeting the comprehensive needs of patients and their families to prevent and relieve the symptoms and suffering of patients that are commonly associated with illness and dying.…”

Section: Introductionmentioning

confidence: 99%

Knowledge and Attitude towards Do-Not-Resuscitate Order among Nurses of a Tertiary Level Hospital

Shrestha

2021

Med. J. Shree Birendra Hosp.

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Introduction: Knowledge regarding and attitude towards end-of-life care can shape the behaviour and actions of a health professional in provision of supportive care for the comfort of the patients as well as their family members. Very little is known about nurses’ knowledge and attitude regarding do-not-resuscitate (DNR) order. Therefore, the purpose of this study was to identify the knowledge of and attitude towards DNR order and relationship between knowledge and attitude towards DNR order among the nurses of a tertiary level hospital. Methods: Descriptive correlation design was used. Convenient sampling method was used to select 70 nurses from a tertiary level hospital. Data were collected using pretested self administered structured questionnaire. Data were analysed using SPSS version 20 and analysed using descriptive and inferential statistics. Result: Among 70 respondents, almost all (95.7%) of the respondents had good level of knowledge, 2.9% had fair and 1.4% had poor level of knowledge. Most (80.0%) of the respondents had positive attitude towards DNR order and 20.0% had negative attitude. There was a positive relationship between knowledge of and attitude towards DNR order (r = 0.068) but the relationship was statistically insignificant. Conclusions: Based on the findings, the study concludes that nurses of tertiary level hospital have good knowledge and positive attitude towards DNR order. Likewise, knowledge regarding DNR order is related with the attitude towards DNR order and thus knowledge can be enhanced to improve the attitude towards DNR by regular in-service education.

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Misunderstanding of the Term DNR in a Middle - Eastern Teaching Hospital

Cited by 4 publications

References 18 publications

Nurses’ care practices at the end of life in intensive care units in Bahrain

Nurses’ care practices at the end of life in intensive care units in Bahrain

The State of the Do-Not-Resuscitate Order in a Pediatric Intensive Care Unit in the Middle East: A Retrospective Study

Knowledge and Attitude towards Do-Not-Resuscitate Order among Nurses of a Tertiary Level Hospital

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