Do-not-resuscitate orders and related factors among family surrogates of patients in the emergency department

Ya Hui Cheng, Jing Jy Wang, Kuan Han Wu, Shan Huang, Mei Ling Kuo, Chao Hui Su

研究成果: Article同行評審

21 引文 斯高帕斯(Scopus)

摘要

Purpose: The purpose of this study was to investigate the prevalence of do-not-resuscitate (DNR) orders and to identify relevant factors influencing the DNR decision-making process by patients’ surrogates in the emergency department (ED). Methods: A prospective, descriptive, and correlational research design was adopted. A total of 200 surrogates of cancer or non-cancer terminal patients, regardless of whether they signed a DNR order, were recruited as subjects after physicians of the emergency department explained the patient’s conditions, advised on withholding medical treatment, and provided information on palliative care to all surrogates. Results: Of the 200 surrogates, 23 % signed a DNR order for the patients. The demographic characteristics of patients and surrogates, the level of understanding of DNR orders, and factors of the DNR decision had no significant influence on the DNR decision. However, greater severity of disease (odds ratio (OR) = 1.38; 95 % confidence interval (CI) = 0.95–1.74), physician’s initiative in discussing with the families (OR = 1.42; 95 % CI = 1.21–1.84), and longer length of hospital stay (OR = 1.06; 95 % CI = 1.03–1.08) were contributing factors affecting patient surrogates’ DNR decisions. Conclusions: The findings of this study indicated that surrogates of patients who were more severe in disease condition, whose physicians initiated the discussion of palliative care, and who stayed longer in hospital were important factors affecting the surrogates’ DNR decision-making. Therefore, early initiation of DNR discussions is suggested to improve end-of-life care.

原文English
頁(從 - 到)1999-2006
頁數8
期刊Supportive Care in Cancer
24
發行號5
DOIs
出版狀態Published - 2016 5月 1

All Science Journal Classification (ASJC) codes

  • 腫瘤科

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