TY - JOUR
T1 - Do-not-resuscitate orders and related factors among family surrogates of patients in the emergency department
AU - Cheng, Ya Hui
AU - Wang, Jing Jy
AU - Wu, Kuan Han
AU - Huang, Shan
AU - Kuo, Mei Ling
AU - Su, Chao Hui
N1 - Publisher Copyright:
© 2015, Springer-Verlag Berlin Heidelberg.
PY - 2016/5/1
Y1 - 2016/5/1
N2 - 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.
AB - 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.
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U2 - 10.1007/s00520-015-2971-7
DO - 10.1007/s00520-015-2971-7
M3 - Article
C2 - 26514563
AN - SCOPUS:84945528939
SN - 0941-4355
VL - 24
SP - 1999
EP - 2006
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 5
ER -