The concept of do not resuscitate for the families of the patients at king abdul-aziz university hospital

Abstract

Aim: Do not resuscitate (DNR) is an order in medical practice for the patients who are suffering from a grave medical condition, and their life is in danger to end. DNR decision-making varies from one hospital to another. This study is aimed to assess the knowledge of the patients' relatives about DNR concept and their opinion about the DNR decision-making. Materials and Methods: This was a nonintervention cross-sectional study conducted, during 2016, among 420 patients' relatives in the Emergency Department at King Abdul-Aziz University Hospital in KSA. Data were collected by interviewing the participants. Data were further analyzed using SPSS software. The Chi-square test was used to determine the associations. Results: Variation in responses related to the DNR concept was observed. Around 44% of participants thought that DNR involved maximum intervention in the hospital, including intensive care. Further, the majority (55.2%) of the participants were assured about the quality of the services the patient would receive. Furthermore, 51% of the participants believed that ultimately, it should always be the doctor who decides on a DNR decision. Meanwhile, 36.4% of the relatives opined that the family members should be involved in the discussion regarding the DNR order. Conclusion: We observed a gap in the understanding of the concept and decision-making of DNR-order among the participants. Health-care providers should provide a greater explanation about DNR orders to the families of the patients to avoid any misunderstandings, and also support them psychologically to avoid any stress they might encounter in such situations.

Caregivers’ Perceptions of Do Not Resuscitate Orders: A Qualitative Study in Rural Southwestern Kenya

“…These findings are like the findings of Vranick et al (2022), who suggested that every facility with palliative care facility should have a DNR policy in place. This data also supports the extensive evidence that there needs to be more understanding of the DNR concept (Alsaati et al, 2020).…”

Do not attempt cardiopulmonary resuscitation decision-making process: scoping review

“…It is acknowledged that there is a need to make DNACPR decisions, as soon as possible in a patient's admission, 18 as part of a timely process 19 and for this to be commenced as early as possible after a diagnosis of an incurable disease. 20 There is a lack of clarity as to when the right time is for decisions to be made within the admission-to-discharge journey. Discussions were held in the emergency department, 21 admission period, 22 23 after admission, 24 within 48 hours of admission, 25 within 72 hours of admission 26 or following admission secondary to their life-limiting illness.…”

“…In addition to providing information to the patient, Alsaati et al, 20 Alwazzeh et al 64 and Ding et al 69 recommend that healthcare professionals also provide an explanation of DNACPR decisions to those close to the patient. This can help avoid misunderstandings, avoid stress on those close to the patient and create a better atmosphere for communication.…”