Korean J Hosp Palliat Care.  2014 Jun;17(2):66-74. 10.14475/kjhpc.2014.17.2.66.

Perceptions of Caregivers and Medical Staff toward DNR and AD

Affiliations
  • 1Kangdong Sacred Heart Hospital, Seoul, Korea.
  • 2Division of Nursing, Hallym University, Chuncheon, Korea. shindong@hallym.ac.kr
  • 3Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Korea.
  • 4Health Services Research Center, Hallym University, Seoul, Korea.

Abstract

PURPOSE
This study is aimed to investigate perceptions of caregivers and medical staff toward do not resuscitate (DNR) and advance directives (AD).
METHODS
Participants were 141 caregivers and 272 medical staff members from five general hospitals. A questionnaire used for the study consisted of 20 items: 14 about DNR perceptions, three about AD, one each for age, gender and employment.
RESULTS
Both medical staff and caregivers strongly recognized the need for DNR and AD, and the level of recognition was higher with medical staff than caregivers (DNR chi2=44.56, P=0.001; AD chi2=16.23, P=0.001). The main reason for the recognition was to alleviate sufferings of patients in the terminal phase. In most cases, DNR and AD were filled out when patients with terminal conditions were admitted, and patients made the decisions by consulting with their guardians. Medical staff better recognized the need and for growing demand for guidelines for the DNR and AD decision making process than caregivers (chi2=7.41, P=0.0025).
CONCLUSION
This study showed that patients highly rely on their caregivers when making decisions for DNR and AD. Thus, it is important that patients and caregivers are provided with objective information about the decisions. Since participants' strong support for DNR and AD was mainly aimed at alleviating patients' suffering, further study is needed in the association with hospice care. Medical staff also needs to understand the different views held by caregivers and fully consider the disparity when informing patients/caregivers to make the DNR and AD decisions.

Keyword

Resuscitation orders; Advance directive adherence; Perception; Caregivers; Hospital personnel

MeSH Terms

Advance Directive Adherence
Advance Directives
Caregivers*
Decision Making
Employment
Hospice Care
Hospitals, General
Humans
Medical Staff*
Personnel, Hospital
Resuscitation Orders
Surveys and Questionnaires
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