• Journal of Hospice and Palliative Care
• /
• v.18 no.3
• /
• pp.208-218
• /
• 2015

Purpose: Although a Do-Not-Resuscitate (DNR) order is widely in use, it is one of the challenging issues in end-of-life care. This study was conducted to investigate attitudes toward DNR according to education and clinical experience. Methods: Data were collected using a structured questionnaire comprising 30 items in a tertiary hospital in Seoul, Korea. Results: Participants were 238 nurses and 72 physicians. Most participants (99%) agreed to the necessity of DNR for reasons such as dignified death (52%), irreversible medical condition (23%) and patients' autonomy in decision making (19%). Among all, 33% participants had received education about DNR and 87% had DNR experience. According to participants' clinical DNR experience, their attitudes toward DNR significantly differed in terms of the necessity of DNR, timing of the DNR consent and post-DNR treatments including antibiotics. However, when participants were grouped by the level of DNR education, no significant difference was observed except in the timing of the DNR consent. Conclusion: This study suggests that the attitudes toward DNR were more affected by clinical experience of DNR rather than education. Therefore, DNR education programs should involve clinical settings.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.18 no.3
• /
• pp.411-420
• /
• 2011

Purpose: The aim of this study was to exam differences in awareness and ethical attitudes associated with Do-Not- Resuscitate (DNR) among emergency department's team. Method: The participants in this study were 402 emergency department's team working in the 41 hospitals. The data was collected by using "awareness measuring tool" by Kang (2003) and "ethical attitudes measuring tool" by Ko (2004) from May 1 to September 15, 2009. Collected data were analyzed by descriptive statistics, t-test, Pearson correlation coefficient using SPSS WIN 14.0 program. Results: 74.4% of subjects was responded that they had never been educated about DNR, but 73.9% of subjects was responded that they had experienced DNR in the emergency room. The majority of subjects responded that the patients and their families should make a decision about the DNR. There was a difference in an appropriate time for explanation of DNR among emergency department's team. There was a difference in ethical attitudes associated with Do-Not- Resuscitate among emergency department's team. Conclusion: For a professional and systematic approach to the problem, DNR guideline sufficient to elicit a social consensus is needed.

• Journal of Hospice and Palliative Care
• /
• v.21 no.2
• /
• pp.51-57
• /
• 2018

Purpose: End-of-life (EoL) decisions are challenging and multifaceted for patients and physicians. This study was aimed to explore how EoL care is practiced for patients with a do-not-resuscitate (DNR) order. Methods: We retrospectively analyzed medical records of patients who died after agreeing to a DNR order in 2016 at a university hospital. Characteristics including cause of death, intensity of EoL care, and other factors were reviewed and statistically analyzed. Results: Of total 375 patients, 170 patients (45.3%) died with malignancies, and 205 patients (54.6%) with other causes involving the central nervous system (19.2%), pulmonary (14.7%), cardiologic (6.7%) and infectious (6.4%) conditions. Both the cancer and non-cancer patient groups showed a short duration from DNR to death (median 3 days vs 2 days, P=0.629). An intensive care group comprising patients who received one or more intensive treatments such as ventilator (n=205) showed a higher number of non-cancer patients and a shorter duration from DNR to death than a group that withheld treatment before DNR (P<0.05). Conclusion: EoL decisions were made very late by both cancer and non-cancer patients. About half of the patients did not have cancer, and two-thirds of them decided DNR during intensive treatment. To make a good EoL decision, a shared decision making with patients should be done at an earlier stage.

• Journal of the Korea Convergence Society
• /
• v.8 no.2
• /
• pp.63-72
• /
• 2017

This study was identify the awareness and ethical attitudes of DNR in nursing college students and use it as basic data to help patients with DNR. The results of the questionnaire were collected from June 1, 2016 to July 10, 2016 and analyzed using SPSS 23.0 program. As a result of the analysis, the recognition of DNR was in favor of the necessity of DNR, the decision of DNR by patient and family will, and the need for documented guidelines. Ethical attitudes favored decisions made by the patient's will, range of treatment, explanation, and guidance, and opposed decisions made by the primary care physician and reduced provision of basic care. Ethical attitudes according to general characteristics were significantly different according to grade, clinical practice experience, educational experience on ethical values, educational experience on DNR, satisfaction with life, and values for death. Based on the results of this study, more follow - up studies are needed to establish the criteria for DNR.

• 한국노년학
• /
• v.27 no.2
• /
• pp.323-334
• /
• 2007

This cross-sectional descriptive study was performed to investigate the relationship among attitude toward DNR orders, depression, and self-esteem in the elderly. Method: The participants of this study were 99 elderly individuals who were hospitalized in four university hospitals in Seoul and Kangwon-do from October 1, 2006 to October 21, 2006. The data were collected using self-administered questionnaires. Results: The mean scores were 3.99 for attitude toward DNR orders(range of 1-5), 6.64 for depression(range of 1-15), and 26.83 for self-esteem(range of 10-40). Self-esteem was significantly correlated with attitude toward DNR orders(r=.200, p=.047). About half of the participants(49.5%) responded that the proper time for obtaining DNR consent was when they were healthy and could express their own intentions and make the decision by themselves. Most of the participants showed a positive attitude toward DNR orders. The participants preferred to make the DNR decision when they were healthy. Therefore, health care providers working with the elderly should try to discuss the DNR decision with their patients when they are conscious and able to make the DNR decision by themselves rather than leaving the decisions up to the patient's family members

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.16 no.1
• /
• pp.397-407
• /
• 2015

The purpose of this study was to evaluate the effect on knowledge, attitude and volition of DNR after implementing the educational program of withdrawing life sustaining treatment to elderly people. The subjects for this study were healthy elders over 65 year-old at J elderly center located at S city, Korea. Data were gathered from October 2 to November 9, 2012. Participants were randomly assigned to either experimental or control group. For the experimental group, a 50 minute educational program on withdrawing life-sustaining treatment program was delivered twice a week for 3 weeks, and the control group did not receive any education. DNR knowledge (F=4.158;p=.049), DNR attitude (F=39.60; p=.001) were higher in experimental group compare to control group. Changes in number of participants who were determined to choose DNR for themselves (p=.006), for spouse (p=.039) and for parents (p=.006) were significantly higher in experimental group compared to control group. The program was effective in changing participant's knowledge, attitude and volition toward DNR and this program can be utilized to guide the decision making process of DNR for elderly.