• 동서간호학연구지
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• 제17권2호
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• pp.139-148
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• 2011

Purpose: The purpose of the study was to explore the meaning of conflicts in nurses caring DNR (do-not-resuscitate) patients. Methods: The participants were 7 nurses caring DNR patients. Data were gathered using in-depth interviews. The interviews were recorded and transcribed verbatim. Colaizzi method was used to analyze the data. Results: The significant results can be categorized into 7 concept descriptions and 5 theme clusters by analyzing the interviews. The major theme clusters for the experiences of nurses were 'Pity about exceptional nursing actions', 'Pity about the unilateral decision making', 'Pity about halfhearted family love', 'Pity about unprepared circumstance for deathbed', and 'Pity about the absent guideline for DNR'. Conclusion: The finding of this study will help nurses resolve conflicts in caring DNR patients and provide a scientific basis for developing nursing intervention strategies for DNR patients.

• 임상간호연구
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• 제16권3호
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• pp.73-84
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• 2010

Purpose: The purpose of this study was to investigate the ethical awareness and attitude of patients' families towards Do-Not-Resuscitate(DNR), and thus provide basic information required to develop Korean appropriate DNR instructions and practice informed consent for DNR. Methods: During April 2010, 219 patient family members visiting the hospital were surveyed using a questionnaire. Results: Most of the participants preferred DNR to meaningless treatment for incurable patients. They recognized the necessity of explaining DNR to the patient with a terminal disease. They also requested DNR orders for themselves if they were in the same medical condition. In making a DNR decision, the patient's family agreed and preferred that it reflect the opinion of the patient and the doctor in charge. They also agreed that treatment should be given with the best efforts even if a DNR decision had been made for the patient. Conclusion: To make a decision on DNR for a patient who is terminally ill or for whom survival is not possible, a practice of informed consent and guidelines for executing the DNR reflecting the patient's opinion are required.

• 대한간호학회지
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• 제36권6호
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• pp.1055-1064
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• 2006

Purpose: The purpose of this study was to analyze and clarify the ambiguous concept of DNR, and to distinguish between DNR and euthanasia. Method: This study used the process of Walker & Avant's concept analysis. Result: The definable attributes of DNR were care for comfort, no further treatment and no CPR. The antecedents of DNR were the autonomy of patients and families feelings about death, the uselessness of treatment and the right to die with dignity. The process of the DNR decision should be documented and the antecedents of DNR also can be a basis for objective standards of DNR decision-making. The result of DNR was the acceptance of death by patients and families. Conclusion: DNR is decided and documented by the antecedents of DNR, and the result is a natural acceptance of death, the last process of human life. Hospice care should be activated and nurses must be patient's advocates and families' supporters in the process.

• 한국응급구조학회지
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• 제19권2호
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• pp.71-82
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• 2015

Purpose: This study aimed to investigate paramedic students' awareness and attitude toward a do not resuscitate (DNR) order and death. Methods: This research was conducted among 421 students from the Department of Emergency Medical Technology in a 4-year college located in the Chungcheong and Daejeon districts, from May 14 to 22, 2014. Data were analyzed by using IBM SPSS 21.0. Results: The mean level of attitude toward death was 2.17. The paramedic students with clinical experience showed a positive attitude toward death, of whom 72.0% answered that a DNR order is necessary. The mean level of attitude toward DNR was 2.88. The paramedic students with clinical experience showed a positive attitude toward a DNR order. They indicated that sanctity of life should be respected rather than extending ineffective treatment and that patients' decisions on DNR should be respected. The students who had more knowledge about DNR and felt the necessity of DNR had a positive attitude about death and DNR. Conclusion: Paramedic students need systematic education for proper recognition and values establishment about death and DNR.

• 대한한의정보학회지
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• 제21권2호
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• pp.25-33
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• 2015

Purpose: The purpose of this study was to examine hospital nurses' nursing activities changes after DNR(do-not-resuscitate) decision. Methods: The subjects were 120 registered nurses working in two university hospitals. The data were collected from September 1 to September 15, 2015 using self-report questionnaires. The data were analyzed using SPSS 20.0 program. Results: DNR awareness of the educational needs was very high(91.7%). But DNR educational experience was low(59.2%). Nursing activity change was classified as the physical, emotional, spiritual, and social areas. There were significant difference among religion(F=3.459, p=.010), working unit(F=3.410, p=.036), DNR awareness of the educational needs(t=5.048, p=.027), DNR educational experience(t=-2.816, p=.006) and nursing activities changes. Conclusion: Nurses are needed DNR educational programs to take care of DNR patients. And the criteria for nursing activities related to DNR is required.

• 기본간호학회지
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• 제18권3호
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• pp.411-420
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• 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.

• 한국응급구조학회지
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• 제18권2호
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• pp.95-108
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• 2014

Purpose: This descriptive study examined awareness of and ethical attitudes associated with Do Not Resuscitate (DNR) orders in 119 emergency medical technicians (EMTs). Method: In total, 255 paramedics and basic EMTs completed questionnaires between March and May, 2013. Data were analyzed using the SPSS WIN 18.0 program. Results: A chi-square analysis revealed significantly different responses given by paramedics and basic EMTs: Paramedics gave "the reason in which DNR is not necessary", as being "due to unclear DNR decision time" whereas basic EMTs answered that this was "due to a legal problem" ($x^2$ = 12.680, p < .05). Paramedics disagreed with the statement, "It is natural for medical teams to have less interest in patients with DNT orders", whereas basic EMTs agreed with the statement ($x^2$ = 6.666, p < .05). Conclusion: A unified manual on attitude toward DNR orders, taking account of social and culture factors, needs to be developed. This research provides a base line for future research.

• 성인간호학회지
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• 제17권5호
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• pp.762-771
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• 2005

Purpose: The purpose of this study was to identify characteristics of patients who were recipients of decision-making DNR, to describe the situations of DNR, and to analyze the APACHE III and MOF scores. Method: Data collection was conducted through reviews of medical records of 51 patients and through interviews with families of patients who were decision-makers for DNR at C university K Hospital located in Seoul from April to September 2002. Results: The men's APACHE III and MOF scores were higher than the women's and the non cancer patients were higher than cancer patients. Some 80.4% of DNR orders was by communication, while 11.8% of consents were written. Each of APACHE III and MOF scores of patients in the intensive care unit was higher than the patients in general ward at both points of admission and decision-making of DNR. APACHE III and MOF scores positively correlated statistically with each other. Conclusions: The findings of this study suggest that APACHE III and MOF scores be useful for decision-making of DNR as a tool measuring severity.

• 대한간호학회지
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• 제38권2호
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• pp.298-309
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• 2008

Purpose: The purpose of the study was to describe the experiences of do-not-resuscitate (DNR) among nurses. Methods: Data were collected by in-depth interviews with 8 nurses in 8 different hospitals. Conventional qualitative content analysis was used to analyze the data. Results: Eight major themes emerged from the analysis: DNR decision-making bypassing the patient, inefficiency in the decision-making process of DNR, negative connotation of DNR, predominance of verbal DNR over written DNR, doubts and confusion about DNR, least amount of intervention in the decision for DNR change of focus in the care of the patient after a DNR order, and care burden of patients with DNR. Decision-making of DNR occurred between physicians and family members, not the patients themselves. Often high medical expenses were involved in choosing DNR, thus if choosing DNR it was implied the family members and health professionals as well did not try their best to help the patient. Verbal DNR permission was more popular in clinical settings. Most nurses felt guilty and depressed about the dying/death of patients with DNR. Conclusion: Clearer guidelines on DNR, which reflect a family-oriented culture, need to be established to reduce confusion and to promote involvement in the decision-making process of DNR among nurses.

• 한국컴퓨터정보학회논문지
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• 제29권9호
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• pp.187-196
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• 2024

본 연구는 전북소재 일개 간호대학생 209명을 대상으로 DNR에 대한 윤리적 태도를 파악하고자 2022년 9월에서 11월까지 자료수집하고, 수집된 자료는 SPSS WIN 25.0 프로그램을 이용하여 기술 통계와 χ²-test로 분석하였다. 간호대학생들의 DNR에 대한 윤리적 태도를 살펴본 결과, 환자의 의사존중, 정확한 정보제공, DNR 지침준수에 대체로 동의하였으며, DNR 결정 후에라도 보호자의 요청에 따른 치료 제공 및 DNR 환자에 대한 무균 원칙 유지 등에 동의하는 경향이 있었다. 가족이 원할 경우 인공호흡기 작동 중단, 살 가망이 없는 환자라도 모든 방법을 동원한 생명 연장, 주치의의 DNR 결정 등에는 중립적 태도를 나타냈다. DNR이 선언된 후 의료진의 관심 감소는 반대의견이 많았다. 19문항 중 '말기 환자에게 모든 치료를 사용하는 것'(p=.028)과 '동료가 DNR 환자를 무균절차없이 치료하는 것을 목격하면 즉시 조언한다' 문항(p=.014)에서 DNR 관련 교육경험에 따른 유의한 차이가 있었다. DNR 상황과 절차, 관련 기준에 대한 더 정확한 근거에 대한 교육이 제공되어야 하며, 높은 수준의 상황적 윤리적 역량을 유지하기 위한 체계적인 교육이 필요하다.