The Iranian physicians attitude toward the do not resuscitate order

Abstract

Background

Physicians are responsible for making decisions about the do not resuscitate (DNR) order of patients; however, most of them are faced with some uncertainty in decision making and ethical aspects. Moreover, there are differences on decision making related to the DNR order among physicians, which may be related to the different attitudes toward this issue. Considering the lack of information, this study was performed to investigate doctors’ attitude about DNR order for patients in their final phases of life.

Methods

In a descriptive–analytical study, 152 physicians were enrolled as quota sampling subjects from educational hospitals affiliated to the Kermanshah University of Medical Sciences. The tool used was a researcher-developed questionnaire. Data were analyzed using SPSS 16 software by descriptive and inferential statistics.

Results

The mean of attitude toward DNR was 3.22, for which the univariate t-test showed a significant positive attitude toward DNR (P=0.002); the mean of attitude number toward DNR was higher in physicians with higher education level (P=0.002). But this difference was not found in terms of age group, sex, and experiences in participating in DNR decisions.

Conclusion

Due to the positive attitude of doctors toward DNR orders and lack of identified guidance, clear guidelines that comply with the Iranian Islamic culture are necessary to be established. Implementing this directive requires comprehensive training to various groups, including patients, doctors, nurses, administrators, and policy makers of the health system.

Keywords:

• cardiopulmonary resuscitation
• physicians
• attitude

Acknowledgments

This article is the result of an MSc thesis of Nursing approved by the School of Nursing and Midwifery of the Shahid Beheshti University of Medical Sciences (SBMU). We appreciate all the officials of SBMU, as well as the physicians working in hospitals of Imam Reza, Imam Ali, and Imam Khomani hospitals affiliated to the Kermanshah University of Medical Sciences, who contributed to the conduct of the study.

Disclosure

The authors report no conflicts of interest in this work.