ur Rahman M, Abuhasna S, Abu-Zidan F M
Tawam Hospital in affiliation with Johns Hopkins, Al-Ain, United Arab Emirates.
Trauma Group, Faculty of Medicine & Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates.
Afr Health Sci. 2013 Dec;13(4):893-8. doi: 10.4314/ahs.v13i4.5.
Modern medicine has allowed physicians to support the dying terminally-ill patient with artificial means. However, a common dilemma faced by physicians in general, and intensivist in particular is when to limit or withdraw aggressive intervention.
To study the effect of training background and seniority on Do-not to resuscitate (DNR) decisions in the Middle East.
Anonymous questionnaire sent to members of the Pan Arab Society of Critical Care.
The response rate was 46.2%. Most of the responders were Muslim (86%) and consultants (70.9%). Majority of the responders were trained in western countries. Religion played a major role in 59.3% for making the DNR decision. DNR was considered equivalent to comfort care by 39.5%. In a futile case scenario, Do Not Escalate Therapy was preferred (54.7%). The likelihood of a patient, once labeled DNR, being clinically neglected was a concern among 46.5%. Admission of DNR patients to the ICU was acceptable for 47.7%. Almost one-half of the responders (46.5%) wanted physicians to have the ultimate authority in the DNR decision. Training background was a significant factor affecting the interpretation of the term no code DNR (P< 0.008).
Training background and level of seniority in critical care provider does not impact opinion on most of end of life issues related to care of terminally-ill patients. However, DNR is considered equivalent to comfort care among majority of Middle Eastern trained physicians.
现代医学使医生能够借助人工手段为濒死的绝症患者提供支持。然而，一般医生尤其是重症监护医生面临的一个常见困境是何时限制或停止积极干预。
研究培训背景和资历对中东地区不进行心肺复苏（DNR）决策的影响。
向泛阿拉伯危重症医学会成员发送匿名问卷。
回复率为46.2%。大多数回复者是穆斯林（86%）和顾问（70.9%）。大多数回复者在西方国家接受过培训。宗教在59.3%的DNR决策中起主要作用。39.5%的人认为DNR等同于舒适护理。在无效病例情况下，更倾向于不升级治疗（54.7%）。46.5%的人担心一旦患者被标记为DNR，在临床中会被忽视。47.7%的人认为将DNR患者收入重症监护病房是可以接受的。近一半的回复者（46.5%）希望医生在DNR决策中拥有最终决定权。培训背景是影响对“无代码DNR”这一术语解释的重要因素（P<0.008）。
重症护理提供者的培训背景和资历水平对与绝症患者护理相关的大多数临终问题的观点没有影响。然而，在大多数接受中东地区培训的医生中，DNR被认为等同于舒适护理。
