护士对患有非癌症长期疾病的老年患者的医疗程序和护理实践以及不进行心肺复苏医嘱的看法：一项病例 vignette 研究 。 （注：“vignette” 可音译为“小插图”“病例 vignette” 这里指一种描述病例等的形式 ，因在医学语境下具体含义需结合原文完整内容进一步理解 ，直接翻译为“病例 vignette” 供参考 ）
Nurses' perceptions of medical procedures and nursing practices for older patients with non-cancer long-term illness and do-not-attempt-resuscitation orders: A vignette study.
作者信息
Higuchi Asaka, Yoshii Azusa, Takita Morihito, Tsubokura Masaharu, Fukahori Hiroki, Igarashi Rika
机构信息
Department of Home Care Nursing in Nursing Graduate School of Health Care Sciences Tokyo Medical and Dental University Tokyo Japan.
Medical Governance Research Institute Tokyo Japan.
出版信息
Nurs Open. 2020 Apr 13;7(4):1179-1186. doi: 10.1002/nop2.495. eCollection 2020 Jul.
AIM
To elucidate influence of a do-not-attempt-resuscitation (DNAR) order on nurses' perceptions of the medical procedures and nursing practices for non-cancer older patients.
DESIGN
A vignette-based questionnaire study.
METHODS
A questionnaire survey asking nurses their perceptions of clinical practices for the following three vignettes was performed in a community hospital in Japan (120): the control vignettes with an older patient with repeated heart failure who was living alone and the other two with either an absence of relatives or a diagnosis of dementia. We also prepared additions to each vignette describing a DNAR order.
RESULTS
Nurses' perception on cardiopulmonary resuscitation, defibrillation, blood tests and intravenous nutrition showed statistically significant and minimally important declines after the DNAR order compared with before for all three vignettes ( < .001). DNAR orders can influence nurses' perceptions of clinical practices for non-cancer older patients with chronic heart failure.
目的
阐明“不要尝试心肺复苏”（DNAR）医嘱对护士对非癌症老年患者医疗程序和护理实践认知的影响。
设计
基于 vignette 的问卷调查研究。
方法
在日本一家社区医院对护士进行问卷调查，询问他们对以下三个 vignette 中临床实践的看法（120 名护士）：对照 vignette 是一位独居且反复出现心力衰竭的老年患者，另外两个 vignette 分别是没有亲属或被诊断为痴呆症的患者。我们还为每个 vignette 准备了描述 DNAR 医嘱的补充内容。
结果
与所有三个 vignette 中 DNAR 医嘱下达前相比，下达后护士对心肺复苏、除颤、血液检查和静脉营养的认知在统计学上有显著且微小但有意义的下降（P <.001）。DNAR 医嘱会影响护士对患有慢性心力衰竭的非癌症老年患者临床实践的认知。
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