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土耳其的医生对 DNR 医嘱的看法:内科医生的调查。

Physician perspectives on the DNR order in Turkey: A survey of physicians in Internal Medicine.

机构信息

Dokuz Eylul University Faculty of Medicine, History of Medicine and Ethics.

Balikesir Provincial Health Directorate.

出版信息

Afr Health Sci. 2023 Mar;23(1):667-677. doi: 10.4314/ahs.v23i1.71.

DOI:10.4314/ahs.v23i1.71
PMID:37545950
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10398497/
Abstract

BACKGROUND

Do not resuscitate (DNR) is a controversial ethico-legal issue and there is no legal regulation in Turkey. Evaluating the physicians' views on DNR is critical to the current problems and contributes to legal regulation.

OBJECTIVES

To examine the views of intensive care unit residents on DNR and the sociocultural and occupational factors affecting them.

METHODS

The research is a descriptive cross-sectional study. The sample of the study consists of 203 residents of internal medicine working in the intensive care unit in a university hospital. A questionnaire form was used as a data collection tool.

RESULTS

62.6% of the physicians know that there is no legal regulation regarding DNR in Turkey, and 14.3% think that DNR is performed. Female physicians approve of DNR at a higher rate than men (p<0.01). Physicians with more experience in the profession stated that not all patients should be performed cardiopulmonary resuscitation (p<0.01), and DNR should be a right (p<0.05). The vast majority of physicians stated that DNR should be legal (88.1%) and should be included in residency training (85.6%).

CONCLUSIONS

It is necessary to establish legal regulations on DNR and implement residency training programs that will ensure the continuous professional development of physicians.

摘要

背景

不复苏(DNR)是一个有争议的伦理法律问题,土耳其没有法律规定。评估医生对 DNR 的看法对于当前的问题至关重要,并有助于法律监管。

目的

调查重症监护病房居民对 DNR 的看法以及影响他们的社会文化和职业因素。

方法

该研究是一项描述性的横断面研究。研究的样本由在大学医院重症监护病房工作的 203 名内科医生组成。问卷调查表作为数据收集工具。

结果

62.6%的医生知道土耳其没有关于 DNR 的法律规定,14.3%的医生认为 DNR 正在进行。女医生比男医生更赞成 DNR(p<0.01)。有更多专业经验的医生表示,并非所有患者都应进行心肺复苏术(p<0.01),DNR 应该是一种权利(p<0.05)。绝大多数医生表示 DNR 应该合法化(88.1%),并应纳入住院医师培训(85.6%)。

结论

有必要制定 DNR 的法律规定,并实施住院医师培训计划,以确保医生的持续专业发展。

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Front Public Health. 2021 May 12;9:560405. doi: 10.3389/fpubh.2021.560405. eCollection 2021.
2
Factors associated with physician decision making on withholding cardiopulmonary resuscitation in prehospital medicine.与院前医学中医生决定是否进行心肺复苏术相关的因素。
Sci Rep. 2021 Mar 4;11(1):5120. doi: 10.1038/s41598-021-84718-4.
3
Are physicians on the same page about do-not-resuscitate? To examine individual physicians' influence on do-not-resuscitate decision-making: a retrospective and observational study.医师对于是否实施心肺复苏术的意见一致吗?为了研究个体医师对是否实施心肺复苏术决策的影响:一项回顾性和观察性研究。
BMC Med Ethics. 2019 Dec 4;20(1):92. doi: 10.1186/s12910-019-0429-z.
4
The training in SHARE communication course by physicians increases the signing of do-not-resuscitate orders for critical patients in the emergency room (cross-sectional study).医生在 SHARE 沟通课程中的培训增加了急诊科危急患者的不复苏医嘱签署率(横断面研究)。
Int J Surg. 2019 Aug;68:20-26. doi: 10.1016/j.ijsu.2019.06.005. Epub 2019 Jun 8.
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CPR decision-making conversations in the UK: an integrative review.英国的心肺复苏决策对话:一项综合综述。
BMJ Support Palliat Care. 2019 Mar;9(1):1-11. doi: 10.1136/bmjspcare-2018-001526. Epub 2018 Aug 14.
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