Fitzgerald Audrey, Fitzgerald Conor, Anderson Louise, Hussain Ammar Ali, Alinier Guillaume
Hamad Medical Corporation, Home Healthcare Services, Doha, Qatar.
Hamad Medical Corporation Ambulance Service, Doha, Qatar.
Front Med (Lausanne). 2023 Dec 14;10:1232954. doi: 10.3389/fmed.2023.1232954. eCollection 2023.
The values and attitudes of healthcare professionals influence their handling of "do-not-attempt-resuscitation" (DNAR) orders, as does that of the families they interact with. The aim of this study was to describe attitudes, perceptions, and practices among community-based medical practitioners towards discussing cardiopulmonary resuscitation and DNAR orders with patients and their relatives, and to investigate if the COVID-19 pandemic affected their practice in having these discussions.
This is a researcher-developed online survey-based study which aimed to recruit a convenience sample of respondents from a total population of 106 healthcare professionals working for the Mobile Healthcare Service (MHS), Hamad Medical Corporation Ambulance Service in the State of Qatar.
33 family physicians, 38 nurses, and 20 paramedics ( = 91) responded to the questionnaire, of who around 40, 8, and 50%, respectively, had engaged in Do Not Attempt Resuscitation discussions during their work with MHS. 15% of physicians who had experience with Do Not Attempt Resuscitation discussions in Qatar felt that the family or patient were not open to having such discussions. 90% of paramedics thought that Do Not Attempt Resuscitation was a taboo topic for their patients in Qatar, and this view was shared by 75% of physicians and 50% of nurses. Per the responses, the COVID-19 pandemic had not affected the likelihood of most of the physicians or nurses (and 50% of the paramedics) identifying patients with whom having a Do Not Attempt Resuscitation discussion would be clinically appropriate.
Overall, for all three groups, the COVID-19 pandemic did not affect the likelihood of identifying patients with whom a Do Not Attempt Resuscitation discussion would be clinically appropriate. We found that the greatest barriers in having Do Not Attempt Resuscitation discussions were perceived to be the religious or cultural beliefs of the patient and/or their family, along with the factor of feeling the staff member did not know the patient or their family well enough. All three groups said they would be more likely to have a conversation about Do Not Attempt Resuscitation if barriers were addressed.
医疗保健专业人员的价值观和态度会影响他们对“不要尝试心肺复苏”（DNAR）医嘱的处理方式，他们与患者家属互动时家属的价值观和态度也会产生同样的影响。本研究的目的是描述社区医生在与患者及其亲属讨论心肺复苏和DNAR医嘱方面的态度、看法和做法，并调查新冠疫情是否影响了他们进行这些讨论的实践。
这是一项由研究人员开展的基于在线调查的研究，旨在从卡塔尔国哈马德医疗公司救护车服务移动医疗服务（MHS）的106名医疗保健专业人员的总体中抽取一个方便样本作为受访者。
33名家庭医生、38名护士和20名护理人员（n = 91）回复了问卷，其中分别约有40%、8%和50%的人在与MHS合作期间参与了不要尝试心肺复苏的讨论。在卡塔尔有过不要尝试心肺复苏讨论经验的医生中，15%认为患者家属或患者不接受进行此类讨论。90%的护理人员认为不要尝试心肺复苏对他们在卡塔尔的患者来说是一个禁忌话题，75%的医生和50%的护士也持这种观点。根据回复，新冠疫情并未影响大多数医生或护士（以及50%的护理人员）确定临床上适合进行不要尝试心肺复苏讨论的患者的可能性。
总体而言，对于所有三组人员来说，新冠疫情并未影响确定临床上适合进行不要尝试心肺复苏讨论的患者的可能性。我们发现，进行不要尝试心肺复苏讨论的最大障碍被认为是患者和/或其家属的宗教或文化信仰，以及认为工作人员对患者或其家属了解不够充分这一因素。所有三组人员都表示，如果消除障碍，他们更有可能就不要尝试心肺复苏进行谈话。
