Basubrin Omar
Faculty of Medicine, Umm Al-Qura University, Makkah, SAU.
Cureus. 2024 Sep 10;16(9):e69132. doi: 10.7759/cureus.69132. eCollection 2024 Sep.
The evolution of medical directives surrounding cardiopulmonary resuscitation (CPR) has led to the prominence of do-not-resuscitate (DNR) orders. These orders aim to respect patient autonomy and ensure dignified end-of-life care. While regulations in the United States emphasize patient choice and comprehensive discussions, Saudi Arabia's approach to DNR orders integrates Islamic principles alongside expert medical judgment. This study aimed to assess the awareness and comprehension of DNR orders among medical students at Umm Al-Qura University, Makkah, Saudi Arabia.
This study employed a cross-sectional design at Umm Al-Qura University in 2023. Convenience sampling yielded a sample of 145 participants, encompassing medical students from all years (first-sixth) and medical interns. A self-administered online questionnaire assessed participants' knowledge, beliefs, and attitudes regarding DNR orders. The questionnaire specifically addressed their familiarity with DNR orders, their understanding of the Islamic perspective on DNR, and the factors influencing their attitudes toward DNR. Results: The majority of respondents (62%) were familiar with the term "DNR," but only 52% correctly defined it. Social media was the primary source of information about DNR for most respondents (56%). A significant portion of respondents (60.7%) agreed with the concept of DNR, and 54% had personal experience with the term. Patient dignity (54%), religious concerns (66.7%), and legal concerns (60.7%) were identified as important factors in DNR decisions. A majority of respondents (67%) agreed that it is acceptable to discontinue life support for DNR patients, and 49.3% believed that organ donation should be encouraged among patient families. The study found that as medical students progressed through their training (from pre-clinical to clinical years and internship), their acceptance and understanding of DNR orders generally increased.
The study found that medical students possess some basic familiarity with DNR orders, but there is considerable room for advancement in their comprehension and acceptance of the topic. Addressing these knowledge gaps may lead to improved patient outcomes. The findings also underscore the need to equip future physicians with a comprehensive understanding of DNR orders, their ethical ramifications, and effective communication strategies for engaging with patients and their families.
围绕心肺复苏（CPR）的医疗指令的演变导致了“不要复苏”（DNR）医嘱的突出。这些医嘱旨在尊重患者自主权并确保有尊严的临终护理。在美国，相关规定强调患者选择和全面讨论，而沙特阿拉伯对DNR医嘱的处理方式则将伊斯兰原则与专业医学判断相结合。本研究旨在评估沙特阿拉伯麦加乌姆古拉大学医学院学生对DNR医嘱的知晓度和理解情况。
本研究于2023年在乌姆古拉大学采用横断面设计。通过便利抽样获得了145名参与者的样本，包括各年级（大一至大六）的医学院学生和医学实习生。一份自行填写的在线问卷评估了参与者关于DNR医嘱的知识、信念和态度。问卷特别询问了他们对DNR医嘱的熟悉程度、对伊斯兰对DNR看法的理解，以及影响他们对DNR态度的因素。结果：大多数受访者（62%）熟悉“DNR”一词，但只有52%能正确定义。对大多数受访者（56%）来说，社交媒体是关于DNR信息的主要来源。相当一部分受访者（60.7%）同意DNR的概念，54%有过与该术语相关的个人经历。患者尊严（54%）、宗教关切（66.7%）和法律关切（60.7%）被确定为DNR决策中的重要因素。大多数受访者（67%）同意对DNR患者停止生命支持是可以接受的，49.3%认为应鼓励患者家属进行器官捐赠。研究发现，随着医学院学生培训进程的推进（从临床前阶段到临床阶段及实习阶段），他们对DNR医嘱的接受度和理解通常会提高。
研究发现医学院学生对DNR医嘱有一定的基本了解，但在对该主题的理解和接受方面仍有很大提升空间。弥补这些知识差距可能会改善患者的治疗结果。研究结果还强调了有必要让未来的医生全面了解DNR医嘱、其伦理影响以及与患者及其家属沟通的有效策略。
