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护士对“不要复苏”医嘱的态度。

Nurses' attitudes toward do-not-resuscitate orders.

作者信息

Purvis R J, Law E, Still J M, Belcher K, Kito N, Dorman J B

机构信息

Columbia Augusta Medical Center, Augusta, Ga., USA.

出版信息

J Burn Care Rehabil. 1998 Nov-Dec;19(6):538-41. doi: 10.1097/00004630-199811000-00014.

Abstract

A study was carried out to evaluate burn nurses' attitudes toward do-not-resuscitate (DNR) orders. Questionnaires were submitted to 57 staff members, 52 of whom responded. Seventy-five percent of those responding ranged in age from 30 to 49 years. Seventy-one percent were registered nurses or licensed practical nurses. Sixty-five percent of the respondents had been in health care for more than 10 years; 25% had been in burn care for more than 10 years. Fifty percent were Protestants. Thirty-seven percent of the total described themselves as very religious. Ninety-four percent of respondents felt that DNR orders are sometimes appropriate. Eighty-eight percent felt that DNR decisions should not be made solely by the physician. Ninety-five percent felt that input from patients, family members, or both is essential. Having formal ethics committees make such decisions was opposed by 75% of the respondents. Fifty-six percent felt nurses should be involved in such decisions and 21% opposed such involvement. There was considerable uncertainty, disagreement, or both about whether a DNR order should include stopping all medical treatment, ventilators, intravenous fluids, gastric feedings, and medication. The study indicated statistically significant support for the view that DNR orders are appropriate in some cases. Which patients should be given DNR status and who should make the decision about writing DNR orders were more controversial questions.

摘要

开展了一项研究以评估烧伤科护士对“不要复苏”(DNR)医嘱的态度。向57名工作人员发放了问卷,其中52人进行了回复。回复者中75%的年龄在30至49岁之间。71%是注册护士或执业护士。65%的受访者从事医疗保健工作超过10年;25%从事烧伤护理工作超过10年。50%是新教徒。37%的受访者称自己非常虔诚。94%的受访者认为DNR医嘱有时是合适的。88%的受访者认为DNR决策不应仅由医生做出。95%的受访者认为患者、家庭成员或双方的意见至关重要。75%的受访者反对由正式的伦理委员会做出此类决策。56%的受访者认为护士应参与此类决策,21%的受访者反对这种参与。对于DNR医嘱是否应包括停止所有医疗治疗、呼吸机、静脉输液、胃饲和药物治疗,存在相当大的不确定性、分歧或两者皆有。该研究表明,从统计学角度显著支持DNR医嘱在某些情况下是合适的这一观点。哪些患者应被给予DNR状态以及谁应做出开具DNR医嘱的决定是更具争议性的问题。

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