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Do-not-attempt-resuscitation orders: attitudes, perceptions and practices of Swedish physicians and nurses
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Universitetsplatsen 1, 35195, Växjö, Sweden.ORCID iD: 0000-0001-7865-3480
Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Universitetsplatsen 1, 35195, Växjö, Sweden.
The Cardio Thoracic Intensive Care Unit, Karolinska University Hospital, Region Stockholm, Eugeniavägen 23, 17164, Solna, Sweden.
Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Universitetsplatsen 1, 35195, Växjö, Sweden.
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2021 (English)In: BMC Medical Ethics, E-ISSN 1472-6939, Vol. 22, no 1, article id 34Article in journal (Refereed) Published
Abstract [en]

Background: The values and attitudes of healthcare professionals influence their handling of ‘do-not-attempt-resuscitation’ (DNAR) orders. The aim of this study was a) to describe attitudes, perceptions and practices among Swedish physicians and nurses towards discussing cardiopulmonary resuscitation and DNAR orders with patients and their relatives, and b) to investigate if the physicians and nurses were familiar with the national ethical guidelines for cardiopulmonary resuscitation.

Methods: This was a retrospective observational study based on a questionnaire and was conducted at 19 wards in two regional hospitals and one county hospital.

Results: 210 physicians and 312 nurses (n = 522) responded to the questionnaire. Every third (35%) professional had read the guidelines with a lower proportion of physicians (29%) compared to nurses (38%). Around 40% of patients had the opportunity or ability to participate in the DNAR discussion. The DNAR decision was discussed with 38% of patients and the prognosis with 46%. Of the patients who were considered to have the ability to participate in the discussion, 79% did so. The majority (81%) of physicians and nurses believed that patients should always be asked about their preferences before a DNAR decision was made.

Conclusions: Swedish healthcare professionals take a patient’s autonomy into account regarding DNAR decisions. Nevertheless, as 50% of patients were considered unable to participate in the DNAR discussion, questions remain about the timing of patient participation and whether more discussions could have been conducted earlier. Given the uncertainty about timing, the majority of patients deemed competent participated in DNAR discussions. © 2021, The Author(s).

Place, publisher, year, edition, pages
Springer Nature, 2021. Vol. 22, no 1, article id 34
Keywords [en]
Attitudes, Autonomy, Cardiac arrest, DNAR order, Informed consent, Nurses, Physicians
National Category
Nursing
Identifiers
URN: urn:nbn:se:hb:diva-25892DOI: 10.1186/s12910-021-00604-8ISI: 000635104400001Scopus ID: 2-s2.0-85103573871Archive number: 000635104400001OAI: oai:DiVA.org:hb-25892DiVA, id: diva2:1579865
Available from: 2021-07-12 Created: 2021-07-12 Last updated: 2025-09-24

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