The Attitude of Healthcare Providers and the General Population on the Concept of Do-Not-Resuscitate (DNR) Order in End-Stage Patients

Abstract

Background: The do-not-resuscitate (DNR) order in end-stage patients constitutes a critical medical decision, directing healthcare providers to withhold cardiopulmonary resuscitation (CPR) in the event of cardiopulmonary arrest upon the patient's request. Objectives: This study aims to analyze the attitudes of healthcare providers and the general population toward the concept of DNR orders in end-stage patients. Methods: Conducted from September 2021 to May 2022, this cross-sectional study aimed to gauge the attitudes of healthcare providers and the general population toward DNR orders in end-stage patients using a questionnaire assessing attitudes toward DNR. The research population included healthcare providers—physicians and nurses—from healthcare centers affiliated with Iran University of Medical Sciences, selected through convenience sampling, and the general population comprising individuals frequenting parks near these healthcare centers within the relevant municipal districts. Results: Among the 164 participating healthcare providers, 139 (84.8%) were female. Participants' ages ranged from 21 to 57 years, with an average age of 36.78 ± 7.79 years. The study found that healthcare providers had a significantly higher average attitude score toward DNR (29.85 ± 9.46) compared to the general population (27.08 ± 9.78). Healthcare providers with adequate financial status exhibited a more positive attitude toward DNR in end-stage patients compared to those with excellent or poor economic status (P = 0.001). Additionally, the relative frequency of individuals experiencing a poor prognosis of disease was significantly lower among healthcare personnel than the general population (P = 0.018). Healthcare providers without family members or friends in their end-stage of life demonstrated a more favorable attitude toward DNR for these patients (P = 0.001). Conclusions: The study revealed that healthcare providers exhibited a significantly more positive attitude toward DNR compared to the general population. Furthermore, healthcare providers experienced a lower relative frequency of individuals facing a poor prognosis of disease compared to the general population. However, the relative frequency of experiencing family members or friends in the end stage did not significantly differ between healthcare providers and the general population. Healthcare providers with less than 2 years or more than 20 years of experience in the medical field demonstrated a more positive attitude toward DNR.