Insights into Chinese perspectives on do-not-resuscitate (DNR) orders from an examination of DNR order form completeness for cancer patients
Resource
Support. Care Cancer, 21(9), 2593-2598
Journal
Supportive Care in Cancer
Pages
2593-2598
Date Issued
2013
Date
2013
Author(s)
Wen, Kuei-Yen
Lin, Ya-Chin
Cheng, Ju-Feng
Chou, Pei-Chun
Wei, Chih-Hsin
Chen, Yun-Fang
Sun, Jia-Ling
Abstract
Discussing end-of-life care with patients is often considered taboo, and signing a do-not-resuscitate (DNR) order is difficult for most patients, especially in Chinese culture. This study investigated distributions and details related to the signing of DNR orders, as well as the completeness of various DNR order forms.
Retrospective chart reviews were performed. We screened all charts from a teaching hospital in Taiwan for patients who died of cancer during the period from January 2010 to December 2011. A total of 829 patient records were included in the analysis. The details of the DNR order forms were recorded.
The DNR order signing rate was 99.8 %. The percentage of DNR orders signed by patients themselves (DNR-P) was 22.6 %, while the percentage of orders signed by surrogates (DNR-S) was 77.2 %. The percentage of signed DNR forms that were completely filled out was 78.4 %. The percentage of DNR-S forms that were completed was 81.7 %, while the percentage of DNR-P forms that were completely filled out was only 67.6 %.
Almost all the cancer patients had a signed DNR order, but for the majority of them, the order was signed by a surrogate. Negative attitudes of discussing death from medical professionals and/or the family members of patients may account for the higher number of signed DNR-S orders than DNR-P orders. Moreover, early obtainment of signed DNR orders should be sought, as getting the orders earlier could promote the quality of end-of-life care, especially in non-oncology wards.
Subjects
Chinese culture
Palliative care
Do-not-resuscitate (DNR)
End-of-life care discussion
Cancer
SDGs
Other Subjects
aged; article; breast cancer; cancer patient; Chinese; clinical protocol; digestive system cancer; do not resuscitate order; female; genital tract cancer; gynecologic cancer; head and neck cancer; hematologic malignancy; human; lung cancer; major clinical study; male; medical record; priority journal; retrospective study; screening; skin cancer; Taiwan; teaching hospital; urogenital tract cancer; Aged; Aged, 80 and over; Asian Continental Ancestry Group; Communication; Family; Female; Hospitals, Teaching; Humans; Male; Medical Records; Middle Aged; Neoplasms; Palliative Care; Resuscitation Orders; Retrospective Studies; Taiwan
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