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Hospital Nurses' Experience of Do-Not-Resuscitate in Korea  

Yi, Myung-Sun (College of Nursing, Seoul National University)
Oh, Sang-Eun (College of Nursing, Chonnam National University)
Choi, Eun-Ok (Department of Nursing & Research Institute of Geriatric Health, Inje University)
Kwon, In-Gak (Department of Clinical Nursing Science, Samsung Medical Center)
Kwon, Sung-Bok (Department of Nursing, Dongshin University)
Choi, Kyung-Mi (Department of Nursing, Kyungin Women's College)
Kang, Young-Ah (Department of Hematology, Asan Medical Center)
Ok, Jeong-Hui (Department of Nursing, Asan Medical Center)
Publication Information
Journal of Korean Academy of Nursing / v.38, no.2, 2008 , pp. 298-309 More about this Journal
Abstract
Purpose: The purpose of the study was to describe the experiences of do-not-resuscitate (DNR) among nurses. Methods: Data were collected by in-depth interviews with 8 nurses in 8 different hospitals. Conventional qualitative content analysis was used to analyze the data. Results: Eight major themes emerged from the analysis: DNR decision-making bypassing the patient, inefficiency in the decision-making process of DNR, negative connotation of DNR, predominance of verbal DNR over written DNR, doubts and confusion about DNR, least amount of intervention in the decision for DNR change of focus in the care of the patient after a DNR order, and care burden of patients with DNR. Decision-making of DNR occurred between physicians and family members, not the patients themselves. Often high medical expenses were involved in choosing DNR, thus if choosing DNR it was implied the family members and health professionals as well did not try their best to help the patient. Verbal DNR permission was more popular in clinical settings. Most nurses felt guilty and depressed about the dying/death of patients with DNR. Conclusion: Clearer guidelines on DNR, which reflect a family-oriented culture, need to be established to reduce confusion and to promote involvement in the decision-making process of DNR among nurses.
Keywords
Bioethics; Resuscitation Orders; Qualitative Research; Nurses;
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1 Han, S. S. (2005b). The moral distress experienced by hospital nurses. Journal of the Korean Bioethics Association, 6(2), 31-47
2 Han, S. S., Park, H. A., Ahn, S. H. Cameron, M. E., Oh, H. S., & Kim, K. U. (2001). Korean nursing students' experience of ethical problems and use of ethical decision-making models. Journal of Korean Academy of Nursing, 31, 846-857   DOI
3 Lee, S. M. (2007). A cross-cultural approach to biomedical ethics: Medical decision making. Korean Journal of Medical Ethics Education, 10, 23-32
4 Park, Y. O., Chang B. H., Yoo, M. S., Cho, Y. S., & Kim, H. S. (2004). Nurses'perception over withdrawl of life-sustaining treatment. Korean Journal of Medical Ethics Education, 7, 198-216
5 Sandelowski, M. (2000). Focus on research method: Whatever happened to qualitative description? Research in Nursing & Health, 23, 334-340   DOI   ScienceOn
6 Condon, J. C. (1977). Interpersonal communication. New York: Macmillan Publishing Company
7 Hall, E. T. (1976). Beyond culture. Doubleday Garden City, New York: Anchor Press
8 Han, S. S. (2005a). Ethical issues on DNR (Do Not Resuscitate) by patients with incurable disease. Korean Journal of Medical Ethics Education, 8, 11-20
9 Hsieh, H. F., & Shannon, S. E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15, 1277-1288   DOI
10 Chung, S. P., Yoon, C. J., Oh, J. H., Yoon, S. Y., Chang, W. J., & Lee, H. S. (1998). A retroperspective review of the Do-Not-Resuscitate patients. Journal of the Korean Society of Emergency Medicine, 9, 271-276
11 Kong, B. H. (2002). Asthetical-ethical paradigm of care ethics in nursing. Journal of Korean Academy of Nursing, 32, 364-372   DOI
12 Han, S. S., Kim, J. H., Moon, I. S., & Yong, J. S. (2005). Proposal of "request and order form" of Do Not Resuscitate (DNR). Journal of the Korean Bioethics Association, 6, 49-62
13 Lee, S. H., Kim, J. S., Hwang, M. J., Hwang, B. D., & Park, Y. J. (1998). Ethical dilemma associated with DNR: The attitude of clinical nurse. Clinical Nursing Rsearch, 4, 147-161
14 Kim, Y. S. (2000). Effect of ethics education on nurse's moral judgement. Journal of Korean Academy of Nursing, 30, 183-193   DOI
15 Morgan, D. L. (1993). Qualitative content analysis: A guide to paths not taken. Qualitative Health Research, 3, 112-121   DOI   ScienceOn
16 Graneheim, U. H., & Lundman, B. (2004). Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24, 105-112   DOI   ScienceOn
17 Han, S. S., Chung, S. A., Ko, G. H., Han, M. H., & Moon, M. S. (2001). Nurses' understanding and attitude on DNR. Journal of Korean Academy of Nursing Administration, 7, 403-413
18 Beauchamp, T. L., & Childress, J. F. (2001). Principle of biomedical ethics (5th ed.). New York: Oxford University Press
19 Son, M. S. (1998). Ethical and legal aspect of termination of hospital care. Journal of Korean Medical Association, 41, 707-711   DOI