Hiroshi Hori, Hanako Yoshihara‐Kurihara, Keishiro Sueda, Takahiko Fukuchi, Hitoshi Sugawara
Geriatrics & Gerontology International 2025年4月23日 査読有り最終著者
Aim
This study aimed to clarify the current understanding/misunderstanding regarding the “do not attempt resuscitation (DNAR)” order among physicians and nurses in Japan as well as related factors.
Methods
We conducted a questionnaire survey of physicians and nurses working in three Japanese medical institutions. We established “misconception indicators” for DNAR orders and identified related factors using the Mann–Whitney U test, with multiple comparisons using the Dunn test. Differences in each misconception indicator were compared between physicians and nurses using the chi‐square test.
Results
We obtained survey responses from 134 physicians and 233 nurses. Among them, >70% of physicians and nurses responded that a DNAR order indicated withholding invasive medical care. Moreover, responses suggesting that DNAR prompted palliative care were more common among physicians and nurses working at hospitals without intensive care units or rapid response systems. Additionally, >40% of physicians responded that a DNAR order prompted them to limit the use of medical resources, including the intensive care unit and blood transfusions, with this proportion being higher than that among nurses. Further, physicians with longer clinical experience were more likely to limit the use of medical resources in cases of a DNAR order.
Conclusions
Many physicians and nurses misinterpreted a DNAR order as prompting palliative care. To facilitate support toward patient decision‐making and correct implementation of DNAR orders, it is important to establish internal guidelines, provide education regarding end‐of‐life care and medical terminology, and introduce specialized care teams.