Investigating Key Factors Related to the Decision of a Do-Not-Resuscitate Consent

Hui-Mei Lin, Chih-Kuang Liu, Yen-Chun Huang, Chieh-Wen Ho and Mingchih Chen
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Hui-Mei Lin: Taipei City Hospital, RenAi Branch Nursing Supervisor, Taipei 106, Taiwan
Chih-Kuang Liu: Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City 242, Taiwan
Yen-Chun Huang: Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City 242, Taiwan
Chieh-Wen Ho: Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City 242, Taiwan
Mingchih Chen: Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City 242, Taiwan

IJERPH, 2021, vol. 19, issue 1, 1-9

Abstract: Background: The decision to sign a do-not-resuscitate (DNR) consent is critical for patients concerned about their end-of-life medical care. Taiwan’s National Health Insurance Administration (NHIA) introduced a family palliative care consultation fee to encourage family palliative care consultations; since its implementation, identifying which families require such consultations has become more important. In this study, the Taiwanese version of the Palliative Care Screening Tool (TW–PCST) was used to determine each patient’s degree of need for a family palliative care consultation. Objective: This study analyzed factors associated with signing DNR consents. The results may inform family palliative care consultations for families in need, thereby achieving a higher DNR consent rate and promoting the effective use of medical resources, including time, labor, and funding. Method: In this retrospective study, logistic regression analysis was conducted to determine which factors affected the DNR decisions of 2144 deceased patients (aged ≥ 20 years), whose records were collected from the Taipei City Hospital health information system from 1 January to 31 December 2018. Results: Among the 1730 patients with a DNR consent, 1298 (75.03%) received family palliative care consultations. The correlation between DNR consent and family palliative care consultations was statistically significant ( p < 0.001). Through logistic regression analysis, we determined that participation in family palliative care consultation, TW–PCST score, type of ward, and length of stay were significant variables associated with DNR consent. Conclusions: This study determined that TW–PCST scores can be used as a measurement standard for the early identification of patients requiring family palliative care consultations. Family palliative care consultations provide opportunities for patients’ family members to participate in discussions about end-of-life care and DNR consent and provide patients and their families with accurate medical information regarding the end-of-life care decision-making process. The present results can serve as a reference to increase the proportion of patients willing to sign DNR consents and reduce the provision of ineffective life-prolonging medical treatment.

Keywords: do not resuscitate; family palliative care consultation; palliative care; TW-PCST score (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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