Home > Issue 2 ( Volume 4 ) > Factors which influence the decision of DNR on malignancy patients. Comparison of views between patients & theit first degree relatives
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Backround: Cardiopulmonary resuscitation (CPR) is a procedure of successive actions in order to resuscitate patients with cardiac arrest. CPR in patients with malignant, incurable disease has been a matter of debate and nowadays, several nations have declared the patient’s right to give the do not resuscitate order (DNR). In Greece the view of the patients with malignancy on this matter, is not well documented.

Aim: The purpose of this study is to examine what factors influence the decision of DNR, in Greek patients with malignancy, and to compare the views of the patients and their first degree relatives on this matter.

Materials and Methods: In this study there were two groups of people: group A that included one hundred patients with malignancy, and group B that included one hundred first degree relatives of these patients. The kind and the stage of the malignancy were not in the inclusion criteria. The total cohort of people was asked to complete a questionnaire. One person interviewed the total cohort of participants. The interviews took place in a quiet room. Univariate and multivariate analysis were conducted. Level of significance was set at <0,05.

Results: In group A, 21% of patients would give the DNR order. The level of information of the patient (p=0,017), the educational level (p=0,001), the presence of end stage disease (p=0,046), the combination of physician and family, in decision making (p=0,001), and the fact that DNR must be implied in coma, cerebral injury and according to the patient’s will were demonstrated as statistically significant with the univariate analysis. On the other hand the educational level (p=0,013) and end stage disease (p=0,001) were shown independently statistically significant following the multivariate analysis. In group B 16% of relatives would give the DNR order.

Conclusions: Statistically significant factors of group A were the presence of end stage disease and the educational level of the patients. There was no statistically important factor for group B. Comparative analysis of the views of groups A & B documented no statistically important differences in the DNR order.

Keywords: cardiopulmonary resuscitation, do not resuscitate order, malignancy, incurable disease

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