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Text
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URL Address
<a href="http://doi.org/10.1089/jpm.2007.0105" target="_blank" rel="noreferrer">http://doi.org/10.1089/jpm.2007.0105</a>
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Title
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Determinants of do-not-resuscitate orders in palliative home care.
Publisher
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Journal Of Palliative Medicine
Date
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2008
Subject
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Female; Humans; Male; Pain Measurement; Adult; Canada; Aged; Middle Aged; Activities of Daily Living; Demography; Case Management; adolescent; 80 and over; retrospective studies; DNAR; Resuscitation Orders; Neuropsychological Tests; Pain/di [Diagnosis]; Advance Directives/sn [Statistics & Numerical Data]; Critical Illness/mo [Mortality]; Critical Illness/th [Therapy]; Palliative Care/sn [Statistics & Numerical Data]; Cognition Disorders/di [Diagnosis]; Cognition Disorders/ep [Epidemiology]; Palliative Care/lj [Legislation & Jurisprudence]
Creator
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Brink P; Smith TF; Kitson M
Description
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OVERVIEW: Do-not-resuscitate (DNR) orders allow home care clients to communicate their own wishes over medical treatment decisions, helping to preserve their dignity and autonomy. To date, little is known about DNR orders in palliative home care. Basic research to identify rates of completion and determinants of DNR orders has yet to be examined in palliative home care., PURPOSE: The purpose of this exploratory study was to determine who in palliative home care has a DNR order as part of their advance directive., METHODS: Information on health was collected using the interRAI instrument for palliative care (interRAI PC). The sample included 470 home care clients from one community care access centre in Ontario., RESULTS: This study indicated that a preference to die at home (odds ratio [OR]: 8.29, confidence interval [CI]: 4.55-15.11); close proximity to death (OR: 0.99, CI: 0.99-1.00); daily incontinence (OR: 2.74, CI: 1.05-7.16); and sleep problems (OR: 1.85, CI: 1.02-3.37) are associated with DNR orders. In addition, clients who are more accepting of their situation are 5.67 times (CI: 1.67-19.27) more likely to have a DNR in place., CONCLUSION: This study represents an important first step to identifying issues related to DNR orders. In addition to proximity to death, incontinence, and sleep problems, acceptance of one's own situation and a preference to die at home are important determinants of DNR completion. The results imply that these discussions might often depend not only on the health of the clients but also on the clients' acceptance of their current situation and where they wish to die.
2008
Identifier
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<a href="http://doi.org/10.1089/jpm.2007.0105" target="_blank" rel="noreferrer">10.1089/jpm.2007.0105</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2008
80 And Over
Activities of Daily Living
Adolescent
Adult
Advance Directives/sn [Statistics & Numerical Data]
Aged
Backlog
Brink P
Canada
Case Management
Cognition Disorders/di [Diagnosis]
Cognition Disorders/ep [Epidemiology]
Critical Illness/mo [Mortality]
Critical Illness/th [therapy]
Demography
DNAR
Female
Humans
Journal Article
Journal of Palliative Medicine
Kitson M
Male
Middle Aged
Neuropsychological Tests
Pain Measurement
Pain/di [diagnosis]
Palliative Care/lj [Legislation & Jurisprudence]
Palliative Care/sn [Statistics & Numerical Data]
Resuscitation Orders
Retrospective Studies
Smith TF