急诊科护士启动不复苏知信行现状及影响因素研究

doi:10.3761/j.issn.2096-7446.2023.09.002

Abstract

Abstract: Objective To investigate knowledge,attitude,and practice （KAP）status of initiating do-not-resuscitate （DNR）among nurses in Chinese emergency department（ED）,and analyze the related influencing factors. Methods A questionnaire survey was conducted by multi-stage sampling of ED nurses in 36 tertiary Garde A hospitals in 18 provinces（municipalities and autonomous regions）across China. The questionnaire consisted of two parts：general information of the respondents and the Knowledge-Attitude-Practice Scale of Initiating DNR among emergency medical staff. Results A total of 701 valid questionnaires were returned. The scores of knowledge,attitude and practice dimensions were （42.68±6.23）,（44.13±6.62）and （37.45±7.31）,respectively,with a total score of （124.26±17.58）. The results of correlation analysis showed that there was a two-by-two correlation between knowledge,attitude and practice of DNR initiation among ED nurses（P<0.05）. The results of multiple linear regression analysis showed that the years of working in ED was an influencing factor of knowledge;ethnicity,years of working in ED,employment type and previous experience of DNR communication were influencing factors of attitude;ethnicity,previous experience of DNR communication and the presence of DNR-related system in the department were influencing factors of practice. Conclusion ED nurses have a good level of initiating DNR knowledge and a moderate level of attitude and practice. Nursing managers and educators should establish and improve a systematic DNR education and training system so as to improve the DNR clinical communication practice of ED nurses.

Key words: Emergency Service, Hospital, Nurse, Do-Not-Resuscitate, Health Knowledge, Attitude, Practice, Cross-Sectional Studies

REN Ying, DING Chuanqi, WANG Yuwei, WANG Sa, ZHANG Yuping, JIN Jingfen. Study on the status and influencing factors of knowledge,attitude and practice of initiating do-not-resuscitate among nurses in emergency department[J]. Chinese Journal of Emergency and Critical Care Nursing, 2023, 4(9): 779-784.

References

[1] 丁传琦,金静芬,王钰炜,等. 急诊科患者不复苏应用现状及决策影响因素[J]. 中国实用护理杂志,2020,36(23):1830-1834.
Ding CQ,Jin JF,Wang YW,et al.Status quo of DNR application and influencing factors of decision-making in emergency department patients[J]. Chin J Pract Nurs,2020,36(23):1830-1834.
[2] Azizi K,Waheed S,Barolia R,et al.Understanding perceptions and factors involved in do not resuscitate(DNR）decision making in the emergency department of a low-resource country:a mixed-methods study protocol[J]. BMJ Open,2020,10(9):e038915.
[3] 蒋堂兴. 院内心脏骤停患者签署不复苏指示相关因素分析[D]. 济南:山东大学,2021.
Jiang TX.Analysis of related factors of signing non-resuscitation instructions for patients with cardiac arrest in hospital[D]. Jinan:Shandong University,2021.
[4] Hildén HM,Louhiala P,Honkasalo ML,et al.Finnish nurses' views on end-of-life discussions and a comparison with physicians' views[J]. Nurs Ethics,2004,11(2):165-178.
[5] Anderson-Shaw L.The unilateral DNR order:one hospital's experience[J]. JONAS Healthc Law Ethics Regul,2003,5(2):42-46.
[6] Richter J,Eisemann MR,Bauer B,et al.Decisions and attitudes of nurses caring for severely ill elderly patients:a culture-comparing study[J]. Pflege,1999,12(4):244-249.
[7] Khalaileh MA.Jordanian critical care nurses' attitudes toward and experiences of do not resuscitate orders[J]. Int J Palliat Nurs,2014,20(8):403-408.
[8] Purvis RJ,Law E,Still JM,et al.Nurses' attitudes toward do-not-resuscitate orders[J]. J Burn Care Rehabil,1998,19(6):538-541.
[9] 丁传琦,金静芬,王钰炜,等. 急诊医护人员启动不复苏知信行量表的编制及信效度检验[J]. 中华急危重症护理杂志,2022,3(5):396-401.
Ding CQ,Jin JF,Wang YW,et al.Development and psychometric testing of Knowledge-Attitude-Practice Scale on Initiating Do-Not-Resuscitate among emergency medical staff[J]. Chin J Emerg Crit Care Nurs,2022,3(5):396-401.
[10] 陶秋云,孙彩霞,张宇,等. 肿瘤患者口服化疗药物安全管理知信行现状调查[J]. 护理学杂志,2020,35(5):27-30.
Tao QY,Sun CX,Zhang Y,et al.Knowledge,belief,and practices of safety management of oral anticancer drugs among cancer patients[J]. J Nurs Sci,2020,35(5):27-30.
[11] Safari Malak-Kolaei F,Sanagoo A,Pahlavanzadeh B,et al. The relationship between death and do not resuscitation attitudes among intensive care nurses[J]. Omega(Westport),2022,85(4):904-914.
[12] 丁传琦,金静芬. 急诊科护士死亡态度对其临终照护态度影响的研究[J]. 中华护理教育,2020,17(3):275-278.
Ding CQ,Jin JF.The influence of death attitude on hospice care attitude among emergency nurses[J]. Chin J Nurs Educ,2020,17(3):275-278.
[13] Flannery L,Ramjan LM,Peters K.End-of-life decisions in the Intensive Care Unit(ICU)-Exploring the experiences of ICU nurses and doctors-A critical literature review[J]. Aust Crit Care,2016,29(2):97-103.
[14] Gül Ş,Bağcivan G Aksu M. Nurses' opinions on do-not-resuscitate orders[J]. Omega,2022,86(1):271-283.
[15] Chang HT,Lin MH,Chen CK,et al.Nurses' experiences and factors related to their attitudes regarding discussions with patients and family members about do-not-resuscitate decisions and life-sustaining treatment withdrawal:a hospital-based cross-sectional study[J]. Int J Environ Res Public Health,2020,17(2):557.
[16] Azmoude E,Farkhondeh F,Ahour M,et al.Knowledge,practice and self-efficacy in evidence-based practice among midwives in east Iran[J]. Sultan Qaboos Univ Med J,2017,17(1):e66-e73.
[17] Fry M,MacGregor C,Hyland S,et al. Emergency nurses' perceptions of the role of confidence,self-efficacy and reflexivity in managing the cognitively impaired older person in pain[J]. J Clin Nurs,2015,24(11/12):1622-1629.

Study on the status and influencing factors of knowledge,attitude and practice of initiating do-not-resuscitate among nurses in emergency department

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Recommended Articles

Metrics

Comments

[1]	KE Yu, ZHANG Yuping, YAO Meiqi, HUA Jing, ZHANG Ruolin, JIN Jingfen. Mechanisms of influence of head nurses’ multiple leadership styles on ICU nurses’ safety behaviors：a mixed-method study [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(7): 856-863.
[2]	LIU Fang, LI Mengnan, AN Jihui, WANG Yue, LI Peiyao, SHEN Yanling, YANG Xiwen, MEI Aiying, WANG Yujiao, GONG Lichao, SUN Hong. A qualitative study on the training experiences and expectations for professional development of critical care advanced practice nurses [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(7): 864-869.
[3]	XU Li, MU Wenfang, FANG Wenjie, QIN Mingyang, WANG Xiyi. Latent profile analysis of readiness for hospital discharge among acute myocardial infarction patients after percutaneous coronary intervention [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(6): 660-666.
[4]	LI Jing, HU Min, LU Xiaoying, YANG Yaya, CHEN Xue-mei, HU Bing. Meta-analysis of delay rate from hospital admission to balloon dilation and influencing factors in patients with acute ST-elevation myocardial infarction [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(6): 689-696.
[5]	CHEN Cailing, WANG Rui, JIANG Zhaoquan, MA Guowei, SUN Pan, ZHU Xiang’an, ZHANG Lan. Analysis of the mediating effect of workplace friendship on the relationship between professional resilience and professional well-being of emergency department nurses [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(6): 725-732.
[6]	CHEN Ruoxi, LIU Lihong, FAN Luo, WANG Huixia, JIA Qianhui, YANG Zhen, FAN Kaisheng, WANG Yuanyunzi. Evidence summary of de-escalation measures for patient-nurse violence in emergency departments [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(6): 748-754.
[7]	ZHAO Lihua, ZHENG Yimei, YUAN Cui, ZHANG Jianxia, YE Jing. Analysis of the current status and influencing factors of core competencies in ECMO nursing care among ICU nurses [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(5): 595-601.
[8]	CUI Mengjiao, CHEN Lu, HUANG Ping, FANG Fang, XIA Ying, MEI Tianshu. A qualitative study on the emergency department nurses’ experience of practicing humanistic care [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(5): 602-607.
[9]	JIANG Yu, LI Na, LI Chuanhao, FENG Yan, TANG Zhihong. Construction and applicability analysis of the evaluation index system for core competencies of advanced practice nurses in ICU [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(4): 412-418.
[10]	HUANG Shuixiu, LIANG Li, ZHANG Wei, XU Junhui, ZHAO Yu. Research on the current status and influencing factors of ethical competence of emergency department nurses [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(4): 432-439.
[11]	MA Na, CHEN Xufeng, CHEN Feng, ZHANG Yangchun, JI Xueli. A meta-synthesis of qualitative studies on nursing experiences of extracorporeal membrane oxygenation nurses [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(4): 440-446.
[12]	DENG Ying, HUANG Shan, SHAO Xin. The correlation analysis of self-compassion and caring ability among emergency and critical care nurses [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(4): 476-480.
[13]	CHEN Xiuwan, CHEN Fuhong, GAO Lu, GUO Jiaying, SHEN Jiali. Qualitative study on the experience of using eye-tracking technology in electrocardiogram training for emergency and critical care nurses [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(3): 294-299.
[14]	JIANG Xiuzhen, WANG Yanli, HE Huiling, WU Yan, MA Liying. Analysis of the latent profile characteristics and influencing factors of change fatigue of nurses in emergency department [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(3): 344-350.
[15]	LIANG Dalian, LI Cuilan, LI Haiyan, HUANG Yu. Latent types and influencing factors of communication barriers between ICU nurses and patients’ families [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(2): 162-167.