آموزش و اخلاق در پرستاری

نگرش کادر درمانی در خصوص دستور عدم احیا: مروری بر مطالعات انجام شده در ایران

نوع مقاله : مقاله پژوهشی

نویسندگان

1 استادیار گروه بیهوشی، مرکز تحقیقات بیهوشی و کنترل درد، دانشگاه علوم پزشکی بندرعباس، هرمزگان، ایران

2 استادیار گروه بیهوشی، مرکز تحقیقات بیهوشی و کنترل درد، دانشگاه علوم پزشکی بندرعباس، هرمزگان، ایران.

3 دانشیار گروه بیهوشی، مرکز تحقیقات بیهوشی و کنترل درد، دانشگاه علوم پزشکی بندرعباس، هرمزگان، ایران.

چکیده

مقدمه: درمان بیماران در روزهای پایانی زندگی، همواره چالشی برای کادر درمان، از جمله: پزشکان و پرستاران بوده است و تصمیم ­گیری در مورد ادامۀ درمان در این نوع بیماران، یکی از اساسی ­ترین نیازهای متخصصان سلامت می ­باشد. پژوهش حاضر، با هدف بررسی نگرش کادر درمانی، در خصوص دستور عدم احیا، مروری بر مطالعات انجام شده در ایران، انجام شده است.
روش­ کار: این پژوهش از نوع مرور نظام­ مند، می ­باشد. برای بررسی اولیۀ مطالعات انجام شده، از مقالات پایگاه­ های اطلاعاتی فارسی زبان، مانند:SID ،Iranmedex ،Magiran  و  انگلیسی زبان، ازجمله: Science Direct, web of science و Scopus و موتورهای جستجوگر PubMed و Google Scholar، بدون محدودیت زمانی و جستجوی منطقی کلیدواژه ­های فارسی، شامل: «عدم احیای قلبی – ریوی»، «سیاست‌های منع احیا»، «دستور عدم احیا»، «ایران» و... و کلیدواژه­ های انگلیسی، مانند: cardiopulmonary  do-not-resuscitate,  do-not-resuscitate  policy, iran,,  do-not-resuscitate   order, DNR، استفاده گردید. ارزیابی کیفیت مقالات، با استفاده از چک لیست استاندارد STROBE، صورت گرفت.
یافته‌ها: در مرحلۀ اولیۀ جستجوی مطالعات، 963 مقاله بررسی گردید؛ سپس پژوهشگران، به بررسی مطالعات جستجو شده پرداختند و تعداد 952 مقاله، به­ دلیل مرتبط نبودن با موضوع مورد بررسی، تکراری بودن و عدم دسترسی به مقاله، کامل حذف گردید. انتخاب پژوهش ­های توصیفی صورت گرفته در ایران، به هر دو زبان فارسی و انگلیسی انجام شد که در نهایت 11 مقاله، جهت تحلیل و نگارش تحقیق، استفاده گردید. مقالات در سه طبقۀ اصلی، مورد ارزیابی نگرش­ ها، ابزارها و سیاست ­ها، مورد بررسی قرار گرفت.
نتیجه ­گیری: با توجه به وجود نگرش مثبت در مطالعات، پیشنهاد می ­شود ضمن توسعه، یکپارچه ­سازی و استانداردسازی ابزارهای نگرش سنجی و بررسی نقش سایر متغیّرهای میانجی، بر نگرش کادر درمان نسبت به دستورعدم احیا، لازم است که ملاحظات اخلاقی، فقهی و حقوقی این امر به درستی مورد تحلیل قرار گیرد و بر طبق آن دستورالعمل اجرایی شفافی در اختیار کادر درمان، قرار گیرد.
 

کلیدواژه‌ها

عنوان مقاله [English]

The attitude of the medical staff regarding the do-not-resuscitate order: a review of studies conducted in Iran

نویسندگان [English]

  • Bibi Mona Razavi 1
  • Tayyebeh Zarei 1
  • Samira Zanbagh 1
  • Pourya Adibi 2
  • Majid Vatankhah 3

1 Assistant Professor, Department of Anesthesiology, Anesthesiology , Critical Care and Pain Management Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran

2 Assistant Professor, Department of Anesthesiology, Anesthesiology , Critical Care and Pain Management Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran

3 Associated Professor, Department of Anesthesiology, Anesthesiology, Critical Care and Pain Management Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran

چکیده [English]

Introduction: The treatment of patients in the last days of life has always been a challenge for the treatment staff, both
doctors and nurses, and deciding on the continuation of treatment in these patients is one of the most basic needs of health professionals. This study was conducted with the aim of investigating the attitude of the medical staff regarding the do not resuscitate order in the studies conducted in Iran.
Materials and Methods: This study is a systematic review. For the preliminary review of the studies carried out from the articles of the Persian language databases: SID, Iranmedex, Magiran and the English language databases Science Direct, Web of Science and Scopus and the search engines PubMed and Google Scholar without time limit and logical search for Farsi keywords of non-revival cardiopulmonary, do-not-resuscitate policies, do-not-resuscitate order, Iran, etc. and the English keywords cardiopulmonary do-not-resuscitate, do-not-resuscitate policy, iran, do-not-resuscitate order, DNR were used. The quality of the articles was evaluated using the STROBE standard checklist.
Results: In the initial stage of searching for studies, 963 studies were reviewed. Then the researchers reviewed the searched articles and 952 studies were removed completely due to not being related to the topic under study and being repetitive and not having access to the article. Descriptive articles in Iran were selected in both Persian and English languages, and finally 11 studies were used to analyze and write the article. The articles were examined in three categories of evaluation of attitudes, tools and policies.
Conclusion: Considering the existence of positive attitude in the studies, it is suggested to develop, integrate and
standardize the attitude measurement tools and examine the role of other mediating variables on the attitude of the treatment staff towards the do not resuscitate order; It is necessary to properly analyze the ethical, jurisprudential, and legal considerations of this matter, and according to that, clear executive instructions should be provided to the treatment staff.

کلیدواژه‌ها [English]

  • No Cardiopulmonary Resuscitation
  • Nurses
  • Attitudes
  • Policies
  • Tools
  • Orders
  • Iran
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آموزش و اخلاق در پرستاری
دوره 11، 3-4
مهر 1401
صفحه 81-90