Doctors’ experiences of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision making: A meta-ethnography

Annalie Baker, Clare Pollard, Andrew Soundy

Research output: Chapter in Book/Report/Conference proceedingConference contribution

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Abstract

Aims: The aim of this study is to use meta-ethnography to analyse and synthesise qualitative data that considers doctors experiences and attitudes towards DNACPR decision making.

Background: DNACPR decisions identify patients who would not benefit from having cardiopulmonary resuscitation attempted. With recent high profile media interest and published recommendations1 there is a need for a greater understanding about doctors’ attitudes towards DNACPR decisions, and the barriers which they perceive when making such decisions.

Methods: A comprehensive literature search was conducted including MEDLINE, EMBASE, PsychINFO, CINAHL, Cochrane library, PubMed, Web of Science and bibliographical reviews of retrieved studies (February 2002–2013). All retrieved articles were reviewed to identify published qualitative research focusing on doctor's experience/attitudes of DNACPR decision making in Adults. The original search identified 377 studies. After exclusions nine relevant studies were identified. Two researchers independently reviewed and critically appraised the studies. Key themes and concepts were extracted from each study. Techniques of meta-ethnography were followed to synthesise the findings.

Result: Four major themes were identified that highlight common issues and concerns experienced by doctors: ethical concerns, decision making, conflicts and communication. A line of argument synthesis produced a decision-dilemma model that describes the challenges faced in three distinct phases of DNACPR decision making: pre decision, making the decision and post decision.

Conclusions: Doctors experience a range of common concerns and issues which may affect the decision making process. DNACPR decisions are influenced by balancing conflicting clinical and ethical demands. This information is well placed to inform future training and policy to provide support for doctors when making DNACPR decisions.
Original languageEnglish
Title of host publication Doctors’ experiences of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision making: A meta-ethnography
PagesS81-S82
Number of pages2
Publication statusPublished - 1 May 2014

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