儿科ICU护士对重症患儿不再心肺复苏决策态度及影响因素分析

The attitudes of nurses in PICU towards do-not-resuscitate for critically ill children and its influencing factors

目的了解儿科ICU护士对重症患儿不再心肺复苏(DNR)决策态度及影响因素。方法采用儿科护士对重症患儿签署DNR意愿书/同意书态度问卷对239名儿科ICU护士进行调查。结果儿科ICU护士DNR决策态度总均分为(2.88±0.27)分,30.96%的儿科ICU护士的DNR决策态度积极。Logistic回归分析显示,文化程度是影响儿科ICU护士DNR沟通态度的主要因素,了解患儿治疗决策、信仰是影响儿科ICU护士DNR决策策略态度的主要因素,了解患儿治疗决策是影响儿科ICU护士DNR决策态度的主要因素(P<0.05,P<0.01)。结论儿科ICU护士对重症患儿DNR决策态度积极性较低,专科以下学历和不了解患儿治疗决策者积极性更低。建议对儿科ICU护士开展临终关怀及DNR相关知识培训,改善DNR决策态度。

Objective To understand the attitudes of nurses in PICU towards do-not-resuscitate(DNR)for critically ill children,and to analyze its influencing factors.Methods A total of 239 nurses in PICU were investigated using the questionnaire of willingness/consent to DNR for critically ill children.Results The average score of PICU nurses′attitudes towards DNR was(2.88±0.27),the nurses with a positive DNR attitude accounted for 30.96%.Logistic regression analysis showed that,educational background was the main influencing factor of DNR communication attitude of PICU nurses,understanding the treatment decision of children and belief were the major influencing factors of DNR decision-making strategy attitude,and understanding the treatment decision of children was the main influencing factor of DNR attitude(P<0.05,P<0.01).Conclusion The positivity of the attitudes of PICU nurses towards DNR for critically ill children is low,especially those nurses with associate degree or below and didn′t understand the treatment decision of children.It is suggested to conduct palliative care and DNR related training for PICU nurses to improve their attitudes towards DNR.