Evaluation of an educational support model for critical care nurses to support surrogate decision making for DNAR

2023 Fiscal Year Final Research Report

• Project/Area Number: 19K19562
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 58060:Clinical nursing-related
• Research Institution: The University of Shimane
• Principal Investigator: Moriyama Mika 島根県立大学, 看護栄養学部, 教授 (50581378)
• Project Period (FY): 2019-04-01 – 2024-03-31
• Keywords: DNAR / クリティカルケア看護師 / 代理意思決定支援 / 教育支援モデル / 評価

Outline of Final Research Achievements

The purpose of this study was to develop an educational support model for critical care nurses to support proxy decision making for Do Not Attempt Resuscitation (DNAR) and to test the effectiveness of this model by comparing before and after intervention based on evaluation measures. Four nurses working in the ICU participated in a DNAR-focused proxy decision support education program was implemented.
The results showed that the ICU nurses' scores on the Difficulty (IND-FDNAR) scale and communication skills for ICU nurses working with families making Do Not Attempt Resuscitation decisions were changed by comparison before and after the intervention, leading to a reduction in the sense of difficulty and an improvement in communication skills. The results of the study showed that the IND-FDNAR scale and communication skill scores of ICU nurses with families involved in not-attempt-resuscitation decision making.

Free Research Field

臨床看護学

Academic Significance and Societal Importance of the Research Achievements

クリティカルケア領域では家族が代理意思決定を迫られる状況が多い。それを支援する看護師には困難感が伴い十分な支援ができない現状がある。蘇生処置拒否の代理意思決定を支援するクリティカルケア看護師の教育支援モデルの有効性が示されたことにより、このプログラムを活用することで、DNARの代理意思を行う家族にかかわるクリティカルケア看護師のコミュニケーション・スキルの向上および困難感を軽減につながり、DNARの代理意思を行う家族への関わりを促進させ、代理意思決定支援の質の向上に寄与できると考える。