General Understanding of DNAR Orders in Japan and an Ideal Ethics Education Method Towards Avoiding Confusion

2017 Fiscal Year Final Research Report

• Project/Area Number: 26463221
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Fundamental nursing
• Research Institution: Nigata University of Phermacy and Applied Life Sciences (2015-2017); Bunri University of Hospitality (2014)
• Principal Investigator: MIZUSAWA HISAE 新潟薬科大学, 健康・自立総合研究機構, 研究員 (20433196)
• Co-Investigator(Kenkyū-buntansha): 深堀 浩樹 東京医科歯科大学, 保健衛生学研究科, 准教授 (30381916) ; 中村 裕美 豊橋創造大学, 保健医療学部, 教授 (60381464)
• Research Collaborator: DEGAI YUKO 宮城大学, 看護学部, 准教授 ; SATO KANA 宮城大学, 看護学部, 准教授 ; NAITO MIHO 新潟県立看護大学, 看護学部, 助教
• Project Period (FY): 2014-04-01 – 2018-03-31
• Keywords: DNAR / DNR / 蘇生不要指示 / End of Life / 看護倫理 / 臨床倫理 / 生命倫理

Outline of Final Research Achievements

This study aimed to ascertain the current general understanding of do-not-attempt-resuscitation (DNAR) orders in Japan; to clarify ethical issues concerning DNAR orders in the actual medical setting; and to examine an ideal ethics education method towards avoiding confusion as to DNAR orders.
The interviews were conducted with five doctors and ten nurses involved in the treatment/care of end-of-life patients at six hospitals. Furthermore, a survey questionnaire was distributed to doctors and nurses at 7,380 general hospitals throughout Japan. The results of this study revealed that DNAR is misused and its meaning is over-extended. They also illustrated the current state of consensus on DNAR orders among medical staff and their decision making processes as well as emotional changes in nurses after the issuance of DNAR orders and their influence on patient care. Based on these results, the content of ethics education towards avoiding confusion as to DNAR orders was determined.

Free Research Field

看護倫理学