RESULTS
Total of 246 emergency specialists and trainees were included to the study. The average age of the group was 33,25+/- 5,09. The demographic features of the participants are shown in Table 1.
Among participants, 69 (30%) mentioned that they use DNAR in practice and 65 (26,5%) think that the DNAR decision should be made by the physician. 78 participants (31,7%) mention that they understand not performing CPR as DNAR due to inefficiency principal. Metastatic terminal stage malignancy patients are found the most DNAR patients (n=187; 76,3%). DNAR decision making compared among the titles of physicians, emergency specialists are the most physicians making this decision (p<0,05).
One hundred and fifty-one physicians (59,2%) mentioned that they did not receive DNAR request from the patients’ relatives. When DNAR request of the patient or his/her relatives rate compared with the medical center, there is not a statistically significant difference among groups. However this request is found the highest in private hospitals. As the relationship between title of the physician and the DNAR request rate compared, the academic titled physicians found to be the most request taking group which is found statistically significant (p<0,05). Only 12 physicians /11,4%) officially recorded DNAR request. 84 physicians (36,1%) mentioned that DNAR application in emergency theater will be safe if this procedure is confirmed by law. This rate is found to be higher in female group (n=30; 51,7%).
It is not statistically significant among groups whom share and do not share their DNAR decision making with the relatives of the patients. The most of the reservation of not sharing DNAR decision with patient’s relatives is found to be the legal uncertainty which is statistically higher than other causes (p<0,05). When not sharing DNAR decision with the relatives and the physician’s working place compared, physical violence is found to be statistically significant (p<0,05). This ratio is found most in research and training hospitals [70 (60,9%)] and least in private hospitals [2 (28,6%)]. When the titles of the physicians and not sharing DNAR decision compared, the disturbance of physical violence is found least in academic titled physicians [11 (31,4%)] and most in trainees [26 (60,5%)] last then 2 years. The relationship between reservation for not sharing DNAR decision with relatives and the working years in emergency theater is analyzed and psychological, physical and verbal violence and other causes did show a statistical significance (p<0,05). Psychological, physical and verbal violence is determined as a reservation among physician working less than 10 years in the emergency service. Violence reservations rates in physicians working in emergency theater more than ten years found lower compared to other groups. Although a statistically significance for reservations due to legal mistrust is not observed it is found lower in physicians working more than 10 years in emergency service.