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.