RESUSCITATION DECISIONS IN RESIDENTS WITH NO DNR ORDER

本研究旨在探讨疗养院的复苏决策 没有“不复苏”(DNR)令的居民是要提供 关于胜任能力的知识和偏好的经验信息 居民对心肺复苏的看法，居民偏好与 那些他们认为是决策者的人，如果他们 变得不称职，与非DNR的CPR相关的疗养院实践 居民和工作人员关于复苏非DNR居民的决定。 将获得关于预测变量DO的子集的信息 在护理中区分赞成或反对复苏的决定 没有DNR订单的家庭居民。对于居民来说，推定的 预测变量有年龄、性别、教育程度、宗教信仰、 感知健康、功能状态及对心肺复苏术的了解。为 医疗保健提供者，假定的预测变量是他们的角色， 年龄、性别、教育程度、宗教信仰、对精神疾病疗效的感知 CPR和虚拟居民在小场景中的四个特征 (性别、身体状况、认知状况、人际“吸引力”)。 疗养院特征可作为心肺复苏实践的预测指标 包括大小、所有权、位置、具有关于 复苏，有一个道德委员会，要求CPR认证 工作人员，拥有心肺复苏相关资源。 从50家有执照的疗养院分层随机抽样中，随机 将采访100名没有DNR订单的合格居民的样本， 他们指定的决策者也会这样做。对250名健康人的邮寄调查 来自50个设施的护理人员(护理部主任，3人 工作人员护士和每个疗养院的医务主任) 进行调查以获取有关疗养院实践、提供者的数据 特征，以及针对四个小插曲做出的CPR决定。 这些信息将有助于设计更大规模的研究， 将：a)有助于制定实质性和程序性的 无DNR的居民的复苏决定标准 订单，以及b)帮助确定消费者和医疗保健的需求 提供有关这些问题的教育。

The purpose of this study of resuscitation decisions for nursing home residents with no "do not resuscitate" (DNR) order is to provide empirical information about the knowledge and preferences of competent residents regarding CPR, the congruence between resident preferences and those of persons they identify as decision makers in the event that they become incompetent, nursing home practices related to CPR for non-DNR residents, and staff decisions about resuscitating non-DNR residents. Information will be obtained about a subset of predictor variables do differentiate between decisions for or against resuscitation in nursing home residents who do not have a DNR order. For residents, the putative predictor variables are age, sex, education, religious affiliation, perceived health, functional status, and understanding of CPR. For health care providers, the putative predictor variables are their role, age, sex, education, religious affiliation, perception of efficacy of CPR, and four characteristics of hypothetical residents in vignettes (sex, physical status, cognitive status, interpersonal "appeal"). Nursing home characteristics to be examined as predictors of CPR practice include size, ownership, location, having a written policy regarding resuscitation, having an ethics committee, requiring CPR certification of staff, having CPR-related resources. From a stratified random sample of 50 licensed nursing homes, a random sample of 100 competent residents with no DNR order will be interviewed, as will their designated decision makers. A mail survey of 250 health care providers from the 50 facilities (the director of nursing, three staff nurses, and the medical director from each nursing home) will be conducted to elicit data regarding nursing home practices, provider characteristics, and CPR decisions in response to four vignettes. Such information will be useful in designing larger scale studies that will: a) contribute to the development of substantive and procedural standards for decisions about resuscitation of residents with no DNR orders, and b) help to determine needs of consumers and health care providers for education about these issues.