{"title":"影响新生儿重症监护室护士对不复苏指令认知和态度的因素：一项混合方法研究。","authors":"Jessie Shaji Paul, Anu P, Surya Kant Tiwari, Shanty Charlin, Meena Joshi, Ankit Verma, Poonam Joshi","doi":"10.1097/JPN.0000000000000865","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This sequential mixed-method study explores neonatal intensive care unit (NICU) nurses' awareness, attitudes, and perceptions regarding do-not-resuscitate (DNR) orders.</p><p><strong>Methods: </strong>Quantitative surveys were conducted among 50 neonatal nurses, supplemented by qualitative focused group discussions involving 10 participants. Data collection included structured questionnaires assessing awareness and attitudes toward DNR orders, alongside qualitative interviews to capture their perceptions.</p><p><strong>Results: </strong>The mean age of the participants was 33.88 ± 8.60 years, predominantly females (98.0%), young adults (44.0%), and holding degree in nursing (68.0%). Findings indicated that over half of the neonatal nurses had poor awareness (52%) and negative attitudes (50%) toward DNR orders. Factors such as being unmarried (adjusted odds ratio [AOR] = 0.01, confidence interval [CI] = 0.01-0.27), <5 years of NICU experience (AOR = 0.04, CI = 0.00-0.53), and not attending refresher course on End of Life Care (AOR = 0.87, CI = 0.00-0.99) significantly reduced odds of good awareness. Additionally, being Christian (AOR = 0.01, CI = 0.00-0.40), unmarried (AOR = 0.05, CI = 0.00-0.51), and <5 years of NICU experience (AOR = 0.03, CI = 0.00-0.38) were associated with significantly lower odds of positive attitude toward DNR orders. Qualitative insights highlight emotional challenges and feelings of inadequacy among nurses during DNR order discussions with parents.</p><p><strong>Conclusion: </strong>The study highlights a need for comprehensive training and support for NICU nurses in navigating DNR order discussions effectively.</p><p><strong>Practical implications: </strong>Hospitals must prioritize regular nurse training on DNR orders. NICU settings need counseling support. Nurses' training should emphasize empathy and effective communication for sensitive DNR discussions.</p><p><strong>Precise: </strong>Most neonatal nurses lacked awareness and positive attitudes toward DNR orders, influenced by factors like marital status and NICU experience. Qualitative insights revealed emotional challenges in discussing DNR with parents.</p>","PeriodicalId":54773,"journal":{"name":"Journal of Perinatal & Neonatal Nursing","volume":" ","pages":""},"PeriodicalIF":1.3000,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Factors Influencing Awareness and Attitude Regarding Do-Not-Resuscitation Orders Among Nurses Working in Neonatal Intensive Care Unit: A Mixed-Method Study.\",\"authors\":\"Jessie Shaji Paul, Anu P, Surya Kant Tiwari, Shanty Charlin, Meena Joshi, Ankit Verma, Poonam Joshi\",\"doi\":\"10.1097/JPN.0000000000000865\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>This sequential mixed-method study explores neonatal intensive care unit (NICU) nurses' awareness, attitudes, and perceptions regarding do-not-resuscitate (DNR) orders.</p><p><strong>Methods: </strong>Quantitative surveys were conducted among 50 neonatal nurses, supplemented by qualitative focused group discussions involving 10 participants. Data collection included structured questionnaires assessing awareness and attitudes toward DNR orders, alongside qualitative interviews to capture their perceptions.</p><p><strong>Results: </strong>The mean age of the participants was 33.88 ± 8.60 years, predominantly females (98.0%), young adults (44.0%), and holding degree in nursing (68.0%). Findings indicated that over half of the neonatal nurses had poor awareness (52%) and negative attitudes (50%) toward DNR orders. Factors such as being unmarried (adjusted odds ratio [AOR] = 0.01, confidence interval [CI] = 0.01-0.27), <5 years of NICU experience (AOR = 0.04, CI = 0.00-0.53), and not attending refresher course on End of Life Care (AOR = 0.87, CI = 0.00-0.99) significantly reduced odds of good awareness. Additionally, being Christian (AOR = 0.01, CI = 0.00-0.40), unmarried (AOR = 0.05, CI = 0.00-0.51), and <5 years of NICU experience (AOR = 0.03, CI = 0.00-0.38) were associated with significantly lower odds of positive attitude toward DNR orders. Qualitative insights highlight emotional challenges and feelings of inadequacy among nurses during DNR order discussions with parents.</p><p><strong>Conclusion: </strong>The study highlights a need for comprehensive training and support for NICU nurses in navigating DNR order discussions effectively.</p><p><strong>Practical implications: </strong>Hospitals must prioritize regular nurse training on DNR orders. NICU settings need counseling support. Nurses' training should emphasize empathy and effective communication for sensitive DNR discussions.</p><p><strong>Precise: </strong>Most neonatal nurses lacked awareness and positive attitudes toward DNR orders, influenced by factors like marital status and NICU experience. Qualitative insights revealed emotional challenges in discussing DNR with parents.</p>\",\"PeriodicalId\":54773,\"journal\":{\"name\":\"Journal of Perinatal & Neonatal Nursing\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-09-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Perinatal & Neonatal Nursing\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/JPN.0000000000000865\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Perinatal & Neonatal Nursing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/JPN.0000000000000865","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NURSING","Score":null,"Total":0}
Factors Influencing Awareness and Attitude Regarding Do-Not-Resuscitation Orders Among Nurses Working in Neonatal Intensive Care Unit: A Mixed-Method Study.
Purpose: This sequential mixed-method study explores neonatal intensive care unit (NICU) nurses' awareness, attitudes, and perceptions regarding do-not-resuscitate (DNR) orders.
Methods: Quantitative surveys were conducted among 50 neonatal nurses, supplemented by qualitative focused group discussions involving 10 participants. Data collection included structured questionnaires assessing awareness and attitudes toward DNR orders, alongside qualitative interviews to capture their perceptions.
Results: The mean age of the participants was 33.88 ± 8.60 years, predominantly females (98.0%), young adults (44.0%), and holding degree in nursing (68.0%). Findings indicated that over half of the neonatal nurses had poor awareness (52%) and negative attitudes (50%) toward DNR orders. Factors such as being unmarried (adjusted odds ratio [AOR] = 0.01, confidence interval [CI] = 0.01-0.27), <5 years of NICU experience (AOR = 0.04, CI = 0.00-0.53), and not attending refresher course on End of Life Care (AOR = 0.87, CI = 0.00-0.99) significantly reduced odds of good awareness. Additionally, being Christian (AOR = 0.01, CI = 0.00-0.40), unmarried (AOR = 0.05, CI = 0.00-0.51), and <5 years of NICU experience (AOR = 0.03, CI = 0.00-0.38) were associated with significantly lower odds of positive attitude toward DNR orders. Qualitative insights highlight emotional challenges and feelings of inadequacy among nurses during DNR order discussions with parents.
Conclusion: The study highlights a need for comprehensive training and support for NICU nurses in navigating DNR order discussions effectively.
Practical implications: Hospitals must prioritize regular nurse training on DNR orders. NICU settings need counseling support. Nurses' training should emphasize empathy and effective communication for sensitive DNR discussions.
Precise: Most neonatal nurses lacked awareness and positive attitudes toward DNR orders, influenced by factors like marital status and NICU experience. Qualitative insights revealed emotional challenges in discussing DNR with parents.
期刊介绍：
The Journal of Perinatal and Neonatal Nursing (JPNN) strives to advance the practice of evidence-based perinatal and neonatal nursing through peer-reviewed articles in a topic-oriented format. Each issue features scholarly manuscripts, continuing education options, and columns on expert opinions, legal and risk management, and education resources. The perinatal focus of JPNN centers around labor and delivery and intrapartum services specifically and overall perinatal services broadly. The neonatal focus emphasizes neonatal intensive care and includes the spectrum of neonatal and infant care outcomes. Featured articles for JPNN include evidence-based reviews, innovative clinical programs and projects, clinical updates and education and research-related articles appropriate for registered and advanced practice nurses.
The primary objective of The Journal of Perinatal & Neonatal Nursing is to provide practicing nurses with useful information on perinatal and neonatal nursing. Each issue is PEER REVIEWED and will feature one topic, to be covered in depth. JPNN is a refereed journal. All manuscripts submitted for publication are peer reviewed by a minimum of three members of the editorial board. Manuscripts are evaluated on the basis of accuracy and relevance of content, fit with the journal purpose and upcoming issue topics, and writing style. Both clinical and research manuscripts applicable to perinatal and neonatal care are welcomed.
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