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Al-Shahri MZ, Sroor M, Ghareeb WAS, Alhassanin S, Ateya HA. Discussion of the do-not-resuscitate (DNR) orders with the family caregivers of cancer patients: An example from a major cancer center in Saudi Arabia. Palliat Support Care 2024; 22:511-516. [PMID: 38126404 DOI: 10.1017/s1478951523001876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
OBJECTIVES To explore the views of the family caregivers (FCGs) about the "do-not-resuscitate" (DNR) discussions and decision-making processes that occurred during hospitalization in a Saudi cancer center. METHODS In this cross-sectional survey, the FCGs of inpatients with advanced cancer completed a self-administered questionnaire soon after giving the patients a DNR status designation by their oncologists. RESULTS Eighty-two FCGs participated in the study, with a median age of 36.5 years and male preponderance (70.7%). The FCGs were mostly sons (41.5%), daughters (14%), or brothers (11%) of patients. Only 13.4% of mentally competent patients had the chance to listen to the DNR discussion. The discussion mainly occurred in the ward corridor (48.8%) or another room away from the patients' rooms (35.4%). In 36.6% of cases, the discussion took ≤5 minutes. Half of the FCGs stated that the oncologists' justifications for the DNR decision were unconvincing. The majority (84.2%) of the FCGs felt that the healthcare providers should share the DNR decision-making with patients (1.2%), families (69.5%), or both (13.4%). FCGs ≤ 30 years of age were more supportive of giving patients' families a chance to participate in the DNR decision-making process (p = 0.012). SIGNIFICANCE OF RESULTS There is considerable room for improving the current practice of DNR discussions and decision-making processes in the studied setting. A readily feasible rectifying measure is to ensure the adequacy of time and privacy when planning for DNR discussions. We expect our findings to draw the attention of stakeholders to a compelling need for reviewing the current policies and processes, aiming to improve the experience of cancer patients and their FCGs.
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Affiliation(s)
- Mohammad Z Al-Shahri
- Palliative Care Medicine, Oncology Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Mahmoud Sroor
- Palliative Care Medicine, Oncology Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- Kaser Al-Ainy Center of Clinical Oncology and Nuclear Medicine, Kaser El-Aini School of Medicine, Cairo University, Cairo, Egypt
| | - Wael Ali Said Ghareeb
- Palliative Care Medicine, Oncology Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Suzan Alhassanin
- Palliative Care Medicine, Oncology Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- Clinical Oncology Department, Menoufia University, Shebin Elkom, Egypt
| | - Heba Aly Ateya
- Palliative Care Medicine, Oncology Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- National Cancer Institute, Cairo University, Cairo, Egypt
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Blanchet I, Michel F, Tardieu C, Camoin A. Difficulties experienced by dentists and orthodontists regarding ethical issues when announcing the diagnosis of a rare oral disease: a qualitative study in Marseille, France. Eur Arch Paediatr Dent 2024; 25:169-179. [PMID: 38457081 DOI: 10.1007/s40368-024-00864-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 01/03/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE It is traditionally considered that breaking bad news to patients does not represent a cause for concern for dental professionals. However, there are situations where they will be confronted with this task, as in the case of rare dental diseases. Little information is available regarding the feelings of healthcare professionals on this subject. There are no qualitative studies that explore how a diagnosis of oligodontia is announced to patients by dentists and orthodontists. The aim of our study is to explore the difficulties and ethical issues experienced by dental health professionals when they have to announce a diagnosis of oligodontia to a patient and their family. METHODS This study relied on a qualitative research method using focus groups of dentists and orthodontists and a thematic analysis procedure. RESULTS The difficulties experienced could be summarised within five topics: organisational difficulties, difficulties with the management of dental treatment and with the administrative management associated with this anomaly, difficulties with the content of the announcement, and relational difficulties. These could be grouped in two categories: practical difficulties and ethical difficulties. CONCLUSION This survey allowed us to understand the difficulties encountered by dentists and orthodontists when announcing oligodontia. The participants felt uncomfortable with this task and were under stress. They reported difficulties in delivering the medical information and in adapting to the message. It is essential that dental professionals develop skills in medical communication.
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Affiliation(s)
- I Blanchet
- APHM Timone Hospital, 264 Rue Saint Pierre, 13005, Marseille, France.
- Medical and Paramedical Sciences Faculty, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France.
- ADES CNRS EFS, UMR 7268, Aix-Marseille University, 51 Bd Pierre Dramard, 13344, Marseille, France.
| | - F Michel
- APHM Timone Hospital, 264 Rue Saint Pierre, 13005, Marseille, France
- Medical and Paramedical Sciences Faculty, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France
- ADES CNRS EFS, UMR 7268, Aix-Marseille University, 51 Bd Pierre Dramard, 13344, Marseille, France
| | - C Tardieu
- APHM Timone Hospital, 264 Rue Saint Pierre, 13005, Marseille, France
- Medical and Paramedical Sciences Faculty, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France
- ADES CNRS EFS, UMR 7268, Aix-Marseille University, 51 Bd Pierre Dramard, 13344, Marseille, France
| | - A Camoin
- APHM Timone Hospital, 264 Rue Saint Pierre, 13005, Marseille, France
- Medical and Paramedical Sciences Faculty, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France
- ADES CNRS EFS, UMR 7268, Aix-Marseille University, 51 Bd Pierre Dramard, 13344, Marseille, France
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