Knowledge and Attitudes Regarding Do-Not-Resuscitate Decisions Among Clinical-Year Medical Students and Interns in the Western Region of Saudi Arabia

Background The directive to withhold emergent interventions in the case of cardiac and/or respiratory arrest with the continuation of standard care and therapy is known as do-not-resuscitate (DNR). The diversity of DNR guidelines depends on moral and religious factors. In Saudi Arabia, a DNR policy was published in 2017 which corresponds to the religious and ethical aspects of Islamic law. To augment future awareness regarding DNR decisions, as they are an essential element in critical care medicine, the foundational principles of DNR must be provided during the clinical years of medical school. Objectives The current study aims to assess and evaluate the knowledge and attitudes regarding DNR decisions among clinical-year medical students and interns in the Western Region of Saudi Arabia. Methods A cross-sectional study was carried out from October to December 2023, utilizing a self-administered online survey distributed via social media platforms. After receiving ethical approval from the institutional review board, data were collected from clinical-year medical students and interns in the Western Region of Saudi Arabia, and an appropriate statistical analysis was performed. Results A total of 397 participants were enrolled in this study. More than half (n = 251, 63.2%) were from Umm Al-Qura University, while the remaining (n=79, 19.9%) were from Taibah University. Of the total, 258 (65%) were male participants, and 139 (35%) were female. A total of 152 (38.3%) were fifth-year medical students, and 102 (25.7%) were interns. The vast majority (n = 364, 91.7%) had heard the term DNR, with the most reported source of information being from healthcare providers (n = 306, 83.2%), while a minority (n = 33, 8.3%) had not. Of the respondents, 226 (56.9%) identified the presence of a clear DNR policy in Saudi Arabia, and 77 (19.4%) had previously had experience with DNR. Most of the studied population (n = 333, 83.9%) expressed a willingness to take a lecture/session regarding DNR. Most of our participants, 347 (87.4%), believe it is essential to consider legal concerns when making a DNR decision. Interestingly, 152 (38.5%) of the participants think it is acceptable to be conservative in investigations and treatments with patients who are labeled as DNR, and 223 (56.2%) agree that patients should be aware of their DNR status. Approximately three-quarters of the study population (n = 290, 73%) agreed that it is stressful to discuss the possibility of a DNR order. In the association of who heard about DNR more, 101 (99%) of the interns had heard about the term DNR, while only 53 (75.7%) of the fourth-year medical students had. At the same time, 74 (72.5%) of the interns showed a positive attitude regarding the DNR definition, compared to 33 (47.1%) of the fourth-year medical students. Conclusion This study highlights the necessity of integrating educational interventions into DNR decisions in addition to clinical placement in the intensive care unit as part of the medical school curriculum.

The Prevalence of Nomophobia and Its Impact on Academic Performance of Medical Undergraduates at the College of Medicine, Umm Al-Qura University, Makkah City, Saudi Arabia

BACKGROUND

Nomophobia, or no mobile phone phobia, is a term used to describe psychological conditions when people fear being without a mobile phone.

OBJECTIVES

This study aimed to measure the prevalence of nomophobia, its associated factors, and its impact on the academic performance of medical undergraduates at Umm Al-Qura University (UQU), Makkah City, Saudi Arabia.

METHODS

A descriptive cross-sectional study included a simple random sample of 595 medical undergraduates. The study administered the Nomophobia Questionnaire, which had been validated in previous articles, using an interview-based model. The collected data were reviewed and entered into the IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York) for analysis.

RESULTS

A total of 595 medical students were included in this study. Most of them (99%, n = 589) had different degrees of nomophobia, while only a small percentage (1%, n = 6) did not exhibit it. The younger medical students (18-19 years old) showed significantly higher percentages of moderate to severe nomophobia in comparison to older students (P = 0.028), while there was no significant relationship between nomophobia and academic performance, despite the fact that 128 (77.1%) of students with severe nomophobia had grade point averages (GPAs) of 3.5-4.0, compared to 244 (69.1%) of students with moderate nomophobia (P = 0.150).

CONCLUSIONS

This study concludes that the prevalence rate of nomophobia is generally high among medical undergraduates at UQU in Makkah City, Saudi Arabia. This disorder was detected more among younger medical undergraduates, with no significant effects on their academic performance. It is mandatory to conduct more studies with larger sample sizes of different university students (medical and non-medical) to identify factors that lead to the development of nomophobia. Qualitative research among groups of university students will add more deep information about this disorder. Health education programs should be designed and targeted at university students, focusing on the harmful health effects of excessive use of mobile phones and measures to prevent this disorder.