Prevalence and related factors of do-not-resuscitate directives among nursing home residents in Taiwan.
OBJECTIVE
To report the prevalence of Do-Not-Resuscitate (DNR) directives and to explore the factors associated with the presence of DNR directives among nursing home residents in Taiwan.


METHODS
A cross-sectional, correlation study.


METHODS
Seven nursing homes in southern Taiwan.


METHODS
Nursing home residents and their family surrogates.


METHODS
Data were collected using chart abstraction and a questionnaire survey. We used multivariate logistic regression to analyze the associations between resident, family surrogate, and facility characteristics and the presence of DNR directives.


RESULTS
Among the 201 nursing home residents, 33 (16.4%) had DNR directives and 91% of the directives had been put in place by family surrogates. Our data revealed that resident's age (OR = 1.06, 95% CI = 1.01-1.12), cognitive function score (OR = 0.91, 95% CI = 0.85-0.97), prior DNR discussion between physician and family surrogate (OR = 4.09, 95% CI = 1.53-10.96), and nursing home with DNR policy (OR = 17.71, 95% CI = 5.87-53.46) were independently and associated with the presence of a DNR directive.


CONCLUSIONS
The prevalence of DNR directives among Taiwanese nursing home residents was lower than that in other countries. Our results point out the lack of DNR policy in most Taiwanese nursing homes and highlight the need for policy makers to implement further regulations. Meanwhile, education about advance directives is warranted to increase public and professional awareness and to facilitate empowerment of the increasing number of frail elderly nursing home residents in Taiwan.
Lo
Yu-Tai
YT
Department of Family Medicine, St. Joseph Hospital, Kaohsiung, Taiwan.
Wang
Jing-Jy
JJ
Liu
Li-Fan
LF
Wang
Chun-Nien
CN
D000328:Adult; D016223:Advance Directives / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D016414:Resuscitation Orders; D013624:Taiwan