本研究目的為探討加護病房重症病人簽署不予急救同意書對醫療處置之影響。研究設計採縱貫前瞻性描述性研究。對象為台灣二家醫學中心住加護病房滿24小時且APACH II分數大於等於20分之重症病人,以自擬之研究工具「加護病房病人簽署不予急救同意書對醫療處置之相關調查表」進行資料收集,其結果共計202人,有簽署DNR病人133人,未簽署DNR者69人。所得資料以卡方檢定、t檢定及二元迴歸檢定分析。 研究結果發現:加護病房重症病人簽署DNR前有較高的急救比例,簽署DNR後有較高比例執行不予治療及撤除治療,而簽署DNR者於臨終前有仍有1/3病人接受至少一項急救處置。加護病房病人年齡較長、主要決策者是子女、已婚者、疾病預後差,有較高比例簽署DNR。
The purpose of this study is to explore the impacts of DNR orders on Medical Treatments for Critical Care Patients in ICU. A prospective survey the Patients from two Medical center hospitals and that data have to fit two critera: The hospitalization time must over 24 hours and the APACHE II score must greater then 20 in ICUs. The study is a self-administered questionnaire was developed to conduct the data collection. All 202 patients data are wihhin this thesis, including with approval of DNR: 133 patients and without approval of DNR: 69 patients. The majer statistics is done by Chi-square test, Student-t test and Logistic Regression analysis. The results show that patients receive higher CPR before approval of DNR and after approval of DNR have low ratio active treatments and high rato for either withhold medical or withdrawal medical treatments. 1/3 of patients who have approval of DNR still receive at least one of sub-category of CPR of dying patients in ICU. The aged Patients, the consent made by patient’s offspring, married patients, and poor survival of disease patients are prone to have the approval of DNR order.