Association between the communication skills of physicians and the signing of do-not-resuscitate consent for terminally ill patients in emergency rooms (Cross-sectional study)

Chih Hung Chen; Ya Hui Cheng; Fen Ju Chen; Engyen Huang; Po Ming Liu; Chia Te Kung; Chao Hui Su; Shu Hwa Chen; Peng Chen Chien; Ching Hua Hsieh

doi:10.2147/RMHP.S232983

Association between the communication skills of physicians and the signing of do-not-resuscitate consent for terminally ill patients in emergency rooms (Cross-sectional study)

Chih Hung Chen, Ya Hui Cheng, Fen Ju Chen, Engyen Huang, Po Ming Liu, Chia Te Kung, Chao Hui Su, Shu Hwa Chen, Peng Chen Chien, Ching Hua Hsieh^*

^*Corresponding author for this work

Research output: Contribution to journal › Journal Article › peer-review

3 Scopus citations

Abstract

Background: The signing of do-not-resuscitate (DNR) consent is mandatory in providing a palliative approach in the end-of-life care for the terminally ill patients and requires an effective communication between the physician and the patients or their family members. This study aimed to investigate the association between the communication skills of physicians who participated in the SHARE (supportive environment, how to deliver the bad news, additional information, reassurance, and emotional support) model course on the patient notification and the signing of do-not-resuscitate (DNR) consent by the terminally ill patients at emergency rooms. Methods: Between May 1, 2017 and April 30, 2018, a total of 109 terminally ill patients were enrolled in this study, of which 70 had signed a DNR and 39 had not. Data regarding the patients’ medical records, a questionnaire survey completed by family members, and patient observation forms were used for the assessment of physicians’ communication skills during patient notification. The observation form was designed based on the SHARE model. A multivariate logistic regression model was applied to identify the independent significant factors of the patient and family member variables as well as the four main components of the observation form. Results: The results revealed that knowing how to convey bad news and providing reassurance and emotional support were significantly correlated with a higher rate of signing DNR consent. Additionally, physician-initiated discussion with family members and a predicted limited life expectancy were negative independent significant factors for signing DNR consent. Conclusion: This study revealed that good communication skills help to increase the signing of DNR consent. The learning of such skills from attendance of the SHARE model course is encouraged for the physicians in the palliative care of terminally ill patients in an emergency room.

Original language	English
Pages (from-to)	307-315
Number of pages	9
Journal	Risk Management and Healthcare Policy
Volume	12
DOIs	https://doi.org/10.2147/RMHP.S232983
State	Published - 2019

Bibliographical note

Publisher Copyright:
© 2019 Chen et al.

Keywords

Communication skills
DNR
Do-not-resuscitate
ER
Emergency room
SHARE model
Terminally ill

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.2147/RMHP.S232983

Cite this

Chen, C. H., Cheng, Y. H., Chen, F. J., Huang, E., Liu, P. M., Kung, C. T., Su, C. H., Chen, S. H., Chien, P. C., & Hsieh, C. H. (2019). Association between the communication skills of physicians and the signing of do-not-resuscitate consent for terminally ill patients in emergency rooms (Cross-sectional study). Risk Management and Healthcare Policy, 12, 307-315. https://doi.org/10.2147/RMHP.S232983

@article{a89e763341a54e8fa5d6d04715930896,

title = "Association between the communication skills of physicians and the signing of do-not-resuscitate consent for terminally ill patients in emergency rooms (Cross-sectional study)",

abstract = "Background: The signing of do-not-resuscitate (DNR) consent is mandatory in providing a palliative approach in the end-of-life care for the terminally ill patients and requires an effective communication between the physician and the patients or their family members. This study aimed to investigate the association between the communication skills of physicians who participated in the SHARE (supportive environment, how to deliver the bad news, additional information, reassurance, and emotional support) model course on the patient notification and the signing of do-not-resuscitate (DNR) consent by the terminally ill patients at emergency rooms. Methods: Between May 1, 2017 and April 30, 2018, a total of 109 terminally ill patients were enrolled in this study, of which 70 had signed a DNR and 39 had not. Data regarding the patients{\textquoteright} medical records, a questionnaire survey completed by family members, and patient observation forms were used for the assessment of physicians{\textquoteright} communication skills during patient notification. The observation form was designed based on the SHARE model. A multivariate logistic regression model was applied to identify the independent significant factors of the patient and family member variables as well as the four main components of the observation form. Results: The results revealed that knowing how to convey bad news and providing reassurance and emotional support were significantly correlated with a higher rate of signing DNR consent. Additionally, physician-initiated discussion with family members and a predicted limited life expectancy were negative independent significant factors for signing DNR consent. Conclusion: This study revealed that good communication skills help to increase the signing of DNR consent. The learning of such skills from attendance of the SHARE model course is encouraged for the physicians in the palliative care of terminally ill patients in an emergency room.",

keywords = "Communication skills, DNR, Do-not-resuscitate, ER, Emergency room, SHARE model, Terminally ill",

author = "Chen, {Chih Hung} and Cheng, {Ya Hui} and Chen, {Fen Ju} and Engyen Huang and Liu, {Po Ming} and Kung, {Chia Te} and Su, {Chao Hui} and Chen, {Shu Hwa} and Chien, {Peng Chen} and Hsieh, {Ching Hua}",

note = "Publisher Copyright: {\textcopyright} 2019 Chen et al.",

year = "2019",

doi = "10.2147/RMHP.S232983",

language = "英语",

volume = "12",

pages = "307--315",

journal = "Risk Management and Healthcare Policy",

issn = "1179-1594",

}

Chen, CH, Cheng, YH, Chen, FJ, Huang, E, Liu, PM, Kung, CT, Su, CH, Chen, SH, Chien, PC & Hsieh, CH 2019, 'Association between the communication skills of physicians and the signing of do-not-resuscitate consent for terminally ill patients in emergency rooms (Cross-sectional study)', Risk Management and Healthcare Policy, vol. 12, pp. 307-315. https://doi.org/10.2147/RMHP.S232983

Association between the communication skills of physicians and the signing of do-not-resuscitate consent for terminally ill patients in emergency rooms (Cross-sectional study). / Chen, Chih Hung; Cheng, Ya Hui; Chen, Fen Ju et al.
In: Risk Management and Healthcare Policy, Vol. 12, 2019, p. 307-315.

Research output: Contribution to journal › Journal Article › peer-review

TY - JOUR

T1 - Association between the communication skills of physicians and the signing of do-not-resuscitate consent for terminally ill patients in emergency rooms (Cross-sectional study)

AU - Chen, Chih Hung

AU - Cheng, Ya Hui

AU - Chen, Fen Ju

AU - Huang, Engyen

AU - Liu, Po Ming

AU - Kung, Chia Te

AU - Su, Chao Hui

AU - Chen, Shu Hwa

AU - Chien, Peng Chen

AU - Hsieh, Ching Hua

PY - 2019

Y1 - 2019

N2 - Background: The signing of do-not-resuscitate (DNR) consent is mandatory in providing a palliative approach in the end-of-life care for the terminally ill patients and requires an effective communication between the physician and the patients or their family members. This study aimed to investigate the association between the communication skills of physicians who participated in the SHARE (supportive environment, how to deliver the bad news, additional information, reassurance, and emotional support) model course on the patient notification and the signing of do-not-resuscitate (DNR) consent by the terminally ill patients at emergency rooms. Methods: Between May 1, 2017 and April 30, 2018, a total of 109 terminally ill patients were enrolled in this study, of which 70 had signed a DNR and 39 had not. Data regarding the patients’ medical records, a questionnaire survey completed by family members, and patient observation forms were used for the assessment of physicians’ communication skills during patient notification. The observation form was designed based on the SHARE model. A multivariate logistic regression model was applied to identify the independent significant factors of the patient and family member variables as well as the four main components of the observation form. Results: The results revealed that knowing how to convey bad news and providing reassurance and emotional support were significantly correlated with a higher rate of signing DNR consent. Additionally, physician-initiated discussion with family members and a predicted limited life expectancy were negative independent significant factors for signing DNR consent. Conclusion: This study revealed that good communication skills help to increase the signing of DNR consent. The learning of such skills from attendance of the SHARE model course is encouraged for the physicians in the palliative care of terminally ill patients in an emergency room.

AB - Background: The signing of do-not-resuscitate (DNR) consent is mandatory in providing a palliative approach in the end-of-life care for the terminally ill patients and requires an effective communication between the physician and the patients or their family members. This study aimed to investigate the association between the communication skills of physicians who participated in the SHARE (supportive environment, how to deliver the bad news, additional information, reassurance, and emotional support) model course on the patient notification and the signing of do-not-resuscitate (DNR) consent by the terminally ill patients at emergency rooms. Methods: Between May 1, 2017 and April 30, 2018, a total of 109 terminally ill patients were enrolled in this study, of which 70 had signed a DNR and 39 had not. Data regarding the patients’ medical records, a questionnaire survey completed by family members, and patient observation forms were used for the assessment of physicians’ communication skills during patient notification. The observation form was designed based on the SHARE model. A multivariate logistic regression model was applied to identify the independent significant factors of the patient and family member variables as well as the four main components of the observation form. Results: The results revealed that knowing how to convey bad news and providing reassurance and emotional support were significantly correlated with a higher rate of signing DNR consent. Additionally, physician-initiated discussion with family members and a predicted limited life expectancy were negative independent significant factors for signing DNR consent. Conclusion: This study revealed that good communication skills help to increase the signing of DNR consent. The learning of such skills from attendance of the SHARE model course is encouraged for the physicians in the palliative care of terminally ill patients in an emergency room.

KW - Communication skills

KW - DNR

KW - Do-not-resuscitate

KW - ER

KW - Emergency room

KW - SHARE model

KW - Terminally ill

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DO - 10.2147/RMHP.S232983

M3 - 文章

AN - SCOPUS:85077077412

SN - 1179-1594

VL - 12

SP - 307

EP - 315

JO - Risk Management and Healthcare Policy

JF - Risk Management and Healthcare Policy

ER -

Association between the communication skills of physicians and the signing of do-not-resuscitate consent for terminally ill patients in emergency rooms (Cross-sectional study)

Abstract

Bibliographical note

Keywords

UN SDGs

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