Knowledge gaps, attitudes, and practices regarding end-of-life medical care among physicians in an academic medical center
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Marwan Jabr Alwazzeh 1 2 * , Abdullah Srour Aljoudi 3 , Arun Vijay Subbarayalu 4 , Abdulelah Fawzi Alharbi 1 , Ali Khalid Aldowayan 1 , Saad Falah Alshahrani 1 , Ali Mohammad Alamri 1 2 , Fahd Abdulaziz Almuhanna 1 2
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1 Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAUDI ARABIA2 King Fahad Hospital of the University, Al-Khobar, SAUDI ARABIA3 Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAUDI ARABIA4 Deanship of Quality and Academic Accreditation, Imam Abdulrahman Bin Faisal University, Dammam, SAUDI ARABIA* Corresponding Author

Abstract

Introduction: End-of-life medical care (ELMC) plans and do-not-resuscitate (DNR) decision-making are usually affected by multiple factors compared to other medical care decisions. ELMC and DNR policy implementation are still diversified and heterogeneous, especially in Saudi Arabia, because policymakers have adopted no guidelines. Thus, this study investigated physicians’ knowledge, attitude, and practice regarding ELMC and DNR.
Methods: A cross-sectional study design was adopted. Three hundred physicians working at King Fahad Hospital of the University, Khobar, Saudi Arabia, were randomly selected and administered an anonymous self-administered questionnaire using the Likert scale. Data analysis was carried out using SPSS 23.0.
Results: Of 300 distributed questionnaires, 264 (88%) were completed and analysed. Knowledge gaps and negative attitudes were observed, a quarter of the participants were opposed to issuing a DNR order, and 29.0% considered DNR as equal to euthanasia as they practice. The participants’ patient age and religious factors were the most critical factors in the ELMC plan and DNR decision. The physician’s level of acceptance regarding a set of ELMC interventions and DNR decisions showed heterogenicity and uncertainty among participants.
Conclusions: The ELMC plan and DNR decision-making should be appropriately addressed in the medical residents’ training programs to bridge the knowledge gap and the physicians’ negative attitudes during their practice. Additionally, there is a need to update and unify the DNR policies at the national level, considering the patient’s right to be informed and involved actively during the decision process making. Finally, more prospective research is needed for the global standardization of ELMC.

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Type: Original Article

ELECTRON J GEN MED, Volume 20, Issue 3, June 2023, Article No: em463

https://doi.org/10.29333/ejgm/12901

Publication date: 01 May 2023

Online publication date: 28 Jan 2023

Article Views: 1396

Article Downloads: 955

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