Do Not Resuscitation kurallarının gelişimi ve karşılaşılan etik ikilemler
Küçük Resim Yok
Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
ÖZET Do Not Resuscitation Kurallarının Gelişimi ve Karşılaşılan Etik İkilemler Amaç: YBÜ (Yoğun Bakım Ünitesi)'de görev yapan anestezi uzmanları, anestezi asistanlarının DNR (Do Not Resuscitation) kurallarının gelişimi ve karşılaşılan etik ikilemler hakkındaki bilgilerini saptamak amacıyla yapılmıştır. Materyal Metod: Çalışma kesitsel ve tanımlayıcı araştırma türünde planlanmıştır. Araştırma, araştırmacı ve etik uzmanları tarafından hazırlanan 18 soruluk anket formu ile Anesteziyoloji ve Reanimasyon Hekimleri ile yüz yüze görüşülerek yapılmıştır. Araştırma MEAH (Malatya Eğitim ve Araştırma Hastanesi)'da çalışan Anesteziyoloji ve Reanimasyon Hekimlerinin görüşleri alınarak DNR uygulamasının içerebileceği etik ikilemler, Türkiye'deki yasal düzenlemeler ve etik açıdan yaşanan sorunlara çözüm önerileri sunacaktır. Çalışmada evrenin tamamına (20 kişi) ulaşılmaya çalışılmıştır. İstatistik analizlerde Pearson ki-kare testi ve Fisher'in kesin ki-kare testi kullanılmıştır. Uygulanan istatistiksel analizlerde p<0.05 değeri istatistiksel olarak anlamlı kabul edilmiştir. Tüm analizler IBM SPSS Statistics 26.0 kullanılarak yapılmıştır. Bulgular: Anket formundaki MEAH YBÜ'de çalışan anestezi uzmanı ve anestezi asistanlarının yaş karşılaştırmalarında p<0,05'e göre istatistiksel olarak anlamlı sonuç çıkmamıştır. Cinsiyet karşılaştırmasında p<0.05 değeri istatistiksel olarak anlamlı kabul edilen; DNR uygulaması yasal olsaydı hastanın özerklik hakkı nedeniyle hasta tarafından tercih edilmişse yapılmalı mıdır? Sorusuna (p=0,028) kadınlar evet, erkekler hayır cevabını vermektedir. Anestezi uzmanları ve Asistanlarının karşılaştırılmasında ''Diğer hastaların YBÜ gereksinimi olsa da mevcut hastalarıma yasal dahi olsa DNR uygulamam'' (p=0,049) ifadesine anestezi uzmanları uygulamam, anestezi asistanları uygularım cevabını vermektedir. Meslek yılları karşılaştırıldığında p<0,05'e göre istatistiksel olarak anlamlı sonuç çıkmamıştır. Yoğun bakımda çalışma yıllarına göre verilen cevaplarda anlamlı bir istatistiksel sonuca varılamamıştır. Sonuç: Çalışmamıza katılan anestezi uzmanları ve anestezi asistanlarına uygulanan ankette DNR'nin anlamını bütün çalışanların bildiği ancak, uygulama yöntemi ve uygulama zamanı hakkında net bir fikir birliğine varamadıkları ve etik ikilem yaşadıkları sonucuna varılmıştır. DNR'nin ülkemizde yasal olmaması, DNR uygulama şeklinin yasalarla netleşmemiş olması, çalışanların kendi etik algısına ve tecrübesine göre cevap verdiğini göstermektedir. Anahtar Kelimeler: Do Not Resuscitation, Do Not Resuscitation kuralları, Türkiye'deki yasalar, etik ikilemler, Anesteziyoloji ve Reanimasyon hekimleri
ABSTRACT Development of Do Not Resuscitation Rules and Ethical Dilemmas Encountered Aim: This study was conducted to determine the knowledge of anesthesiologists and anesthesia assistants working in the ICU (Intensive Care Unit) about the development of DNR (Do Not Resuscitation) rules and the ethical dilemmas encountered. Material Method: The study was planned as a cross-sectional and descriptive research type. The research was conducted by face-to-face interviews with Anesthesiology and Reanimation Physicians with an 18-question survey form prepared by researcher and ethicists. The research will take the opinions of Anesthesiology and Reanimation Physicians working at MEAH (Malatya Training and Research Hospital) and offer solutions to ethical dilemmas that DNR practice may involve, legal regulations in Turkey and ethical problems. In the study, an attempt was made to reach the entire population (20 people). Pearson chi-square test and Fisher's exact chi-square test were used in statistical analyses. In the statistical analysis applied, a p value of <0.05 was considered statistically significant. All analyzes were performed using IBM SPSS Statistics 26.0. Results: No statistically significant results were found in the age comparisons of the anesthesiologists and anesthesia assistants working in the MEAH ICU in the survey form, according to p < 0.05. In gender comparison, p<0.05 value is considered statistically significant; If DNR was legal, should it be performed if it was preferred by the patient due to the patient's right to autonomy? To the question (p=0.028), women answer yes and men answer no. In the comparison of anesthesiologists and their assistants, the answer to the statement "I do not apply DNR to my current patients, even if it is legal, even if other patients require ICU" (p=0.049) is answered by anesthesiologists, but anesthesia assistants say I do. When career years were compared, no statistically significant results were found according to p<0.05. No significant statistical result could be reached in the answers given according to the years of working in intensive care. Conclusion: In the survey applied to the anesthesiologists and anesthesia assistants who participated in our study, it was concluded that all employees knew the meaning of DNR, but they could not reach a clear consensus about the application method and application time and experienced an ethical dilemma. The fact that DNR is not legal in our country and the way DNR is implemented is not clarified by law shows that employees respond according to their own ethical perception and experience. Keywords: Do Not Resuscitation, Do Not Resuscitation rules, laws in Turkey, ethical dilemmas, Anesthesiology and Reanimation physicians
ABSTRACT Development of Do Not Resuscitation Rules and Ethical Dilemmas Encountered Aim: This study was conducted to determine the knowledge of anesthesiologists and anesthesia assistants working in the ICU (Intensive Care Unit) about the development of DNR (Do Not Resuscitation) rules and the ethical dilemmas encountered. Material Method: The study was planned as a cross-sectional and descriptive research type. The research was conducted by face-to-face interviews with Anesthesiology and Reanimation Physicians with an 18-question survey form prepared by researcher and ethicists. The research will take the opinions of Anesthesiology and Reanimation Physicians working at MEAH (Malatya Training and Research Hospital) and offer solutions to ethical dilemmas that DNR practice may involve, legal regulations in Turkey and ethical problems. In the study, an attempt was made to reach the entire population (20 people). Pearson chi-square test and Fisher's exact chi-square test were used in statistical analyses. In the statistical analysis applied, a p value of <0.05 was considered statistically significant. All analyzes were performed using IBM SPSS Statistics 26.0. Results: No statistically significant results were found in the age comparisons of the anesthesiologists and anesthesia assistants working in the MEAH ICU in the survey form, according to p < 0.05. In gender comparison, p<0.05 value is considered statistically significant; If DNR was legal, should it be performed if it was preferred by the patient due to the patient's right to autonomy? To the question (p=0.028), women answer yes and men answer no. In the comparison of anesthesiologists and their assistants, the answer to the statement "I do not apply DNR to my current patients, even if it is legal, even if other patients require ICU" (p=0.049) is answered by anesthesiologists, but anesthesia assistants say I do. When career years were compared, no statistically significant results were found according to p<0.05. No significant statistical result could be reached in the answers given according to the years of working in intensive care. Conclusion: In the survey applied to the anesthesiologists and anesthesia assistants who participated in our study, it was concluded that all employees knew the meaning of DNR, but they could not reach a clear consensus about the application method and application time and experienced an ethical dilemma. The fact that DNR is not legal in our country and the way DNR is implemented is not clarified by law shows that employees respond according to their own ethical perception and experience. Keywords: Do Not Resuscitation, Do Not Resuscitation rules, laws in Turkey, ethical dilemmas, Anesthesiology and Reanimation physicians
Açıklama
Sağlık Bilimleri Enstitüsü, Tıp Tarihi ve Etik Ana Bilim Dalı
Anahtar Kelimeler
Deontoloji ve Tıp Tarihi, Medical History and Ethics
