The Perspective of the General Population in Saudi Arabia towards Do-Not-Resuscitate (DNR) Orders: A Cross-Sectional Study

Rayan Abubakker Qutob; Najd Khalid Aljarba; Bassam Abdulaziz Alhusaini; Omar Nasser Alzaid; Abdullah Hussien Alghamdi; Abdullah Abdulaziz Alaryni; Abdullah Ibraheem Bukhari; Ahmed Alburakan; Abdulrahman Mohammed Alanazi; Eysa Nahar Alsolamy; Omar Abdulaziz Alfozan; Saad Abdullah Alzmamy; Abdalmohsen A Ababtain; Alyaa Elhazmi; Osamah A Hakami

doi:10.3390/healthcare11142073

The Perspective of the General Population in Saudi Arabia towards Do-Not-Resuscitate (DNR) Orders: A Cross-Sectional Study

Healthcare (Basel). 2023 Jul 20;11(14):2073. doi: 10.3390/healthcare11142073.

Authors

Rayan Abubakker Qutob¹, Najd Khalid Aljarba¹, Bassam Abdulaziz Alhusaini¹, Omar Nasser Alzaid¹, Abdullah Hussien Alghamdi¹, Abdullah Abdulaziz Alaryni¹, Abdullah Ibraheem Bukhari¹, Ahmed Alburakan², Abdulrahman Mohammed Alanazi¹, Eysa Nahar Alsolamy¹, Omar Abdulaziz Alfozan¹, Saad Abdullah Alzmamy¹, Abdalmohsen A Ababtain³, Alyaa Elhazmi⁴, Osamah A Hakami¹

Affiliations

¹ College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 11432, Saudi Arabia.
² Department of Surgery, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia.
³ Critical Care Department, King Abdullah bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University, Riyadh 11451, Saudi Arabia.
⁴ College of Medicine, AlFaisal University, Riyadh 11533, Saudi Arabia.

Abstract

Objectives: In the event of cardiac arrest, cardiopulmonary resuscitation (CPR) is an emergency procedure used to maintain the heart and lungs functional simultaneously. The do-not-resuscitate (DNR) order prohibits CPR and is therefore legally required. Despite this, a DNR remains a delicate and contentious issue that places physicians in morally ambiguous situations. This study aimed to assess Saudi citizens' understanding of DNR orders, prior exposure to them, and preferences for DNR conversations.

Methods: This was an online cross-sectional study that was conducted between January and April 2023 and aimed to assess the knowledge regarding DNR orders among Saudi populations. This study adapted a previously developed questionnaire tool by Al Ahmadi et al., which examined the knowledge and attitude toward do-not-resuscitate among patients and their relatives visiting outpatient clinics. Binary logistic regression analysis was the mean knowledge score for the study participants.

Results: A total of 920 participants were involved in this study. Almost half of the study participants (49.6%) reported that they had heard of DNR before. The most commonly reported source of their information on DNR was healthcare providers (58.2%). The mean knowledge score of the study participants was 1.9 (1.3) out of 6, which is equal to 31.7% of the total maximum score. This demonstrates the weak level of knowledge about DNR among the general public. Females, divorced, and those who had a post-graduate level of education were more likely to be knowledgeable of DNR compared to others (p < 0.05). Around one-quarter of the study participants showed agreement with DNR. More than half of them (59.5%) believe that physicians should be involved in DNR decision making.

Conclusions: Saudi Arabia's general community has limited knowledge of DNR. It is recommended that healthcare professionals increase patients' and caregivers' understanding of this concept. This will improve the planning and the provision of end-of-life care.

Keywords: DNR; Saudi Arabia; attitude; do-not-resuscitate; knowledge.

Grants and funding

This research received no external funding.