Ordem de não reanimar sob a perspectiva depacientes oncológicos e seus familiares / Do not resuscitate orders from the perspective of oncology patients and their relatives

RESUMO

O presente estudo objetivou verificar a perspectiva dos pacientes oncológicos e familiares em relação à Ordem deNão Reanimar (ONR). Foram entrevistados 104 pacientes oncológicos e 100 familiares que frequentavam o serviço deoncologia do Hospital Universitário Santa Terezinha, Joaçaba, Santa Catarina, Brasil, no ano de 2014. Os termos ONReram desconhecidos por 81,73% dos pacientes e por 82% dos familiares. Após esclarecimento do significado, 65,4%dos pacientes e 67% dos familiares mostraram-se favoráveis à ONR em caso de parada cardiorrespiratória de pacienteem fase final de doença terminal. A decisão compartilhada entre pacientes, familiares e médico obteve a preferência de58,65% dos pacientes e de 73% dos familiares, por iniciativa do médico que acompanha o tratamento, segundo 60,58%dos pacientes e 72% dos familiares. A realização de sua própria ONR foi considerada importante por 63,47% dospacientes e 68,63% dos familiares e a implantação da Ordem de não reanimar no Brasil por 75% dos pacientes e 74%dos familiares. Concluiu-se que a maioria dos pacientes e familiares desconhecia os termos ordem de não reanimar, masera favorável à implantação do procedimento no Brasil, à realização pessoal por meio de decisão compartilhada e quea abordagem ocorresse durante as consultas médicas. Os resultados deste estudo permitem inferir a necessidade de seampliar a discussão sobre a Ordem de Não Reanimar, no âmbito ético e social, com a finalidade de se emitir orientaçõespara assegurar a autonomia dos pacientes que se encontram na terminalidade da vida

ABSTRACT

This study aims to determine the perspective of oncological patients and their families in relation to the Do Not ResuscitateOrder (DNR). A questionnaire was applied to 104 oncological patients and 100 relatives, who were attended to by theoncology service of Hospital Universitário Santa Terezinha, Joaçaba, Santa Catarina, Brazil in 2014. The term DNR wasunknown by 81.73% of the patients and by 82% of the relatives. After clarifying its meaning, 65.4% of patients and 67%of the relatives were favorable towards DNR in the event of cardiorespiratory failure of the patient, in the final phase ofthe terminal disease. A shared decision between the patients, their relatives, and the doctor was preferred by 58.65%of patients and 73% of the relatives; a decision prompted by the initiative of the doctor accompanying the treatmentwas preferred by 60.58% of the patients and 72% of the relatives. The execution of the DNR by the patient him/herselfwas considered important by 63.47% of the patients and 68.63% of the relatives, and the introduction of the DNR inBrazil was considered important by 75% of the patients and 74% of the relatives. It is concluded that the majority ofthe patients and relatives did not know the term "Do Not Resuscitate Order", but were favorable to the introduction ofthe procedure in Brazil, the personal realization through the shared decision, and that the approach would occur duringmedical visits. The results of this study enable us to infer the need to broaden the discussion on DNR, in the ethical socialscope, in order to issue guidance to ensure the autonomy of patients who are in the terminal phases of life