Caregivers’ Perceptions of Do Not Resuscitate Orders: A Qualitative Study in Rural Southwestern Kenya

Abstract

The need for palliative care services has increased with the rise of patients with terminal illnesses. Unfortunately, there is a need for more research in palliative care, especially on end-of-life care. Conversations during that period present an ethical and cultural challenge in both collectivistic and individualistic societies. Worldwide, the laws regulating Do Not Resuscitate orders differ from country to country. The perceptions also vary from society to society. Studies have shown the need to involve families in this era of rising advocacy for patient-centered care. Caregivers have an essential role in decision-making and are involved in end-of-life decisions. This study aimed to describe caregivers' perceptions of Do Not Resuscitate orders. The study used a qualitative approach and phenomenological research design. It involved eighteen caregivers of patients receiving palliative care. The sampling procedure was non-probability purposive. Data was collected using in-depth interviews and analyzed using thematic analysis. Overall, two themes emerged from the findings. The first theme was a lack of awareness of the Do Not Resuscitate orders and the resuscitation techniques, and the second theme was subjective perceptions based on caregivers' beliefs and emotional responses. Caregivers need counseling, preparation, and education on Do Not Resuscitate orders and resuscitation methods to improve Do Not Resuscitate discussions. Healthcare providers need to be empowered to hold those discussions.