PENGAMBILAN KEPUTUSAN DO NOT RESUSCITATE (DNR) PADA PASIEN END OF LIFE (EOL) DITINJAU DARI PERSPEKTIF TENAGA KESEHATAN TAHUN 2026
Abstract
Dalam proses pengambilan keputusan Do Not Resuscitate (DNR) bertujuan mendukung otonomi pasien atau keluarga serta mencegah intervensi medis yang sia-sia. Namun seringkali tenaga kesehatan mengalami tantangan dan kesulitan saat membuat keputusan tentang DNR. Oleh karena itu eksplorasi proses pengambilan keputusan pada pasien melibatkan petugas kesehatan menjadi sangat penting. Penelitian ini bertujuan menggali secara mendalam tentang pengambilan keputusan DNR pada pasien End of Life (EoL) di area rawat inap ditinjau dari perspektif tenaga kesehatan yaitu dokter dan perawat. Penelitian ini menggunakan metode kualitatif fenomenologi deskriptif diikuti 13 responden yang terdiri dari 6 responden dokter dan 7 responden perawat yang diambil dengan purposive sampling. Pengumpulan data dengan in depth interview face to face dan video call, dan analisa data menggunakan metode Colaizzi. Hasil penelitian didapati 9 tema dari responden dokter yaitu pertimbangan penentuan tindakan, perlunya inisiasi komunikasi dan pemberian informasi, pengambilan keputusan harus dilakukan bersama, mempertimbangkan psikologi pasien dan keluarga, pertimbangan budaya dan tradisi, pendidikan keluarga tentang kondisi pasien, keterbatasan waktu, pertimbangan finansial, keyakinan terhadap mujizat. 7 tema dari responden perawat yaitu proses komunikasi informasi, pengambilan keputusan adalah otonomi keluarga, pertimbangan penentuan tindakan, hambatan personal dokter, keterbatasan waktu keluarga berpikir, keluarga belum siap kehilangan, nilai dan keyakinan berharap mujizat. Temuan penelitian bahwa proses komunikasi dan penyampaian informasi belum efektif dan belum adekuat. Beberapa faktor penghambat yang ditemukan terkait budaya, keyakinan dan nilai-nilai agama, kemudian kurangnya pengetahuan, keterbatasan waktu, pengalaman, serta keterbatasan finansial. Saran bagi petugas kesehatan perlu meningkatkan kemampuan berkomunikasi informasi efektif dan adekuat yang sesuai dengan standar prosedur operasional, serta memfasilitasi pengambilan keputusan bersama sehingga dapat meningkatkan pelayanan dalam pengambilan keputusan DNR bagi pasien EoL.
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