Aggressiveness of nursing care for older patients and those with do-not-resuscitate orders

Age and do-not-resuscitate (DNR) orders were experimentally manipulated with a 2 X 2 factorial design using four vignettes which were randomly assigned to 95 staff nurses from four sites in a mid-Atlantic metropolitan area. Attitudes toward aggressiveness of nursing care were measured using the same 13-item 6-point Likert scale with all vignettes. Two replications with 183 nursing students and 86 intensive care nurses from six sites followed. Both increased age and DNR orders significantly, p less than .05 and .01, reduced aggressiveness of nursing care attitudes in all three studies. However, attitudes toward care still remained in the moderately aggressive range, which is more aggressive than current patient classification systems describe for DNR patient care.