Conceptualizing surrogate decision making at end of life in the intensive care unit using cognitive task analysis.

Background Surrogate decision makers (SDMs) face difficult decisions at end of life (EOL) for decisionally incapacitated intensive care unit (ICU) patients. Purpose To identify and describe the underlying psychological processes of surrogate decision making for adults at EOL in the ICU. Methods Qual...

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Publicado en:Nursing Outlook Vol. 63; no. 3; pp. 331 - 341
Autores principales: Dionne-Odom, J. Nicholas, Willis, Danny G., Bakitas, Marie, Crandall, Beth, Grace, Pamela J.
Formato: research Journal Article
Publicado: Elsevier B.V. May/Jun2015
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Conceptualizing surrogate decision making at end of life in the intensive care unit using cognitive task analysis.
      aug:
        au:
          Dionne-Odom, J. Nicholas
          Willis, Danny G.
          Bakitas, Marie
          Crandall, Beth
          Grace, Pamela J.
        affil: Boston College, William F. Connell School of Nursing, Chestnut Hill, MA
      sug:
        subj:
          Palliative Care
          Terminally Ill Patients
          Decision Making, Family
          Human
          Adult
          Intensive Care Units
          Qualitative Studies
          Case Studies
          Semi-Structured Interview
          New England
          Conceptual Framework
          Male
          Female
          Adult: 19-44 years
          Male
          Female
      ab: Background Surrogate decision makers (SDMs) face difficult decisions at end of life (EOL) for decisionally incapacitated intensive care unit (ICU) patients. Purpose To identify and describe the underlying psychological processes of surrogate decision making for adults at EOL in the ICU. Methods Qualitative case study design using a cognitive task analysis interviewing approach. Participants were recruited from October 2012 to June 2013 from an academic tertiary medical center's ICU located in the rural Northeastern United States. Nineteen SDMs for patients who had died in the ICU completed in-depth semistructured cognitive task analysis interviews. Discussion The conceptual framework formulated from data analysis reveals that three underlying, iterative, psychological dimensions (gist impressions, distressing emotions, and moral intuitions) impact an SDM's judgment about the acceptability of either the patient's medical treatments or his or her condition. Conclusion The framework offers initial insights about the underlying psychological processes of surrogate decision making and may facilitate enhanced decision support for SDMs.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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