The process used by surrogate decision makers to withhold and withdraw life-sustaining measures in an intensive care environment.

Purpose/Objectives: To understand the process used by surrogate decision makers who have chosen to withhold and withdraw life-sustaining measures in intensive care units (ICUs). Design: Grounded theory. Setting: Multihospital system in central Texas. Sample: 17 surrogates who decided to withhold and...

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Publicado en:Oncology Nursing Forum Vol. 34; no. 2; pp. 331 - 340
Autor principal: Limerick MH
Formato: research tables/charts Journal Article
Publicado: Oncology Nursing Society Mar2007
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2007
      vid: 34
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      pub: Oncology Nursing Society
      place: Pittsburgh, Pennsylvania
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        10.1188/07.ONF.331-339
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        atl: The process used by surrogate decision makers to withhold and withdraw life-sustaining measures in an intensive care environment.
      aug:
        au: Limerick MH
        affil: Assistant Professor of Clinical Nursing, School of Nursing, University of Texas at Austin; michael.limerick@utsouthwestern.edu
      sug:
        subj:
          Decision Making, Family
          Euthanasia, Passive
          Adult
          Aged
          Aged, 80 and Over
          Audiorecording
          Conceptual Framework
          Corbin and Strauss Chronic Illness Trajectory Framework
          Critical Care Nursing
          Critically Ill Patients
          Data Analysis Software
          Family Role
          Female
          Funding Source
          Grounded Theory
          Intensive Care Units
          Interviews
          Male
          Middle Age
          Multiinstitutional Systems
          Purposive Sample
          Record Review
          Texas
          Thematic Analysis
          Theoretical Sample
          Human
          Adult: 19-44 years
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Female
          Male
      ab: Purpose/Objectives: To understand the process used by surrogate decision makers who have chosen to withhold and withdraw life-sustaining measures in intensive care units (ICUs). Design: Grounded theory. Setting: Multihospital system in central Texas. Sample: 17 surrogates who decided to withhold and withdraw life-sustaining measures from patients with a variety of diagnoses, including cancer. Methods: Surrogates were identified by review of charts of patients in ICUs. Interviews were recorded on audiotape and analyzed using the process of constant comparison. Saturation of data occurred when no new themes emerged. Main Research Variable: The surrogate decision-making process. Findings: Domains and their respective themes included: (a) the personal domain: rallying family support, evaluating the patient's past and present condition, and viewing past and future quality of life; (b) the ICU environment domain: chasing doctors, developing relationships with the healthcare team, and confirming probable medical outcomes; and (c) the decision domain: arriving at a new belief, getting alone to make the decision, and communicating the decision. Conclusions: Surrogates use a definite process to make decisions regarding withholding and withdrawing life-sustaining measures for patients in ICUs. Implications for Nursing: The results reveal opportunities for healthcare providers to improve education and change practice when supporting surrogates. Additional opportunities exist for further research to expand nursing knowledge related to end-of-life issues.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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