Back to Search
Start Over
How Surrogate Decision-Makers for Patients With Chronic Critical Illness Perceive and Carry Out Their Role
- Source :
- Critical care medicine. 46(5)
- Publication Year :
- 2018
-
Abstract
- OBJECTIVES: Family members commonly make medical decision for patients with chronic critical illness. This study examines how family members approach this decision-making role in real time. DESIGN: Qualitative analysis of interviews with family members in the intervention arm of a randomized controlled communication trial. SETTING: Medical Intensive Care Units at four US hospitals. PARTICIPANTS: Family members of patients with chronic critical illness (adults mechanically ventilated for ≥ 7 days and expected to remain ventilated and survive for ≥ 72 hours) who participated in the active arm of a communication intervention study. INTERVENTIONS: Family members participated in at least two content-guided, informational and emotional support meetings led by a palliative care physician and nurse practitioner. MEASUREMENTS AND MAIN RESULTS: Grounded theory was used for qualitative analysis of 66 audio-recordings of meetings with 51 family members. Family members perceived their role in 4 main ways: voice of the patient, advocate for the patient, advocate for others, and advocate for oneself. Their decision making was characterized by: balancing goals, sharing their role, keeping perspective, remembering previous experiences, finding sources of strength, and coping with various burdens. CONCLUSIONS: Family members take a multifaceted approach as they participate in decision-making. Understanding how surrogates perceive and act in their roles may facilitate shared decision-making among clinicians and families during critical care.
- Subjects :
- Male
Critical Illness
Decision Making
MEDLINE
Patient Advocacy
Critical Care and Intensive Care Medicine
Grounded theory
Article
Interviews as Topic
03 medical and health sciences
0302 clinical medicine
Qualitative analysis
Nursing
Intervention (counseling)
Medicine
Humans
Family
030212 general & internal medicine
Qualitative Research
business.industry
Extramural
Middle Aged
030228 respiratory system
Caregivers
Critical illness
Chronic Disease
Grounded Theory
Female
business
Qualitative research
Subjects
Details
- ISSN :
- 15300293
- Volume :
- 46
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Critical care medicine
- Accession number :
- edsair.doi.dedup.....364331a82e5d03666898d0b0922d0e47